PURPOSE: This study was conducted for analysis of menu pattern and food diversity of snack menus of child care centers in order to provide preliminary data for establishment of related guidelines for snack menus for child care centers. METHODS: Data from 630 snack menus (350 for morning snacks and 280 for afternoon snacks) of March, 2013 from 14 Child Care Information Centers in Seoul provided for child care centers were analyzed. In addition, the menu pattern and food diversity of morning snack menus were compared with those of afternoon snack menus. RESULTS: Differences in menu pattern and food diversity were observed between morning and afternoon snack menus. The majority of snack menus (66.8%) included two menu items and the numbers of menu items of afternoon snack menus were significantly larger than those of morning snack menus. The percentages of "Grains (G)" and "Grains (G) + Milk (D)" patterns were higher in snack menu (G: 18.9%, G+D: 17.1%). Approximately one third of snack menus were composed of only one food group. In addition, 45.6 % of all snack menus comprised milk and only 23.0% included fruits. CONCLUSION: These results demonstrated the need for improvement in food composition and diversity of snack menus provided by Child Care Information Centers for child care centers. Therefore, to ensure children's intake of nutritionally balanced snacks, it will be necessary to establish more detailed guidelines for the menu pattern and food composition in snack menus for child care centers.
Child ; Child Care* ; Fruit ; Humans ; Information Centers* ; Milk ; Seoul ; Snacks*

Gamma band neural oscillations in the human electroencephalogram (EEG) play an important role in perceptual and cognitive processes. Auditory steady state responses (ASSR) can probe neural oscillations with respect to phase synchronization and response magnitude. EEG recordings in bipolar disorder and schizophrenia patients showed reduced evoked power and phase locking for 40 Hz ASSR. Also, several studies have reported increased evoked power and decreased synchronization of the gamma band in patients with Alzheimer's disease. ASSR deficits in various psychiatric disorders may index disturbances of gamma-aminobutyric acid neurotransmission within auditory pathways and cortex. Although, several studies have reported ASSR deficits in various psychopathologies of psychiatric illness, further studies are necessary that investigate biological mechanism based on the ASSRs. In this review, the current concept and biological mechanism of ASSRs are discussed.
Alzheimer Disease ; Auditory Pathways ; Bipolar Disorder ; Electroencephalography ; gamma-Aminobutyric Acid ; Humans ; Psychopathology ; Schizophrenia ; Synaptic Transmission

BACKGROUND: Atrial fibrillation (AF) and patent foramen ovale (PFO) are established sources of cardioembolism. We investigated differences in stroke outcome and patterns between PFO and AF. METHODS: We performed a retrospective review of the medical records and brain MR images of patients with AF or PFO from the prospective acute stroke and transient ischemic attack registry. Infarct pattern and volume on diffusion-weighted imaging, and the national institutes of health stroke scale (NIHSS) on admission were compared between patients with AF and PFO. RESULTS: From June 2005 to July 2008, a total of 289 subjects were enrolled (AF group, n=156; PFO group, n=133). Infarct pattern analyzed with MR images revealed that multiple vascular territorial infarction was more prevalent in AF group than in PFO group (26.9% vs. 8.3%, P<0.01). A probable cardiac embolism, radiologically defined as territorial infarction without symptomatic steno-occlusion of the corresponding artery, was more frequently documented in AF group than in PFO group (71.8% vs. 41.4%, P<0.01) The infarct volume of PFO was smaller than that of AF. Compared to AF, PFO was associated with the mild neurologic deficit (NIHSS< or =3) after adjusting age, sex and previous stroke history. CONCLUSION: These results suggested that AF and PFO had different characteristics such as infarct patterns and initial clinical severity although both are classified as cardioembolism.
Arteries ; Atrial Fibrillation ; Brain ; Embolism ; Foramen Ovale, Patent ; Humans ; Infarction ; Ischemic Attack, Transient ; Medical Records ; National Institutes of Health (U.S.) ; Neurologic Manifestations ; Prospective Studies ; Retrospective Studies ; Stroke

OBJECTIVES: This study was performed to set easily applicable portion sizes by sex and age for children at the Community Child Centers (CCC) in Korea. METHODS: Considering the age and gender specific energy level at Target Patterns for children aged 6-18 years, which were suggested as a part of the 2010 Korean Food Guidance System (KFGS), we set three meal sizes. We reclassified the recommended daily servings of Grains, Meat.fish.eggs.beans and Vegetables group at Target Patterns into three meal sizes, and then calculated the recommended serving per meal. Each proposed amount of food per meal was calculated based on serving size of foods commonly eaten at KFGS, which was then allocated to five meal components; rice, soup, stew, protein and vegetable side-dishes and Kimchi. Each proposed amount of food per meal was applied to 173 menus' recipes from CANpro 3.0 as main ingredient's amounts. We cooked the 173 menus at the medium size and measured their weights after cooking. RESULTS: Each recommended serving per meal was 0.75, 0.9 and 1.2 for Grains; 1.2, 1.6 and 2.4 for Meat.fish.eggs.beans; 2, 2.4 and 2.8 for Vegetables by meal sizes. Among five meal components, the ratio of small and large to medium size was 1/5 less and 1/3 more for rice and 1/3 less and 1/3 more for soup.stew, protein side-dish and Kimchi, respectively. We suggested the same amount for a vegetable side-dish to encourage vegetable intake. Proper portion sizes per meal of medium were rice 190 g, soup.stew 210 g (solid ingredients 60 g), protein side-dish 100 g (meat.eggs.beans) and 70 g (fish), vegetable side-dish 80g and Kimchi 30 g. CONCLUSIONS: Proper portion size per meal suggested in this study may be useful at the CCC where dietitians are not available and the approach could be applicable to the other types of meal services.
Edible Grain ; Child* ; Cooking ; Humans ; Korea ; Meals* ; Nutritionists ; Portion Size ; Serving Size* ; Vegetables ; Weights and Measures

Malignant lymphoma is tumor of the immune system. It is mainly found in the lymph node but it can also originate from extranodal organs such as gastrointestinal tract, sinonasal tract, and etc. We experienced a case of 18-year-old female patient with a huge nasopharyngeal mass. The patient visited our clinic with complaints of nasal obstruction and mouth breathing without general symptoms. After extirpation and biopsy of the nasopharyngeal mass, lesion was diagnosed as malignant lymphoma. In immunohistochemistry, CD 20, Bcl-2, Bcl-6 were positive. Final diagnosis was diffused large B cell lymphoma, for which she received chemotherapy (Rituximab, Cyclophosp, Ahamide, Adriamycin, Vincristine, Prednisone). We report a case of huge malignant lymphoma that occurred in the nasopharynx with a brief review of literature.
Adolescent* ; Biopsy ; Diagnosis ; Doxorubicin ; Drug Therapy ; Female* ; Gastrointestinal Tract ; Humans ; Immune System ; Immunohistochemistry ; Lymph Nodes ; Lymphoma ; Lymphoma, B-Cell* ; Mouth Breathing ; Nasal Obstruction ; Nasopharynx ; Vincristine

Objectives: This study was conducted to find out if the dietary iron intake of Koreans estimated by 2 different methods (iron content sources) using the food intake data from the Korea National Health and Nutrition Examination Survey (KNHANES) are comparable. One method was based on the KNHANES's Food & Nutrient Database (FND) derived mainly from the Korean Food Composition Table and the other used the iron content (IC) of food samples processed in the Korean Total Diet Study (KTDS). Methods: Dietary intake data from the 2013-2016 KNHANES was used to select representative foods (RFs) in KTDS for iron analysis. Selection of the RFs and cooking methods for each RF (RF × cooking method pair) was performed according to the ‘Guidebook for Korean Total Diet Studies’ and resulted in a total of 132 RFs and 224 ‘RF × cooking method’ pairs. RFs were collected in 9 metropolitan cities nationwide once or twice (for those with seasonality) in 2018 and made into 6 composites each, based on the origin and season prior to cooking. Then, the RF composites prepared to a ‘table ready’ state for KTDS were analyzed by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Dietary iron intake of the Korean population was estimated using only RFs’ intake data based on the 2 sources of iron content, namely FND-KNHANES and IC-KTDS. Results: RFs in KTDS covered 92.0% of total food intake of Koreans in the 2016-2018 KNHANES. Mean iron intake of Koreans was 7.77 mg/person/day by IC-KTDS vs 9.73 mg/person/day by FND-KNHANES. The major food groups contributing to iron intake were meats (21.7%), vegetables (20.5%), and grains & cereals (13.4%) as per IC-KTDS. On the other hand, the latter source (FND-KNHANES) resulted in a very different profile: grains & cereals (31.1%), vegetables (16.8%), and meats (15.3%). While the top iron source was beef, accounting for 8.6% in the former, it was polished rice (19.2%) in the latter. There was a 10-fold difference in the iron content of polished rice between 2 sources that iron intakes excluding the contribution by polished rice resulted in very similar values: 7.58 mg/person/day by IC-KTDS and 7.86 mg/person/day by FNDKNHANES. Conclusions This study revealed that the dietary iron intake estimated by 2 different methods were quite comparable, excluding one RF, namely polished rice. KTDS was thus proven to be a useful tool in estimating a ‘closer-to-real’ dietary intake of nutrients for Koreans and further research on various nutrients is warranted.

Objectives: This study was conducted to estimate the dietary iodine intake of Koreans by a Total Diet Study (TDS) which provides ‘closer-to-real’ estimates of exposure to hazardous materials and nutrients through an analysis of table-ready (cooked) samples of foods. Methods: Dietary intake data from 2013-2017 Korea National Health and Nutrition Examination Survey (KNHANES) was used to select representative foods (RFs) for iodine analysis. A total of 115 RFs were selected and 158 ‘RF × cooking method-combination’ pairs were derived by pairing each RF to corresponding cooking method(s) used more frequently. RFs were collected from 9 mega-markets in 9 metropolitan cities nationwide and mixed into composites prior to cooking preparation to a ‘table ready’ state for iodine analysis by inductively coupled plasma mass spectrometry. Iodine intake of Koreans was estimated based on the food intake data of the 2016-2018 KNHANES. Results: High iodine content was detected in seaweeds such as sea mustard and kelp. The mean iodine intake/capita/day was 418.4 ㎍ and the median value was 129.0 ㎍. Seaweeds contributed to 77.4% of the total iodine intake and the contribution by food item was as follows: sea mustard (44.0%), kelp (20.4%), laver (13.1%), milk (3.9%), egg (3.5%). Compared to the Dietary Reference Intakes for Koreans 2020, the proportion of people with iodine intake exceeding the tolerable upper intake level or below the estimated average requirement was high in the physiologically vulnerable groups (infants, children, pregnant women, and lactating women). Conclusions The results, drawn from a TDS, are regarded closer to real estimates for iodine intake of Koreans compared with values in existing literature, which were based on a very limited variety of foods. On the other hand, it seems necessary to seek out solutions for the problematic iodine intake among physiologically vulnerable groups through in-depth analyses on food intake data collected with significant scale & quality.

Objectives: This study was conducted to estimate the dietary iodine intake of Koreans by a Total Diet Study (TDS) which provides ‘closer-to-real’ estimates of exposure to hazardous materials and nutrients through an analysis of table-ready (cooked) samples of foods. Methods: Dietary intake data from 2013-2017 Korea National Health and Nutrition Examination Survey (KNHANES) was used to select representative foods (RFs) for iodine analysis. A total of 115 RFs were selected and 158 ‘RF × cooking method-combination’ pairs were derived by pairing each RF to corresponding cooking method(s) used more frequently. RFs were collected from 9 mega-markets in 9 metropolitan cities nationwide and mixed into composites prior to cooking preparation to a ‘table ready’ state for iodine analysis by inductively coupled plasma mass spectrometry. Iodine intake of Koreans was estimated based on the food intake data of the 2016-2018 KNHANES. Results: High iodine content was detected in seaweeds such as sea mustard and kelp. The mean iodine intake/capita/day was 418.4 ㎍ and the median value was 129.0 ㎍. Seaweeds contributed to 77.4% of the total iodine intake and the contribution by food item was as follows: sea mustard (44.0%), kelp (20.4%), laver (13.1%), milk (3.9%), egg (3.5%). Compared to the Dietary Reference Intakes for Koreans 2020, the proportion of people with iodine intake exceeding the tolerable upper intake level or below the estimated average requirement was high in the physiologically vulnerable groups (infants, children, pregnant women, and lactating women). Conclusions The results, drawn from a TDS, are regarded closer to real estimates for iodine intake of Koreans compared with values in existing literature, which were based on a very limited variety of foods. On the other hand, it seems necessary to seek out solutions for the problematic iodine intake among physiologically vulnerable groups through in-depth analyses on food intake data collected with significant scale & quality.

Digital therapeutics based on software, such as artificial intelligence, virtual reality, games, and smartphone applications, are in the spotlight as new therapeutic alternatives in child and adolescent psychiatry. It draws attention to overcoming conventional therapeutics’ limitations, such as toxicity, cost, and accessibility, and encourages patients to participate in the treatment attractively. The growth potential of the digital therapeutics market for psychiatric disorders in children and adolescents in Korea and abroad has been highlighted. Clinical studies and Food and Drug Administration approvals for digital therapeutics have increased, and cases approved by the Ministry of Food and Drug Safety have emerged in Korea. As seen above, digital transformation in child and adolescent psychiatry will change treatment paradigms significantly. Therefore, as this new field has just begun to emerge, it is necessary to verify the effectiveness and scope of the application of digital therapeutics and consider preparing a compensation system and institutional arrangements. Accordingly, this study analyzed the development trends and application status of digital therapeutics in children and adolescents and presented limitations and development directions from the perspective of application in healthcare. Further, the study is expected to identify the utility and limitations of digital therapeutics for children and adolescents and establish effective application measures.

BACKGROUND AND OBJECTIVES: Obstructive sleep apnea (OSA) is highly prevalent in commercial vehicle operators (CMVOs). This study aimed to evaluate the poor sleep quality, daytime sleepiness, and the prevalence of self-reported OSA in CMVOs. SUBJECTS AND METHOD: We performed a retrospective review of the medical records of patients who visited a single institution with sleep problems from 2011 January to 2016 December. Among the patients, a total of 38 CMVOs was analyzed. Clinical information, questionnaires about sleep quality (Pittsburg sleep questionnaire, PSQI), excessive daytime sleepiness (Epworth sleepiness scale, ESS) and risk factors for OSA (STOP-Bang) were analyzed. The frequency of motor vehicle accidents and near accidents was assessed, and polysomnography (PSG) was used for OSA diagnosis purposes. RESULTS: The mean age of the study population was 45.3±11.8 years. The average score of PSQI, ESS, and STOP-Bang were 6.75±4.22, 10.79±7.12, and 4.62±3.34, respectively. A significant association between near accidents and high-risk group of OSA was observed [odds ratio (OR)=2.73, 95% confidence interval (CI)=1.08–4.48]. Subjects with poor sleep quality showed significantly increased risk of near accidents (OR=2.34, 95% CI=1.01–3.56). Receiver operating characteristic curves of STOP-Bang questionnaire using apnea-hypopnea index (cut-off value=5) indicates that suspected OSA group predicted by STOP-Bang score was significantly correlated with OSA severity (area under curve=0.72, sensitivity 77.1%, specificity 59.4%). CONCLUSION: Administration of STOP-Bang questionnaire before a PSG can identify high-risk subjects, supporting its further use in OSA screening of CMVOs.
Diagnosis ; Humans ; Korea ; Mass Screening ; Medical Records ; Methods ; Motor Vehicles ; Polysomnography ; Prevalence ; Retrospective Studies ; Risk Factors ; ROC Curve ; Sensitivity and Specificity ; Sleep Apnea, Obstructive ; Surveys and Questionnaires