This study investigated the clinical characteristics and kidney outcomes of childhood-onset lupus nephritis (LN), and risk factors associated with prognosis. Methods: We enrolled 216 patients with histologically diagnosed LN during childhood. The Korean Society of Pediatric Nephrology organized a retrospective cohort study of childhood-onset LN in 13 major pediatric nephrology centers in South Korea. Results: The mean age at kidney biopsy was 13.2 ± 3.22 years. The main forms of presentation were nephrotic syndrome and/or hematuria in 152 patients (70.4%), and the most common histological finding was World Health Organization (WHO) class IV in 138 patients (63.9%), followed by WHO class III in 34 patients (15.7%). In the outcome analysis, the mean follow-up period of the patients was 7.8 ± 5.11 years. At last follow-up, 32 patients (14.8%) developed advanced chronic kidney disease (CKD). Male sex and failure to achieve remission at 12 months of treatment were significant risk factors for developing advanced CKD (hazard ratio of 2.57 and 2.29, respectively). Conclusion: Our study demonstrated the clinical characteristics and long-term outcomes of patients with childhood-onset LN. Male sex and failure to achieve remission in the first year of treatment were predictive of advanced CKD. Therefore, prompt awareness and close monitoring of these high-risk patients are needed, which may further improve the prognosis of children with LN.

Objectives: To apply a healthy dietary program with reduced sodium intake, developed using data from the Korea National Health and Nutrition Examination Survey (KNHANES), focusing on the sodium intake level and eating patterns. Methods: The program was implemented using a living lab model, an open innovation ecosystem for user-centered problem-solving. Analysis of the KNHANES data revealed that older age groups had a low energy intake but a high sodium intake, particularly among those who frequently dined out. The program was designed to improve sodium-reduction literacy and enhance practical competency. Over four weeks, 40 participants tracked their dietary intake and worked with a clinical nutritionist through a process of diagnosis, experience, improvement, and expansion. A self-administered survey was conducted before and after the program to assess effectiveness. Results: Participants were four teenagers (10%), 26 in their twenties (65%), and 10 aged ≥ 30 years (25%), with eight males (20%) and 32 females (80%). Post-program analysis showed significant improvements in sodium-related nutrition knowledge (P < 0.01), with increased agreement on adopting low-sodium intake practices (e.g., interest in sodium content, choosing lower-sodium foods). Nutrient intake analysis showed a decrease in energy, carbohydrates, lipids, and proteins (P < 0.001), with sodium intake decreasing from 3,382.37 mg/d to 2,119.05 mg/d (P < 0.001). Conclusion The community-based, living lab model for the sodium-reduction program effectively improved participant sodium-reduction literacy and practical competency, suggesting that step-by-step, autonomous learning, can reduce sodium intake and promote healthier eating habits.

Objectives: This study aimed to develop and apply a dietary program to reduce sugar intake among community residents using a Living Lab approach. Methods: We developed and applied a community-based dietary program to reduce sugar intake. Participants were recruited from community organizations, including a children’s food service management center, elementary to high schools, a university, a family center, a community health center, and an elderly welfare center. The dietary program was conducted in two phases; start and next levels. The start level included a pre-assessment of dietary behaviors and participation in educational platforms, whereas the next level included activities using educational platforms, tailored mission and feedback, and pre- and post-surveys. Extension educators at each community organization implemented the dietary program following organization-specific guidelines. Changes in participants’ nutrition knowledge, dietary behaviors and perceptions, self-efficacy, intention to reduce sugar intake, and participants’ program satisfaction were analyzed using paired t-tests. Results: In total, 1,238 and 339 individuals participated in the start and next level, respectively. Participants reported significantly lower scores on dietary behavior items regarding drinking more juice or soft drinks after program participation (P = 0.009) and craving sweet foods (P = 0.046). They reported a higher intention to take interest in sugar content in food (P = 0.009) and lower-sugar recipes (P = 0.019), eat less food with high sugar content (P = 0.020), and drink water or sparkling water instead of soft drinks (P = 0.042). Nutrition knowledge did not significantly change after program participation. Program satisfaction significantly increased from the start level to the next level (P<0.050). Conclusion This study showed the potential of using a Living Lab approach to implement community-wide dietary interventions. Further research is required to evaluate the effectiveness of the Living Lab approach in various community settings.

In addition to classical synaptic transmission, information is transmitted between cells via the activation of extrasynaptic receptors that generate persistent tonic current in the brain. While growing evidence supports the presence of tonic NMDA current (INMDA) generated by extrasynaptic NMDA receptors (eNMDARs), the functional significance of tonic I(NMDA) in various brain regions remains poorly understood. Here, we demonstrate that activation of eNMDARs that generate I(NMDA) facilitates the α-amino-3-hydroxy-5-methylisoxazole-4-proprionate receptor (AMPAR)-mediated steady-state current in supraoptic nucleus (SON) magnocellular neurosecretory cells (MNCs). In low-Mg2+ artificial cerebrospinal fluid (aCSF), glutamate induced an inward shift in I(holding) (I(GLU)) at a holding potential (V(holding)) of -70 mV which was partly blocked by an AMPAR antagonist, NBQX. NBQX-sensitive I(GLU) was observed even in normal aCSF at V(holding) of -40 mV or -20 mV. I(GLU) was completely abolished by pretreatment with an NMDAR blocker, AP5, under all tested conditions. AMPA induced a reproducible inward shift in I(holding) (I(AMPA)) in SON MNCs. Pretreatment with AP5 attenuated I(AMPA) amplitudes to ~60% of the control levels in low-Mg2+ aCSF, but not in normal aCSF at V(holding) of -70 mV. I(AMPA) attenuation by AP5 was also prominent in normal aCSF at depolarized holding potentials. Memantine, an eNMDAR blocker, mimicked the AP5-induced I(AMPA) attenuation in SON MNCs. Finally, chronic dehydration did not affect I(AMPA) attenuation by AP5 in the neurons. These results suggest that tonic I(NMDA), mediated by eNMDAR, facilitates AMPAR function, changing the postsynaptic response to its agonists in normal and osmotically challenged SON MNCs.
alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid* ; Brain ; Cerebrospinal Fluid ; Dehydration ; Glutamic Acid ; Memantine ; N-Methylaspartate* ; Neurons ; Receptors, AMPA ; Receptors, N-Methyl-D-Aspartate* ; Supraoptic Nucleus ; Synaptic Transmission

The hand hygiene behavior of 400 middle school students (grades 1-3) in Seoul and Gyeonggi-Do was studied to determine how stages of change were affected by food safety education, focusing on hand hygiene and general food safety. Subjects were 51.3% male and 44.3% of study subjects were first graders of middle school. Approximately 40% of subjects were at the stage of action, 42.7% were at the stage of contemplation, and 16.4% were at pre-contemplation. The most important factor that influenced proper hand washing was self efficacy (P < 0.001). Proper hand washing was also correlated significantly with positive belief (P < 0.01) and stages of change (P < 0.01). After food safety education by high-school mentors, middle-school students who were in the stages of pre-contemplation (11.1%) and contemplation (88.9%) showed significant progression toward the action stage (P < 0.001). Proper hand washing (P < 0.01) and food safety knowledge (P < 0.05) were also significantly increased after educational intervention.
Food Safety ; Hand ; Hand Disinfection ; Hand Hygiene ; Humans ; Male ; Mentors ; Self Efficacy

This study represents the first epidemiological study based on the national registry of primary immunodeficiencies (PID) in Korea. Patient data were collected from 23 major hospitals. A total of 152 patients with PID (under 19 yr of age), who were observed from 2001 to 2005, have been entered in this registry. The period prevalence of PID in Korea in 2005 is 11.25 per million children. The following frequencies were found: antibody deficiencies, 53.3% (n = 81), phagocytic disorders, 28.9% (n = 44); combined immunodeficiencies, 13.2% (n = 20); and T cell deficiencies, 4.6% (n = 7). Congenital agammaglobulinemia (n = 21) and selective IgA deficiency (n = 21) were the most frequently reported antibody deficiency. Other reported deficiencies were common variable immunodeficiencies (n = 16), X-linked agammaglobulinemia (n = 15), IgG subclass deficiency (n = 4). Phagocytic disorder was mostly chronic granulomatous disease. A small number of patients with Wiskott-Aldrich syndrome, hyper-IgE syndrome, and severe combined immunodeficiency were also registered. Overall, the most common first manifestation was pneumonia. This study provides data that permit a more accurate estimation PID patients in Korea.
Adolescent ; Agammaglobulinemia/congenital/epidemiology ; Age Distribution ; Child ; Child, Preschool ; Common Variable Immunodeficiency/epidemiology ; Female ; Genetic Diseases, X-Linked/epidemiology ; Humans ; IgA Deficiency/epidemiology ; IgG Deficiency/epidemiology ; Immunologic Deficiency Syndromes/*epidemiology ; Infant ; Infant, Newborn ; Job's Syndrome/epidemiology ; Male ; Prevalence ; Questionnaires ; Registries ; Republic of Korea/epidemiology ; Severe Combined Immunodeficiency/epidemiology ; Sex Distribution ; Wiskott-Aldrich Syndrome/epidemiology ; Young Adult

Adult ; Biopsy ; Diagnosis, Differential ; Female ; Fibroma ; Follow-Up Studies ; Humans ; Maxilla ; Molar ; Recurrence ; Tooth

BACKGROUND AND OBJECTIVES : Several studies have reported that (18)F-fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) imaging is physiologically increased at the intact vocal cord in patients with unilateral vocal cord paralysis, which is explained by a compensatory mechanism of the intact vocal cord. We aimed to evaluate internal laryngeal muscles related to phonation and the compensatory mechanism in patients with unilateral vocal cord paralysis. SUBJECTS AND METHOD : We performed (18)FDG-PET imaging and neck computed tomography (CT) scan in the normal control group composed of 13 subjects and the paralyzed group composed of 11 patients with unilateral vocal cord paralysis. The two groups were divided into two groups, phonating and silent, before performing (18)FDG-PET. (18)FDG-PET and neck CT images by Syntegra. A specialist in nuclear medicine performed all the test measurements, the standardized uptake value (SUV) in the interarytenoid muscle (IA), both thyroarytenoid muscles (TA), and both lateral cricoarytenoid muscles (LCA). The mean SUVs were statistically analyzed. RESULTS : In the Normal-Phonating group, the mean SUV of IA was the highest, with 3.68+/-0.96 (Mean+/-SD), followed by that of LCA, with 2.34+/-0.67. However, when compared with the same muscles in the Phonating-Silent group, only the SUV of IA was significantly increased by phonation. In the Paralyzed-Silent group, the SUV of TA in the intact side was the highest, with 2.30+/-0.39. In the Paralyzed-Phonating group, the SUV of TA in the intact side, IA, and LCA in the intact side were 5.88+/-2.65, 3.92+/-1.65, and 3.87+/-1.37, respectively. When compared with the same muscles in the Phonating-Silent group, the SUVs of TA and IA were significantly increased. CONCLUSION : The muscle related to the compensatory mechanism in patients with unilateral vocal cord paralysis is thyroarytenoid muscle in the intact side. The interarytenoid muscle plays a major role in the mechanism of phonation in humans.
Humans ; Laryngeal Muscles* ; Muscles ; Neck ; Nuclear Medicine ; Phonation* ; Positron-Emission Tomography ; Specialization ; Vocal Cord Paralysis* ; Vocal Cords

OBJECTIVES: The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. METHODS: Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. RESULTS: Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. CONCLUSION: The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.
Anxiety ; Attention Deficit and Disruptive Behavior Disorders ; Checklist ; Child Behavior ; Child* ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Nocturnal Enuresis* ; Parents ; Psychopathology ; Social Problems

PURPOSE: Nocternal enuresis is a common disorder. Tricyclic antidepressant and desmopressin have been accepted pharmacological treatment for this disorder. We conducted a cooperative study to investigate the efficacy and adverse reactions of imipramine, desmopressin and combination treatment in children with primary monosymptomatic nocturnal enuresis(PMNE). METHODS: Data from a large multicenter study were analysed. In the period of 8 months in 2002, the study comprised of 168 children(78 boys and 90 girls, 5 to 15 years old) with PMNE for imipramine, desmopressin or combination treatment. Before treatment a history, physical examination and laboratory tests were performed and the children were observed for 2 weeks. Response rate, adverse reactions and enuresis episodes after stopping drug administration were evaluated after 12-weeks of imipramine, desmopressin or combination of both. RESULTS: After 4 weeks, the frequency of bed wetting in all treated patients decreased during treatment significantly. Even though a 30-50% reduction in the number of wet nights were 68.6%, 74.4% and 86.1% during 12 weeks treatment by imipramine, desmopressin and both of them respectively, there was no significant difference between them. The most common adverse reaction was decreased appetite from imipramine administration. But no serious drug-related adverse events were reported. CONCLUSION: Efficacy of the combination therapy of imipramine and desmopressin in PMNE appears not to be better than either drug alone. It is necessary to pay attention on account of adverse reactions during imipramine treatment even though imipramine and desmopressin were generally well tolerated.
Appetite ; Child ; Deamino Arginine Vasopressin* ; Enuresis ; Female ; Humans ; Imipramine* ; Nocturnal Enuresis* ; Physical Examination