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Carotid artery intima media thickness in obese children : relation with cardiovascular risk factors (비만 소아에서 경동맥 내중막 두께와 심혈관질환 위험인자와의 상관관계)

  • Lee, Jin;Kwon, Hyo Jin;Park, Moon Ho;Jang, Ki Young;Lee, Kee-Hyoung;Lee, Kwang Chul;Son, Chang Sung;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1091-1096
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    • 2007
  • Purpose : The of common carotid artery intima media thickness (IMT) is an acknowledged noninvasive marker for early atherosclerotic changes. We investigate whether common carotid IMT is different between obese and normal-weight children and also evaluate the relationships IMT with cardiovascular risk factors. Methods : We collected the clinical data (age, sex, pubertal stage, body mass index) and measured blood pressure, glucose, insulin, lipid profiles and adiponectin in 49 obese children (mean age, 12 years) and 24 nonobese children as controls. The control group was composed of 24 nonobese children of the same age, sex and pubertal stage. We measured the carotid IMT of all subjects by B-mode ultrasound with a 7.5-MHz linear transducer and analyzed. Results : Obese children demonstrated a significantly thicker intima media (mean, 0.34 mm, peak, 0.42 mm) compared to the control group (mean, 0.31 mm, peak, 0.38 mm, P<0.01). IMT was significantly correlated to the BMI (r=0.431, P<0.01), age (r=0.317, P<0.01), total cholesterol (r=0.377, P< 0.01), triglyceride (r=0.253, P<0.05) and low-density lipoprotein cholesterol (r=0.289, P<0.05). Serum adiponectin was significantly lower in obese children than in controls (11.2 ng/mL vs. 14.7 ng/mL, P<0.05) and negatively related with IMT (r=-0.267, P<0.05). Conclusion : Obesity is associated with increased carotid artery IMT in children. Our results suggest vascular changes in obesity seem to occur already in childhood and vascular ultrasonography may helpful for screening cardiovascular complications in obese children.

The Relationship Between Adiposity and Risk factors for Cadiovascular Disease at Normal Body Weight Male (정상 체중인 성인 남성에서 지방과다와 심혈관질환의 위험요인간의 관련성)

  • Kwon, Woo-Sung;Kim, Jun-Su;Chae, Jin-Wook;Lee, Keun-Mi;Jung, Seung-Pil;Moon, Yong
    • Journal of Yeungnam Medical Science
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    • v.20 no.1
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    • pp.62-70
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    • 2003
  • Background: Most of all studies about the relation between the health risk and obesity are based on the European and American data. The purpose of this study is to examine the relation between adiposity and risk factors for cardiovacular disease (CVD) in normal weight individuals. Materials and Methods: Normal weight subjects with a body mass index (BMI) between 18.5 and $23kg/m^2$ (76 subjects) and overweight subjects with a BMI between 23 and $25kg/m^2$ (53 subjects) were retained for this study. Normal weight subjects were divided into three group of each adiposity variable, then three group and the overweight group were evaluated for the presence of CVD risk factors and analyze the correlation coefficients between adiposity variables and risk factors controlled for age in normal weight, overweight groups. Using logistic regression analysis, the odds ratio (OR) for the prevalence of risk factors for each group of adiposity variables and the overweight group was estimated relative to the first group in normal weight subjects. Results: Systolic BP, diastolic BP, LDL cholestrol, HDL cholesterol, triglycerides in normal weight subjects were significantly correlated with all adiposity variables (P<0.01). Third group (3.7 for %fat and 4.7 for fat mass)of adiposity variables in the normal weight group and the overweight group (6.6 for %fat and 11.5 for fat mass) tended to have higher ORs compared to first group for risk factor variables. Conclusion: Normal weight subjects with elevated adiposity had higher prevalence of risk factors than normal weights subjects with less adiposity. Measuring of adiposity added additional information of cardiovascular disease risk factors in normal weight subjects.

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The Study of Fat Infiltration Ratio in Lumbar Paraspinal Muscle of Patient with Herniated Intervertebral Lumbar Disc (요추간판 수핵 탈출증 환자의 요부 척추 주위근 내 지방침윤 비율에 관한 연구)

  • Kong, Bong-Jun;Lee, Jung-Ho;Yong, Min-Sik;Kim, Jin-Sang
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.11
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    • pp.5254-5260
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    • 2012
  • The purpose of this study is to find the relationship between lumber Herniated Nuclesus Pulposus of specific part and fat infiltration in paraspinal muscle. Also we intended to find the relationship between Body Mass Index(BMI) and fat infiltration ratio in the lumber paraspinal muscle based on the sexes of patients. We conducted this study of patients who visited our hospital from May, 2010 to May, 2012. The subjects are composed of 40 patients(20 females and 20 males), who are 30 to 50 years old suffering from severe lumber herniated nuclesus pulposus, who had or were going to have operation treatment. BMI is measured through anthropometry of each patient and fat infiltration inside the muscle is estimated by measuring the cross section area of lumbar paraspinal muscle from mid-cross section of disc(L2-S1) and fat infiltration ratio. The data of this study are analyzed by independent t-test to figure out the difference of fat infiltration between male and female, and by paired sample T-test after getting mean and standard deviation to find the changes of fat infiltration of lumbar on each level. Also correlation analysis is done by setting age as a control variable to find the correlation between BMI and fat infiltration of the whole lumbar. As a result, we could get only the meaningful difference between the sexes on upper lumber part(L2-L3) while we couldn't find any significant difference in the rest of lumbar(L3-S1). Besides, the changes of fat infiltration ratio on each lumbar level increased rapidly from lumbar 3,4 to lumbar 4,5. We also found that there is no correlation between fat infiltration ratio of lumbar paraspinal muscle(L2-S1) and BMI.

The Effects of Trunk Stabilization Training on a Stroke Patient's Postural Control and Activities of Daily Living: A Sing Subject Design (뇌졸중 환자의 체간안정화 훈련이 자세조절과 일상생활동작에 미치는 영향: 단일사례연구)

  • Nam, Ju-Hyeon;Shim, Gyeong-Bo;Gwak, Seong-Won
    • The Journal of Korean society of community based occupational therapy
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    • v.4 no.1
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    • pp.75-84
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    • 2014
  • Objective : This study intends to suggest an effective clinical intervention method for stroke patients by applying a trunk stabilization training program to a single stroke patient and investigating and analyzing the effects of the program on postural control and activities of daily living. Methods : The subject of this study was a 75 year-old female stroke patient hospitalized in C Hospital located in Gyeongju, Gyeongsangbuk-do. As for the research design, A-B-A reversal design was used with a single subject design; and the research period was a total of five weeks from April 21, 2014 to May 23, 2014. As for the research process, a total of 15 sessions were carried out including three sessions of baseline(A), nine sessions of an intervention period(B), and three sessions of maintenance(A'); and the trunk stabilization program was applied during the intervention period. To evaluate the participant's postural control and activities of living life, the Postural Assessment Scale for Stroke(PASS) and the modified Barthel Index(MBI) were used. Visual analysis was used in which collected data were plotted on a graph, using Microsoft Office Excel 2013. Results : In the postural control test, the mean scores improved from 11.7 in the baseline phase to 14.8 in the intervention phase and 15.3 in the maintenance phase. In the evaluation of activities of daily living, the score improved from 66(medium dependence) during the baseline period to 80(low dependence) after intervention and at the maintenance phase. Conclusion : It was found that the trunk stabilization training program showed effects on the stroke patient's postural control or alignment, and furthermore a beneficial improvement in the patient's performing the activities of daily living, as well.

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Clinicopathologic and Epidemiologic Study of Childhood Nephrotic Syndrome in Taejon, Korea (대전지역 소아 신증후군의 임상병리학적 및 역학적 연구)

  • Yim Sam-Hwa;Yoon Kye-Nam;Cha Sang-Won;Lee Dong-Joon;Han Ji-Whan;Whang Kyung-Tae;Lee Kyung-Yil
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.145-152
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    • 1999
  • Purpose: The prevalence of childhood renal diseases including the nephrotic syndrome in Korea has not been well established. In priority to this point, we analyzed ninety-six nephrotic children of the annual incidence, the ratio of them to all inpatients and estimated incidence of childhood nephrotic syndrome under 15 years of age in Taejon, Korea. Also we classified them by clinical and histopathological findings. Methods: we analyzed the admission and outpatient records retrospectively between June 1986 and December 1998. For the estimation of incidence, we were assisted with three other general hospitals in Taejon Results: The mean annual number and the ratio to inpatients were $7.4{\pm}2.1,\;0.3{\pm}0.11%$ respectively. The latter showed a tendency to decrease during the recent three years. The estimated annual incidences of childhood nephrotic syndrome in Taejon were 5.6 in 1988, 5.5 in 1993 and 4.8 in 1998 per 100,000 for children aged up to 15 years. The mean age of our patients was $6.8{\pm}3.5$ tears, 1-7 years of age was 55 cases(57.3%), and male to female ratio was 3.6:1. By the clinicopathologic classification, 89 cases(92.7%) were classified as primary nephrotic syndrome, and 7 cases(7.3%) as secondary nephrotic syndrome. Among the primary nephrotic syndrome, there was 79.8% of minimal change nephrotic syndrome, focal segmental glomerulosclerosis 11.2%, mesangial proliferation 4.5%, membranoproliferative glomerulonephritis 3.4%, and membranous nephropathy 1.1%. $Henoch-Sch\"{o}nlein$ nephritis was the most frequent of 3 cases in the secondary nephrotic syndrome. Respones to steroid therapy of 71 cases minimal change were classified as non-relapse 22.5%, non-frequent relapse 49.3%, frequent relapse 18.3% and steroid-dependence 9.9%. Conclusion: The estimated incidence of childhood nephrotic syndrome was about 5 per 100,000 for children aged up to 15 years and it showed little changes during 10 years in Taejon, Korea. Our results of clinicopathologic study was little difference from the results reported in other literatures.

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Factors Related to Poor School Performance of Elementary School Children (국민학교아동의 학습부진에 관련된 요인)

  • Park, Jung-Han;Kim, Gui-Yeon;Her, Kyu-Sook;Lee, Ju-Young;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.4 s.44
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    • pp.628-649
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    • 1993
  • This study was conducted to investigate the factors related to the poor school performance of the elementary school children. Two schools in Taegu, one in the affluent area and the other in the poor area, were selected and a total of 175 children whose school performance was within low 10 percentile (poor performers) and 97 children whose school performance were within high 5 percentile (good performers) in each class of 2nd, 4th and 6th grades were tested for the physical health, behavioral problem and family background. Each child had gone through a battery of tests including visual and hearing acuity, anthropometry (body weight, height, head circumference), intelligence (Kodae Stanford-Binet test), test anxiety (TAI-K), neurologic examination by a developmental pediatrician and heavy metal content (Pb, Cd, Zn) in hair by atomic absorption spectrophotometry. A questionnaire was administered to the mothers for prenatal and prenatal courses of the child, family environment, child's developmental history, and child's behavioral and learning problems. Another questionnaire was administered to the teachers of the children for the child's family background, arithmatic & language abilities and behavioral problem. The poor school performance had a significant correlation with male gender, high birth order, broken home, low educational and occupational levels of parents, visual problem, high test anxiety score, attention deficit hyperactivity disorder (ADHD), poor physical growth (weight, height, head circumference) and low I.Q. score. The factors that had a significant correlation with the poor school performance in multiple logistic regression analysis were child's birth order (odds ratio=2.06), male gender(odds ratio=5.91), broken home(odds ratio=9.29), test anxiety score(odds ratio=1.07), ADHD (odds ratio=9.67), I.Q. score (odds ratio=0.85) and height less than Korean standard mean-1S.D.(odds ratio=11.12). The heavy metal contents in hair did not show any significant correlation with poor school performance. However the lead and cadmium contents were high in males than in females. The lead content was negatively correlated with child's grade(P<0.05) and zinc was positively correlated with grade (P<0.05). among the factors that showed a significant correlation with the poor school performance, high birth order, short stature and ADHD may be modified by a good family planning, good feeding practice for infant and child, and early detection and treatment of ADHD. Also, teacher and parents should restrain themselves from inducing excessive test anxiety by forcing the child to study and over-expecting beyond the child's intellectual capability.

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The Analysis of Theses Content Related to Parents' Needs for Their Education (부모교육 요구조사 관련 논문 내용 분석)

  • Kim, Jong-Han
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.5
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    • pp.2115-2123
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    • 2011
  • The purpose of this study is to draw a general conclusion through summing up theses on parents' need for their education up to the present. The subjects of this study are 25 masters' degree theses on parents' need for their education in the kindergarten from 2001 to 2010. The results of data on parents' education method and style were conducted by frequency analysis. Also it was surveyed if in how many theses the contents of parents' education were rated over average points by Licker. The results of this study are as follows: First, the parents think that the proper frequency of their education is once or two in a semester and the favorite time is from 10 to 12 o'clock or from 2 p. m. to 4 p.m. They also want to learn on Wednesday, Friday and Saturday. And they want a professional as their lecturer the most and then a homeroom teacher. Secondly, in the survey of their education style they like more lecture or a short course than any other thing, and then they like home messenger, group council and so on. But especially they don't like the style of visiting class, book lending, ceremony/class assistance, practice (workshop), and visiting home. Thirdly, they want to know a general guide in the kindergarten of the contents of their education a lot. And they want to know some of a budget, program, and assessment of a principal and the teachers in the kindergarten. Fourthly, they want to know all parts of the parents' roles related to rearing their children in their own elements of the contents of their education above all. And they also want strongly their free time, hobby, the liberal arts, amusement and recreation. Fifthly, in the view of infant development they want strongly to know how to communicate with their children rightly, and how to adjust their children's activities and how to praise or blame their children. And they also want how to form their children's right habit and to guide their children's right acts in the infant period the most. Lastly, they want to know children's physical development and their cognitive development in the view of infant development the most. And then they want to know the development of sociology, creativity, morality, and emotion in good order.

A Study on the Deduction of the Forest Play Activity and Space through Preschooler Participatory Workshop (유아참여 워크숍을 통한 숲놀이 활동 및 공간 요소의 도출에 관한 연구)

  • Kang, Taesun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.5
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    • pp.69-81
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    • 2018
  • Recently, user participatory workshops have been applied as a way to plan landscape spaces that reflects the needs and demands of the users. It is also required to improve the quality of the FECC (Forest Experience Center for Children), which is growing rapidly. Therefore, the purpose of this study is to deduct the design elements (forest play activities and space), the basic needs, and the demands of users in making the FECC a preschooler participatory workshop. For this, materials for preschooler participation were selected, and a step-by-step workshop was conducted to satisfy the demands of the preschooler's development. First, in the pre-workshops phase, design elements standards were deducted through the preschooler participatory results (41 children aged 6 and 7, Kindergarten). Second, in the main workshop phase, the design elements to be introduced on the site (Songsan-mulbit FECC) were deducted through the participating preschooler's selection and those results were analyzed. The materials used at the preschooler participatory process were 'drawing a picture' in the pre-workshop phase, and the design elements and the standard types charts were the forest play activity pictogram chart, and the forest play space general images chart in the main workshop. As for results, frst, there are 38 standard types of forest play activities that have been deducted. It consists of 27 cognitive activities (functional 16, constructive 4, symbolic 4, game on rule 3), 9 games (sensory 5, other 4), and two social play activities (solo, group). There are 21 standard types of forest play spaces. They consist of 8 play facility spaces (5 facility, 3 natural), 2 water spaces, and 11 spaces of 5 types. Second, as a result of applying the results to the site, the forest play activities to be introduced on the site were selected, and the functional play was most selected. Additionally, climbing and water play were most selected as the unit activities. Also, functional, constructive, symbolic, games based on rules were selected, even in the preschooler's development play. In the case of the forest play spaces to be introduced in the site, the preschooler's selection results by sex and age tended to be similar to the preschooler's comprehensive selection results, but the boys preferred function and adventure spaces more than the girls, while the girls preferred rest spaces more than the boys. This result is similar to the previous study results, which directly observed the preschooler's forest play behavior, and analysis that the preschooler recognized the site and selected the design elements introduced on the site. Therefore, the participatory workshop process and the materials process in this study are analyzed and applied to the purpose of the study. It is valuable as a case to be applied in design of the FECC from this point forward.

The relationship between adiponectin, leptin, insulin, insulin-like growth factor and IGF binding protein-3 in cord blood and neonatal anthropometric parameters (제대혈에서 아디포넥틴, 렙틴, 인슐린, IGF-I, IGFBP-3와 신생아의 신체계측과의 상관관계)

  • Cho, Hai Jung;Kim, Ji Young;Kim, Me Jin;Hwang, Il Tae;Lee, Hae Ran
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.722-728
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    • 2008
  • Purpose : This study was designed to examine the effects of adiponectin, leptin, insulin, insulin-like growth factor (IGF)-I and IGF binding protein (BP)-3 levels in cord blood on weight, length, and adiposity at birth in healthy term infants. In addition, we evaluated the mechanism to change the hormone levels in appropriate for gestational age (AGA) during the first month. Methods : We collected cord blood from 200 term neonates (109 males, 91 females) with no perinatal problems, and measured the hormone levels and anthropometric parameters including weight, length, and skin-fold thickness. Term neonates were divided into 3 groups as follows: birth weight appropriate for gestational age (AGA) (n=132), birth weight less for gestational age (SGA) (n=29), and birth weight more for gestational age (LGA) (n=39). Venous blood samples of 15 fullterm healthy neonates were obtained at 3, 7, and 30 d after birth. Results : The adiponectin, insulin, and IGF-I levels were significantly lower in the SGA group than in the AGA and LGA groups. The leptin levels were significantly higher in the LGA group than in the AGA and SGA groups. Cord blood adiponectin, leptin, insulin, IGF-I, and IGFBP-3 levels correlated significantly and positively with birth weight and the sum of the skin-fold thickness. A significant positive correlation was observed between adiponectin, leptin, and IGF-I levels and birth weight. Adiponectin level correlated significantly with that leptin level (r=0.191, P=0.038), but not with insulin, IGF-I and IGFBP-3 levels. IGF-I levels were higher in females than in males. At 7 d after birth, the leptin level decreased along with physiologic weight loss, and then increased. IGF-I, also decreased at 3 d, significantly increased 1 month later. Conclusion : We suggest that adiponectin, leptin, insulin, IGF-I, and IGFBP-3 play an important role in regulating fetal growth. Adiponectin may be involved in regulating fetal growth through mechanisms different from those mediated by insulin or IGF-I. High levels of IGF-I in female neonates indicates a gender difference which serves as evidence for in utero sexual dimorphism. It is likely that IGF-I has a more important role than that of hormones in postnatal growth.

The Relationship between Thymic Size and Vesicoureteral Reflux in Infants with Febrile Urinary Tract Infection (발열성 요로감염 영아에서 방광요관역류와 연관된 흉선의 크기)

  • Jung, Seong-Kwan;Park, Kyu-Hee;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.215-221
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    • 2009
  • Purpose : Thymus is a lymphoproliferative organ that changes size in various physiological states in addition to some pathological conditions. Thymus is susceptible to involution, and shows a dramatic response to severe stress. Thymic measurements may be helpful in various diseases. UTI (urinary tract infection) is most common bacterial infection in infants and VUR (vesicoureteral reflux) is a common abnormality associated with UTI. In our study, the size of thymus was compared on the premise that a greater stress is exerted on the body when UTI is accompanied by VUR, than when occurs on its own. Methods : Thymic size was measured on standard chest anteroposterior radiographs and expressed as the ratio between the transverse diameter of the cardiothymic image at the level of the carina and that of the thorax (CT/T). The medical records of 99 febrile urinary tract infection infants without other genitourinary anomalies except VUR were reviewed retrospectively. Results : Among 99 patients with febrile UTIs, 25 were febrile UTI without VUR and 74 with VUR. For the UTI with VUR group, there was a significant decrease in the thymic size compared to the those without VUR group ($0.382{\pm}0.048$ vs $0.439{\pm}0.079$, P<0.05). However, there were no differences in the duration of fever and WBC, CRP between the UTI with VUR and UTI without VUR. In addition, there were no differences in the cardiothymic/thoracic ratios between renal defects and renal scars in febrile UTI patients. Conclusion : The results of this study show that the shirinkage of thymus was more frequently found in the UTI patients with VUR. Therefore, awareness of the risks associated with thymic size is important for the appropriate work up and management of UTI patients.