BACKGROUND/OBJECTIVES: To evaluate the nutritional status and prevalence of malnutrition in hospitalized children at admission and during hospitalization in South Korea. SUBJECTS/METHODS: This first cross-sectional nationwide “Pediatric Nutrition Day (pNday)” survey was conducted among 872 hospitalized children (504 boys, 368 girls; 686 medical, 186 surgical) from 23 hospitals in South Korea. Malnutrition risk was screened using the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool Risk on Nutritional status and Growth. Nutritional status was assessed by z-scores of weight-for-age for underweight, weight-for-height for wasting, and height-for-age for stunting as well as laboratory tests. RESULTS: At admission, of the 872 hospitalized children, 17.2% were underweight, and the prevalence of wasting and stunting was 20.2% and 17.3%, respectively. During hospitalization till pNday, 10.8% and 19.6% experienced weight loss and decreased oral intake, respectively.During the aforementioned period, fasting was more prevalent in surgical patients (7.5%) than in medical patients (1.6%) (P < 0.001). According to the PYMS, 34.3% and 30% of the children at admission and on pNday, respectively, had a high-risk of malnutrition, requiring consultation with the nutritional support team (NST). However, only 4% were actually referred to the NST during hospitalization. CONCLUSIONS Malnutrition was prevalent at admission and during hospitalization in pediatric patients, with many children experiencing weight loss and poor oral intake. To improve the nutritional status of hospitalized children, it is important to screen and identify all children at risk of malnutrition and refer malnourished patients to the multidisciplinary NST for proper nutritional interventions.

BACKGROUND/OBJECTIVES: To evaluate the nutritional status and prevalence of malnutrition in hospitalized children at admission and during hospitalization in South Korea. SUBJECTS/METHODS: This first cross-sectional nationwide “Pediatric Nutrition Day (pNday)” survey was conducted among 872 hospitalized children (504 boys, 368 girls; 686 medical, 186 surgical) from 23 hospitals in South Korea. Malnutrition risk was screened using the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool Risk on Nutritional status and Growth. Nutritional status was assessed by z-scores of weight-for-age for underweight, weight-for-height for wasting, and height-for-age for stunting as well as laboratory tests. RESULTS: At admission, of the 872 hospitalized children, 17.2% were underweight, and the prevalence of wasting and stunting was 20.2% and 17.3%, respectively. During hospitalization till pNday, 10.8% and 19.6% experienced weight loss and decreased oral intake, respectively.During the aforementioned period, fasting was more prevalent in surgical patients (7.5%) than in medical patients (1.6%) (P < 0.001). According to the PYMS, 34.3% and 30% of the children at admission and on pNday, respectively, had a high-risk of malnutrition, requiring consultation with the nutritional support team (NST). However, only 4% were actually referred to the NST during hospitalization. CONCLUSIONS Malnutrition was prevalent at admission and during hospitalization in pediatric patients, with many children experiencing weight loss and poor oral intake. To improve the nutritional status of hospitalized children, it is important to screen and identify all children at risk of malnutrition and refer malnourished patients to the multidisciplinary NST for proper nutritional interventions.

PURPOSE: This study aimed to evaluate the utility of acanthosis nigricans (AN) severity as an index for predicting insulin resistance in obese children. METHODS: The subjects comprised 74 obese pediatric patients who attended the Department of Pediatrics at Chosun University Hospital between January 2013 and March 2016. Waist circumference; body mass index; blood pressure; fasting glucose and fasting insulin levels; lipid profile; aspartate transaminase, alanine transaminase, glycated hemoglobin, C-peptide, and uric acid levels; and homeostatic model assessment insulin resistance (HOMA-IR) and quantitative insulin check sensitivity index (QUICKI) scores were compared between subjects with AN and those without AN. Receiver operating characteristic curves were used to investigate the utility of the AN score in predicting insulin resistance. HOMA-IR and QUICKI were compared according to AN severity. RESULTS: The With AN group had higher fasting insulin levels (24.1±21.0 mU/L vs. 9.8±3.6 mU/L, p<0.001) and HOMA-IR score (5.74±4.71 vs. 2.14±0.86, p<0.001) than the Without AN group. The AN score used to predict insulin resistance was 3 points or more (sensitivity 56.8%, specificity 83.9%). HOMA-IR scores increased with AN severity, from the Without AN group (mean, 2.15; 95% confidence interval [CI], 1.72-2.57) to the Mild AN (mean, 4.15; 95% CI, 3.04-5.25) and Severe AN groups (mean, 7.22; 95% CI, 5.08-9.35; p<0.001). CONCLUSION: Insulin resistance worsens with increasing AN severity, and patients with Severe AN (AN score ≥3) are at increased risk of insulin resistance.
Acanthosis Nigricans* ; Alanine Transaminase ; Aspartate Aminotransferases ; Blood Pressure ; Body Mass Index ; C-Peptide ; Child* ; Fasting ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Hyperinsulinism ; Insulin Resistance* ; Insulin* ; Pediatric Obesity ; Pediatrics ; ROC Curve ; Sensitivity and Specificity ; Uric Acid ; Waist Circumference

Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disease. Mesalizine for the first-line therapy of UC has adverse effects include pancreatitis, pneumonia and pericarditis. UC complicated by two coexisting conditions, however, is very rare. Moreover, drug-related pulmonary toxicity is particularly rare. An 11-year-old male patient was hospitalized for recurring upper abdominal pain after meals with vomiting, hematochezia and exertional dyspnea developing at 2 weeks of mesalizine therapy for UC. The serum level of lipase was elevated. Chest X-ray and thorax computed tomography showed interstitial pneumonitis. Mesalizine was discontinued and steroid therapy was initiated. Five days after admission, symptoms were resolved and mesalizine was resumed after a drop in amylase and lipase level. Symptoms returned the following day, however, accompanied by increased the serum levels of amylase and lipase. Mesalizine was discontinued again and recurring symptoms rapidly improved.
Abdominal Pain ; Amylases ; Child ; Colitis, Ulcerative* ; Dyspnea ; Gastrointestinal Hemorrhage ; Humans ; Inflammatory Bowel Diseases ; Lipase ; Lung Diseases, Interstitial* ; Male ; Meals ; Pancreatitis* ; Pericarditis ; Pneumonia ; Thorax ; Ulcer* ; Vomiting

Gilbert syndrome is the most common inherited disorder of bilirubin glucuronidation. It is characterized by intermittent episodes of jaundice in the absence of hepatocellular disease or hemolysis. Hereditary spherocytosis is the most common inherited hemolytic anemia and is characterized by spherical, osmotically fragile erythrocytes that are selectively trapped by the spleen. The patients have variable degrees of anemia, jaundice, and splenomegaly. Hereditary spherocytosis usually leads to mild-to-moderate elevation of serum bilirubin levels. Severe hyperbilirubinemia compared with the degree of hemolysis should be lead to suspicion of additional clinical conditions such as Gilbert syndrome or thalassemia. We present the case of a 12-year-old boy with extreme jaundice and nausea. The diagnosis of hereditary spherocytosis was confirmed by osmotic fragility test results and that of Gilbert syndrome by genetic analysis findings.
Anemia ; Anemia, Hemolytic ; Bilirubin ; Child* ; Diagnosis ; Erythrocytes ; Gilbert Disease* ; Hemolysis ; Humans ; Hyperbilirubinemia ; Jaundice* ; Male ; Nausea ; Osmotic Fragility ; Spleen ; Splenomegaly ; Thalassemia

PURPOSE: Weight loss reduces cardiovascular risk factors in the obese. However, weight reduction through diet negatively affects long-term bone health. The aim of study was to determine the ability of combined aerobic and resistance exercise (CE) to reduce weight and cardiovascular risk without diminishing bone health. METHODS: Twenty-five young adults participated in an 8-week weight loss CE program. Subjects were allocated to an obese group or a control group by body mass index (BMI). Body weight, BMI, body composition, and bone mineral density (BMD) of the lumbar spine and total hip were measured before and after the CE trial. Serum levels of metabolic markers, including adipokines and bone markers, were also evaluated. RESULTS: Weight loss was evident in the obese group after the 8 weeks CE trial. Fat mass was significantly reduced in both groups. Fasting insulin, homeostatic model assessment-insulin resistance (HOMA-IR), leptin and aminotransferases level were significantly reduced from baseline only in the obese group. High density lipoprotein cholesterol increased in both groups. Hip BMD increased in the obese group. In all study subjects, BMI changes were correlated with HOMA-IR, leptin, and HDL changes. BMI decreases were correlated with lumbar spine BMD increases, lumbar spine BMD increases were positively correlated with osteocalcin changes, and lumbar spine bone mineral content increases were correlated negatively with C-terminal telopeptide of type 1 collagen changes. CONCLUSION: These findings suggest that CE provides effective weight loss and improves cardiovascular risk factors without diminishing BMD. Furthermore, they indicate that lumbar spine BMD might be maintained by increasing bone formation and decreasing bone resorption.
Adipokines ; Body Composition ; Body Mass Index ; Body Weight ; Bone Density ; Bone Resorption ; Cholesterol ; Cholesterol, HDL ; Collagen Type I ; Diet ; Fasting ; Hip ; Humans ; Insulin ; Leptin ; Lipoproteins ; Obesity ; Osteocalcin ; Osteogenesis ; Risk Factors ; Spine ; Transaminases ; Weight Loss ; Young Adult

With an uncontrollable amount of energy dense food engulfing children's life today, no child is completely protected against being overweight or obese. An inordinate intake of energy dense food and lack of physical activity have resulted in a higher rate of obesity in children. In order to combat the seemingly intractable problem, various preventive measures against childhood obesity have been suggested and are currently in effect. It is imperative to evaluate the methodology and potential impact of published obesity-prevention programs, that focus primarily on home, school, and health care environments.
Adolescent ; Child ; Delivery of Health Care ; Humans ; Motor Activity ; Obesity ; Overweight

PURPOSE: Recently, the incidence of acute hepatitis A has increased nationwide and is related to a low rate of IgG anti-HAV production. To establish effective measures for preventing hepatitis A virus infection, an epidemiologic study on the seroprevalence of anti-HAV is needed. Thus, we investigated the seroprevalence of IgG anti-HAV in children living in Gwangju and Jeonnam. METHODS: IgG anti-HAV levels were measured in a total of 1,435 patients who visited Chosun University Hospital between January 2009 and December 2009. RESULTS: The overall seropositve rate was 40.8% (586/1,435). The seropositive rates were 41% among children under the age of 1 year, 49.9% for children 1~5 years old, 51.1% among individuals 5~10 years old, 12.9% for individuals 10~15 years old, and 8.2% for subjects over 15 years old. There was no significant difference between genders in any group. The seropositive rates in Gwangju and Jeonnam were 57.3% and 32.9% for children under the age of 1 year, 52.5% and 44.3% for children 1~5 years old, 60.2% and 33.9% among children 5~10 years old, 14.1% and 9.7% for children 10~15 years old, and 10.8% and 4.2% for individuals over 15 years old. CONCLUSION: The results demonstrated the low rates of IgG anti-HAV, particularly among subjects over 10 years old, which suggests the possibility of increasing clinical HAV infection rates among adults in the near future. We should actively prevent the spread of hepatitis A virus. Vaccination is the most effective means of preventing hepatitis A virus transmission among persons at risk for infection. Hepatitis A vaccination is recommended for children who have low IgG anti-HAV seropositive rates.
Adult ; Child ; Epidemiologic Studies ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A virus ; Humans ; Immunoglobulin G ; Incidence ; Seroepidemiologic Studies ; Vaccination

We report a familial case of visceral larva migrans of Toxocara canis after eating raw chicken liver. A 9-year-old female ate raw chicken liver with her father and older brother and was admitted to the hospital with periumbilical pain, a mild fever, and headache. The total peripheral eosinophil count was 9,884/mm3 and the total lgE concentration was 2,317 IU/dL. Chest and abdominal computed tomography (CT) scans demonstrated multiple, poorly-defined, small, nodular lesions scattered in the liver and lung parenchyma. Toxocara ELISA and Western blot tests were positive in the patient, and her father and brother. A liver biopsy revealed extensive eosinophilic infiltrations in the portal and lobular areas. She took albendazole for 5 days and was discharged in good condition. These results suggest that clinicians should consider foodborne toxocariasis in patients with multiple, small nodules in the liver and lung parenchyma with eosinophilia and a history of raw meat ingestion.
Albendazole ; Biopsy ; Blotting, Western ; Chickens ; Child ; Eating ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Fathers ; Female ; Fever ; Headache ; Humans ; Larva Migrans, Visceral ; Liver ; Lung ; Meat ; Siblings ; Thorax ; Toxocara ; Toxocara canis ; Toxocariasis

An antral web is an extremely rare gastric anomaly that disturbs the gastric outlet. The onset of symptoms will depend on the diameter of the aperture. Obstructive symptoms may not occur when the aperture is >l centimeter in diameter. If the aperture is larger than 1 cm without significant symptoms, conservative treatment is sufficient. A case of an antral web with an ulcer and vomiting in a 7-year-old boy who received ibuprofen for 2 days is presented. The patient became symptom-free after medical treatment.
Carbamates ; Child ; Humans ; Ibuprofen ; Organometallic Compounds ; Stomach Ulcer ; Ulcer ; Vomiting