PURPOSE: The aim of this study was to assess changes in neuropeptide Y (NPY) immunoreactivity in the hypothalamus and interstitial cells of Cajal (ICC) in the small intestine of rats fed high-fat diets (HFD). METHODS: Male Sprague-Dawley rats (200~250 g body weight) were randomly divided into two groups, which were the control group (normal chow diet for 6 weeks), and the HFD group (rodent diet with 60% kcal fat for 6 weeks). The immunoreactivity of NPY in the hypothalamus and ICC in the small intestine was evaluated after every feed for 6 weeks. RESULTS: NPY immunoreactivity was observed strongly in the hypothalamic nuclei in the HFD group compared to the control group. The numbers of NPY-immunoreactive (IR) cells were significantly higher in the paraventricular hypothalamic nucleus in the HFD group than in the control group. In the region of Auerbach's plexus (AP) of small intestine, the staining intensity of the ICC-IR cells was reduced in the HFD group compared to the control group. The numbers of ICC in the small intestine with HFD, including ICC in the inner circular and outer longitudinal muscle were significantly lower than in the control group. CONCLUSION: This study suggested that increasing NPY-IR cells in the hypothalamus may reflect resistance of NPY action after a HFD, and decreasing ICC-IR cells in the small intestine after a HFD is functionally significant in gastrointestinal motility.
Animals ; Diet ; Diet, High-Fat ; Gastrointestinal Motility ; Humans ; Hypothalamus ; Interstitial Cells of Cajal ; Intestine, Small ; Male ; Muscles ; Myenteric Plexus ; Neuropeptide Y ; Neuropeptides ; Paraventricular Hypothalamic Nucleus ; Rats ; Rats, Sprague-Dawley

PURPOSE: The aim of this study was to investigate the feeding patterns, use of dietary supplements, and nutrient intake of Korean toddlers. METHODS: We used data for 930 toddlers who participated in the 4th Korean National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2009. Feeding patterns and use of dietary supplements were assessed using standardized questionnaires, and nutrition intake was assessed using the 24 hr recall method. RESULTS: In 2007~2009, 48.7% of toddlers used dietary supplements. Most parents (95.4%) initiated a regime of dietary supplements for their children following the advice of friends or relatives. Only 0.4% of parents followed the advice given by their doctors for dietary supplements use. In the survey of nutrient intake for toddlers, the prevalence of inadequate calcium intake was 53.9% for subjects aged 1 year, 55.2% for 2 years and 65.6% for subjects aged 3 years. The prevalence of inadequate iron intake was 52.0% for subjects aged 1 year, 48.7% for 2 years and 48.4% for subjects aged 3 years. In the survey performed on feeding patterns of toddlers during the infant period, mixed feeding accounted for 57.4%, breast feeding for 32.2%,and formula feeding for 10.4%. Sixty-five percent of toddlers began weaning between 4 and 6 months. CONCLUSIONS: This study indicated that a number of toddlers were at risk of inadequate calcium and iron intake. The role of professionals in counseling for qualified dietary intake and dietary supplement use is therefore necessary for Korean toddlers.
Aged ; Breast Feeding ; Calcium ; Child ; Counseling ; Dietary Supplements ; Feeding Behavior ; Friends ; Humans ; Infant ; Iron ; Nutrition Surveys ; Nutritional Status ; Parents ; Prevalence ; Surveys and Questionnaires ; Weaning

PURPOSE: This study was performed to evaluate the role of colonoscopy in children with hematochezia. METHODS: We retrospectively reviewed the medical records of 277 children who underwent colonoscopy because of hematochezia between January, 2003 and July, 2010. RESULTS: The mean age of the patients was 6.0+/-4.4 (7 days~17.8 years) years. The male to female ratio was 2.2 : 1. The duration between the 1st episode of hematochezia and colonoscopy was 4.9+/-12.1 months. Characteristics of hematochezia included red stool (65.1%), blood on wipe (12.8%), bloody toilet (11.9%), and blood dripping (10.2%). The most proximal region of colonoscopic approach was terminal ileum (84.5%), cecum (9.5%), hepatic flexure (2.8%), and splenic flexure (3.2%). Eighty five patients (30.6%) had no specific abnormal findings. Major causes of hematochezia were polyp (26.4%), food protein induced proctocolitis (6.9%), infectious colitis (5.4%), lymphofolliculitis (5.7%), non specific colitis (5.7%), and vascular ectasia (5.1%). The hemorrhagic sites included the rectum (24.0%), rectosigmoid junction (18.1%), sigmoid colon (13.5%), ascending colon (14.2%), transverse colon (11.3%), descending colon (7.8%), cecum (8.1%), and terminal ileum (3.1%). The recurrence rate of hematochezia after colonoscopy was 19.1%. Colonoscopy was performed in 262 patients (94.6%) with conscious sedation. Endoscopic hemostasis was performed in 5 patients. Complications of colonoscopy or sedation were not found. CONCLUSION: The causes and lesional localization of pediatric hematochezia were diverse. Colonoscopy has an important role in the diagnosis and treatment of hematochezia in children. Total colonoscopy is recommended to detect the cause of hematochezia.
Cecum ; Child ; Colitis ; Colon, Ascending ; Colon, Descending ; Colon, Sigmoid ; Colon, Transverse ; Colonoscopy ; Conscious Sedation ; Dilatation, Pathologic ; Female ; Gastrointestinal Hemorrhage ; Hemostasis, Endoscopic ; Humans ; Ileum ; Male ; Medical Records ; Polyps ; Proctocolitis ; Rectum ; Recurrence ; Retrospective Studies

PURPOSE: We aimed to study the distribution of rotavirus genotypes (VP7 and VP4) and disease severity of rotavirus gastroenteritis prevalent in our community. METHODS: Stool samples were collected from 156 children who were hospitalized with rotavirus gastroenteritis from December 2007 to June 2008. The disease severity of all patients was scored using the Vesikari scale. After extraction of ds-RNA of the rotavirus, cDNA synthesis using reverse transcription and polymerase chain reaction (RT-PCR) and multiplex PCR was performed. Following this, the final identification of genotypes was performed. RESULTS: Of the 156 samples, VP7(G) and VP4(P) genotypes were identified in 147 (94.2%) and 140 (89.7%) samples, respectively. G1 (116 of 147 samples; 78.9%) and P[8] (137 of 140 samples; 97.9%) were the most prevalent, respectively. Of the 138 samples identified of combination types of VP7 and VP4, G1P[8] (111 samples; 80.4%) was the most prevalent. Other combination types varied with very low distribution rates. 9.4% of genotypes were not included in the new vaccines. The disease severity score was 11.8+/-3.3 (mean+/-2SD). The distribution of disease severity was mild or moderate in 37.8% and severe in 62.2% of patients. CONCLUSION: The most prevalent genotype combination of rotavirus was G1P[8] and genotypes not included in the vaccines represented 9.4% in our community. Disease severity distribution of hospitalized children with rotavirus gastroenteritis was higher in the severe than in the mild and moderate categories.
Child ; Child, Hospitalized ; DNA, Complementary ; Gastroenteritis ; Genotype ; Humans ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction ; Reverse Transcription ; Rotavirus ; Vaccines

PURPOSE: Ultrasonography (US) is widely used as a screening test in patients with abdominal pain (AP). We investigated the usefulness of US by a pediatrician in children with AP. METHODS: We retrospectively analysed the medical records of children with AP who undertook US from December, 2008 to July, 2010. RESULTS: A total of 628 patients (325 male, 303 female) were enrolled in this study. The mean age of patients was 8.08+/-4.61 years. Duration of AP was acute in 427 and chronic in 201 patients. Localization of AP was diffuse (36.9%), periumbilical (24.4%), epigastric (21.0%), and right lower quadrant (8.1%). On the examination, there were no abnormal findings in 327 patients (52.1%). Abnormal ultrasonographic findings were mesenteric lymphadenitis (27.1%), intestinal mural thickening (10.0%), intussusception (3.0%), appendicitis (2.6%), choledochal cyst (1.6%), and pancreatitis (0.3%). We performed additional imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) in 39 patients who showed obscure findings on the US. In 33 patients (84.6%), the same results were obtained from CT or MRI. Two cases of appendicitis, one case of pancreatitis and one case of Henoch-Shonlein purpura were diagnosed by the CT examination. However, there were two cases of appendicitis diagnosed by US thathad no evidence of appendicitis on the CT. Diagnostic accuracy of initial US in children with abdominal pain was 99.4%. CONCLUSION: US by a pediatrician as a screening test in children with AP provides a rapid and accurate diagnostic indication and has non-invasive and radiation-free advantages.
Abdominal Pain ; Appendicitis ; Child ; Choledochal Cyst ; Humans ; Intussusception ; Magnetic Resonance Imaging ; Male ; Mass Screening ; Medical Records ; Mesenteric Lymphadenitis ; Pancreatitis ; Purpura ; Retrospective Studies

Research and development (R&D) is very important to acquire new knowledge in various fields. The significance of public R&D is also increasing, especially related to health policy making, establishing basic databases, and enhancing basic and clinical science. The total budget of general public R&D in Korea was approximately ten billon US Dollars in 2008, but the proportion of health care research was just below 10%. In private sectors, it was three times the amount allocated to the public budget. In this article, recent trends in public R&D in Korea, especially related to health care policy and biotechnology are summarized. A brief overview of the application process for a specific policy fund is also described for early-stage researchers in these fields.
Biotechnology ; Budgets ; Delivery of Health Care ; Financial Management ; Health Policy ; Health Services Research ; Korea ; Private Sector

Plain X-ray radiographs are the first line of investigation taken in the diagnosis of abdominal pathology and are considered an important diagnostic tool to provide guidelines for further imaging studies and comprehensive therapeutic management. Although most abdominal pathology demonstrates non-specific radiologic findings, the plain abdominal radiography is very useful in specific diseases, including certain gastrointestinal anomalies. This review provides image findings of normal plain abdominal radiography and some common abdominal pathology in infants and children.
Child ; Humans ; Infant ; Infant, Newborn ; Radiography, Abdominal

The persistence of jaundice beyond the first 2 weeks of life require further investigation and this can be determined if the conjugated bilirubin levels are greater than 1.5 mg/dL or greater than 20% of the total bilirubin level. There is a diverse differential diagnosis for the cause of neonatal cholestasis due to hepatobiliary disease including biliary atresia, which eventually leads to liver cirrhosis if uncorrected before 60~80 days of life. Long-established initial studies include abdominal ultrasonography, hepatobiliary scintigraphy and liver biopsy, but better diagnostic methods are needed. Promising new options are described including MRCP (magnetic resonance cholangiography), ERCP (endoscopic retrograde cholangiography), and PCC (percutaneous cholecysto-cholangiography). Though no single test can differentiate biliary atresia from other neonatal cholestasis with confidence, a combination of diagnostic methods is usually consistently beneficial. By excluding biliary atresia as early as possible, the risk of unnecessary explolaparotomy with intraoperative cholangiography is decreased. Further evaluation would be required for the diagnosis of neonatal cholestasis after excluding biliary atresia.
Biliary Atresia ; Bilirubin ; Biopsy ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Cholestasis ; Diagnosis, Differential ; Hepatitis ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Liver ; Liver Cirrhosis

Food allergies affect 7~8% of infants and young children, and their prevalence appears to have increased in recent years. Food allergy refers to an abnormal immunological reaction to a specific food. These reactions can be recurrent each time the food is ingested. Food allergy manifests itself with a wide spectrum of clinical characteristics including IgE-mediated diseases as immediate reactions, non-IgE-mediated disorders as delayed reactions, and mixed hypersensitivities. As a consequence, the clinical picture of a food allergy is pleomorphic. A well-designed oral food challenge is the most reliable diagnostic test for infants and young children whose clinical history and physical examination point towards a specific food allergy. Food specific IgE antibody tests (RAST, MAST, skin prick test, Uni-CAP, etc) are an alternative tool to determine oral food challenge for IgE-mediated disorders, but not for non-IgE-mediated allergies. Moreover, parents often impose their children on unnecessary diets without adequate medical supervision. These inappropriate dietary restrictions may cause nutritional deficiencies. This review aims to introduce clinical perspectives of food allergy in infants and young children and to orient clinicians towards different strains of diagnostic approaches, dietary management, and follow-up assessment of tolerance development.
Child ; Diagnostic Tests, Routine ; Diet ; Follow-Up Studies ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Malnutrition ; Organization and Administration ; Parents ; Physical Examination ; Prevalence ; Skin

Chronic abdominal pain (CAP) is a common complaint encountered in pediatric clinics and a great concern for patients and their caretakers as well as health care professionals. A constant challenge is detecting individuals with organic diseases or psychosomatic disorders from the majority of patients who have a functional disorder including functional dyspepsia, irritable bowel syndrome, functional abdominal pain, and abdominal migraine. Beginning with a detailed history and physical examination, physicians must determine a differential diagnosis of CAP by applying the symptom-based Rome III criteria to positively identify a functional disorder. These findings should then be further analyzed based on diagnostic clues and red flags that indicate the presence of specific organic diseases and/or the need for further testing. Once a functional diagnosis has been made or an organic disease is suspected, physicians can initiate an empiric therapeutic trial. Since psychological distress accompanies both organic and non-organic abdominal pain in children, a cooperative diagnostic approach involving pediatricians and psychiatrists is recommended.
Abdominal Pain ; Child ; Delivery of Health Care ; Diagnosis, Differential ; Dyspepsia ; Humans ; Irritable Bowel Syndrome ; Migraine Disorders ; Physical Examination ; Psychiatry ; Psychophysiologic Disorders ; Rome