• Journal of Nutrition and Health
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• v.56 no.6
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• pp.683-701
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• 2023

Purpose: The purpose of the study was to analyze the status of dietary behavior and nutrition intakes according to the gender and the level of physical activity of adolescents. Methods: Data from 659 adolescents aged 13 to 18 years who participated in the Korea National Health and Nutrition Examination Survey (2017-2018) were analyzed. Collected data were analyzed using complex sampling data analysis with SPSS v. 27.0. Results: The adolescents were categorized into three groups based on their physical activity as follows: The first group with high physical activity (8.9%), a second group with normal physical activity (29.7%), and a third group without physical activity (61.4%). Boys showed significantly higher physical activity than the girls. Adolescents with high physical activity had a significantly lower body mass index than adolescents without physical activity, but their meal regularity, subjective health status, and recognition of body image were significantly higher. In terms of biochemical factors, adolescents with high physical activity had lower triglycerides and cholesterol than adolescents without physical activity, while hemoglobin and hematocrit were significantly higher. In addition, the intakes of energy, carbohydrates, proteins, fat, vitamin B₁, niacin, calcium, phosphorus, sodium, potassium, iron increased significantly as adolescents' physical activity increased. Conclusion: The physical activity of adolescents had a positive effect on dietary behavior, lifestyle, and nutritional factors. Therefore, it is necessary to increase participation in physical classes in schools and develop various programs considering the level of physical activity among adolescents.

• Journal of the Korean Society of School Health
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• v.13 no.2
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• pp.295-317
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• 2000

This study was conducted to prevent oral disease of primary school, middle school, and high school students, providing basic data for the development of oral health education programs. Data were collected from 898 primary school, middle school, and high school students from March 2, 1999 to May 31, 1999. The results of this study are summarized as follows; 1) The subjects of this study were primary school students(32.6%), middle school students(33.0%), and high school students(34.4%). Boy students were slightly more prevalent than girl students. That is, primary school boys were 56.3%, middle school boys were 53.2%, and high school boys were 52.6%. 2) According to the self-judgement of oral health, primary school students were better than middle/high school students and boy students were better than girl students, 63.5% of primary school students and 57.8% of middle/high school students brushed their teeth once or twice a day. 3) 76.3% of middle/high school students and 63.5% of primary school students experienced dental caries. Girl students were higher than boy students in experiencing dental caries, 35.9% of primary school students and 27.6% of middle/high school students experienced periodontal disease. 4) 22.9% of primary school students and 7.9% of middle/high school students received oral examinations periodically. Girl students showed a higher rate than boy students in primary school, while boy students showed a higher rate than girl students in middle/high school. 5) Explaining to the reasons for reluctant visits to dental hospitals and clinics, 'no time to go' was highest(22.9% of primary school students; 27.4% of middle/high school students) and the rate of 'feeling scared' was second highest. Middle/high school students were more reluctant to visit dental hospitals and clinics than primary school students. In case of problematic symptoms in the mouth, the rate of 'feeling painful or cold in teeth when eating cold or hot foods' was highest, 71.3% of primary school students was concerned about oral health, while 68.6% of middle/high school students was concerned about it. 6) In gathering to the sources of information on oral health, the rate of medical institutions was highest(30.0%) in primary school students, while the rate of family members or persons around them was highest in middle/high school students. 7) 54.9% of primary school students received oral health education, while 13.1% of middle/high school students received it. Only 4.7% of middle school and high school girls received it. In relation to dental health education, the rate of 'possibility of prevention of oral caries or disease of the gum' was highest. 79.5% of primary school students and 80.3% of middle school students answered that they would attend oral health education. 8) 60.4% of primary school students and 60.2% of middle/high school students think the purpose of oral health is to prevent dental caries and disease of the gums. In preventing dental caries, 78.8% of primary school students and 71.8% of middle school students thought that periodical oral examination was effective, 88.4% of primary school students and 88.8% of middle/high school thought that brushing one's teeth was effective and 64.1% of primary school students and 50.7% of middle school students thought that the use of toothpaste containing fluoride was effective. In preventing periodontal disease, 91.1% of primary school students and 90.2% of middle/high school students thought that brushing one's teeth was effective, while 72.4% of primary school students and 70.3% of middle/high school students thought that teeth cleaning was effective. 9) 16.0% of middle school students and 12.7% of high school students thought that their oral health condition was healthy. According to individual experiences in dental treatment, the rate of experience of middle school students was higher than that of high school students, 12.7% of middle school students received oral examinations periodically, while only 3.3% of high school students did so. 10) In cases of 'having no problematic symptoms in the mouth' and 'concerns about oral health', the rate of middle school students was higher than that of high school students. In gathering obtaining information on oral health, the rate of obtaining it through broadcast media including TV, Radio, etc. was highest in middle school students, while the rate of obtaining it through family members or persons around them was highest in high school students. 11) 81.7% of middle school students have not received oral health education. In case of girl students, 97.3% have not received it in high school students. 85.6% of middle school students and 151.2% of high school students think that oral health education is necessary. 12) According to the knowledge level of oral health, the point of high school students($26.33{\pm}2.33$) was similar to the point of high school students($26.23{\pm}2.30$). It appeared that the point of primary school students was highest($26.35{\pm}2.50$) The more concerned about oral health the students were the higher the knowledge level of oral health was. In conclusion, the middle/high school students' knowledge level of oral health was lower than primary school students. The rate of middle/high School students' experience in oral health education was too low. Therefore, it is necessary to intensify oral health education for middle/high school students. Especially, the necessity of oral health education to girl students is strongly recommended. Developing an oral health education program for primary school, middle school, and high school students, related public authority and organizations, teachers; and dentists must actively make efforts together in order to maintain healthy teeth through having students prevent dental caries and periodontal disease.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.253-261
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• 2009

The purpose of this study was to present new data on the timing and sequence of permanent teeth emergence and to compare these findings with the results of earlier studies. The dental examinations had been performed to E-elementary school students, who visited the Yonsei University Dental Hospital between 1998 and 2005; 1,307 boys and 1,312 girls with the age ranging from 6 to 12 years old. The followings were concluded. 1. Eruption time of the maxillary permanent teeth is as follows. It was 6.81 years in male and 6.73 years in female for the central incisor, 7.78 years in male and 7.65 years in female for the lateral incisor, 10.48 years in male and 9.92 years in female for the canine, 9.76 years in male and 9.63 years in female for the first premolar, 10.66 years in male and 10.49 years in female for the second premolar, 6.39 years in male and 6.26 years in female for the first permanent molar, and 12.13 years in male and 12.03 years in female for the second permanent molar. 2. Eruption time of the mandibular permanent teeth is as follows. The central incisor could not be determined in this study, but it is assumed to erupt before the age of 6.08. In the mandible, eruption time was 6.78 years in male and 6.65 years in female for the lateral incisor, 9.76 years in male and 9.05 years in female for the canine, 9.82 years in male and 9.59 years in female for the first premolar, 10.67 years in male and 10.52 years in female for the second premolar, 6.22 years in male and 6.12 years in female for the first permanent molar, and 11.58 years in male and 11.14 years in female for the second permanent molar. 3. The eruption sequence is as follows. In the maxilla, the first permanent molar erupted first, followed by the central incisor, the lateral incisor, the first premolar, the canine, the second premolar, and the second permanent molar. In the mandible, the central incisor erupted first, followed by the first permanent molar, the lateral incisor, the canine, the first premolar, the second premolar, and the second permanent molar. 4. Tooth eruption occurred earlier in female compared to male by average of 0.19 year in the maxilla and 0.29 year in the mandible. 5. In both male and female, the hiatus (interval of rest) occurred between the emergence of lateral incisor and first premolar in the maxilla while it was observed between the lateral incisor and canine in the mandible. Male had a hiatus of 1.98 years in the maxilla and 2.90 years in the mandible, while the female's were 1.98 years and 2.40 years, respectively.

• Childhood Kidney Diseases
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• v.9 no.2
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• pp.222-230
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• 2005

Purpose : ARC syndrome refers to an association of arthrogryposis, renal tubular dysfunction, and cholestasis. The VPS33B gene was recently identified as the causative gene. So far, 41 cases of ARC syndrome have been reported worldwide, and it has rarely been reported in Korea. This study was conducted to report the clinical findings of seven ARC syndrome cases in Korean children, focusing especially on renal tubular dysfunction. Methods : The hospital records of 7 cases diagnosed as ARC syndrome at Severance Hospital between Mar. 1995 and Aug. 2005 were reviewed and analyzed. Results : Of the 7 cases, 4 were boys and 3 were girls. Six patients(85$\%$) were born with normal birth weight at term, and one was born at preterm. All cases presented with cholestasis and severe jaundice. According to the type of arthrogryposis described by Brown et al, type 3 and 4 were found in 2 patients and type,6, 7, and the undistributed type in one patient respectively. Other associated clinical findings were as follows : failure to thrive in 6(85$\%$), lax skin in 5(71$\%$), and gray platelet syndrome in 4(57$\%$). Urine analysis revealed 6 cases(85$\%$) with proteinuria, 3(43$\%$) with hematuria, 5(71$\%$) with glycosuria, 2(29$\%$) with phosphaturia and 2(29$\%$) with calciuria. Serum electrolytes showed 4 cases(57$\%$) with hyponatremia, 3(43$\%$) with hypokalemia, and 1(14$\%$) with creatinine elevation. Renal tubular dysfunctions were diagnosed as renal tubular acidosis in 6 cases(85$\%$), nephrogenic diabetes insipidus in 2(29$\%$), and Fanconi syndrome in 2(29$\%$). During the follow-up period, 2(29$\%$) had no treatment, 5(85$\%$) had continuous supplementation to correct the electrolyte imbalance and acidosis, and 1(14$\%$) had dialysis. Only one patient had a family history of ARE syndrome in a sibling. Four cases(57$\%$) were diagnosed at the mean age of 8.2 months, and one case was lost during follow-up. Ages of the survived 2 cases were 13 and 25 months, respectively. Conclusion : The rare disease of ARC syndrome Is associated with severe renal dysfunction. However, this study revealed that the renal manifestation of ARC syndrome in Korean children is relatively mild and survival rate is higher than that of previous studies. Contrary to previous reports, this study showed that familial cases are rare and sporadic occurence is possible in Korea. Thus, the diagnosis of this syndrome requires a careful evaluation of the venal function in cases of congenital arthrogryposis, and a mandatory genetic counseling of affected family for prevention of familial occurance. (J Korean Soc Pediatr Nephrol 2005;9:222-230)

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.557-566
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• 2009

Purpose : To evaluate the clinical features and characteristics of childhood periodic syndromes (CPS) in Korea using the new criteria of the International Classification of Headache Disorders (ICHD)-II. Methods : The study was conducted at pediatric neurology clinics of five urban tertiary-care medical centers in Korea from January 2006 to December 2007. Patients (44 consecutive children and adolescents) were divided into three groups (cyclic vomiting syndrome [CVS], abdominal migraine [AM], and benign paroxysmal vertigo of childhood [BPVC]) by recurrent paroxysmal episodes of vomiting, abdominal pain, dizziness, and/or vertigo using the ICHD-II criteria and their characteristics were compared. Results : Totally, 16 boys (36.4%) and 28 girls (63.6%) were examined (aged 4-18 yr), with 20 CVS (45.5%), 8 AM (18.2%), and 16 BPVC (36.4%) patients. The mean age at symptom onset was $6.3{\pm}3.6$ yr, $8.5{\pm}2.7$ yr, and $8.5{\pm}2.9$ yr in the CVS, AM, and BPVC groups, respectively, showing that symptoms appeared earliest in the CVS group. The mean age at diagnosis was $8.0{\pm}3.4$ yr, $10.5{\pm}2.6$ yr, and $10.1{\pm}3.2$ yr the CVS, AM, and BPVC groups, respectively. Of the 44 patients, 17 (38.6%) had a history of recurrent headaches and 11 (25.0%) showed typical symptoms of migraine headache, with 5 CVS (25.0%), 2 AM (25.0%), and 4 BPVC (25.0%) patients. Family history of migraine was found in 9 patients (20.4%): 4 in the CVS group (20.0%), 2 in the AM group (25.0%), and 3 in the BPVC group (18.8%). Conclusion : The significant time lag between the age at symptom onset and final diagnosis possibly indicates poor knowledge of CPS among pediatric practitioners, especially in Korea. A high index of suspicion may be the first step toward caring for these patients. Furthermore, a population-based longitudinal study is necessary to determine the incidence and natural course of these syndromes.

• Journal of the Korean Society of Food Science and Nutrition
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• v.41 no.3
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• pp.408-417
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• 2012

This study examined the satisfaction of a school milk program as well as the preference of school milk and flavored milk. The subjects of this study were $4^{th}$ , $5^{th}$ and $6^{th}$ grade students in 4 different elementary schools, who were attending the school milk program in Ulsan. The survey was conducted from April 10, 2009 to April 30, 2009. Of the 403 questionnaires distributed, 347 responded and analyzed (usage rate: 86%). The results were as follows. Of the 347 respondents, 53.9% were boys and 46.1% were girls. 34%, 31.1% and 34.9% of the students were $4^{th}$, $5^{th}$ and $6^{th}$ graders, respectively. Second, 80.1% of the students reported 'have milk everyday', and 89.9% of the students reported 'have milk as it is'. Third, the overall satisfaction with the school milk program was 3.32 based on a 5-point likert scale, the 'guidance of nutrition teachers and class teacher' was 3.21 and 'taste of school milk' was 3.37. There were significant positive correlations between the school milk satisfaction variables and overall satisfaction (p<0.01). Fourth, the preference for school milk was 3.33. The preference for flavored-milk were 3.63 (coffee milk), 4.44 (chocolate milk), 4.16 (strawberry milk), 4.26 (banana milk) and 3.53 (black bean milk). Fifth, to improve the school milk program, 85.9% of students wanted a provision for flavored milk. In conclusion, schools need to find a way to increase the satisfaction of the school milk program and the preference of school milk to increase the milk intake of students. Nutrition education for students and parents should be conducted systematically and choices for various kinds of milk and milk products should be given to the students.

• Childhood Kidney Diseases
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• v.4 no.2
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• pp.120-126
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• 2000

Purpose : This retrospective study has been undertaken to find out the clinical outcome of children with HS nephntis and its relationship with initial clinical presentation and/or renal pathologic finding. Patients and methods : Study population consisted of 59 children with HS nephritis who have been admitted to the Pediatric department of Kyungpook University Hospital from 1987 to 1999, and biopsy was done with indications of heavy proteinuria (> 1 g/m2/day) lasting over 1 month, nephrotic syndrome, and persistent hematuria and/or proteinuria over 1 year. Patients were divided clinically into 3 groups ; isolated hematuria, hematuria with proteinuria and heavy proteinuria (including nephrotic syndrome). Biopsy findings ore graded from I-V according to International Study of Kidney Disease in Children (ISKDC). Results : Mean age of presentation was $8.1{\pm}3.0$ years and slight male preponderance m noted (33 boys md 26 girls). Histopathologic grading showed Grade I ; 2, Grade II ; 44, and Grade III ; 13 cases. Clinical outcome at the follow-up period of 1-2 year (49 cases) and 3-4 years (30 cases) shooed normal urinalysis in 75 (30.6$\%$) and 18 cases (60.0$\%$), persistent isolated hematuria in 20 (40.8$\%$) and 2 cases (6.7$\%$), hematuria with proteinuria in 11 (22.5$\%$) and 8 cases (26.6$\%$), and persistent heavy proteinuria in 3 (6.1$\%$) and 2 cases (6.7$\%$) respectively. Clinical outcome according to histopathologic grading showed the frequency of normalization of urinalysis being lower in Grade III compared to grade I or II. Clinical outcome according to initial clinical presentation showed no relationship to the normalization or urinalysis at follow-up periods. However, 15-20$\%$ of children with initial heavy proteinuria showed persistent heavy proteinuria (3 out of 20 cases at 1-2 years, and 2 out of 10 case at 3-4 years of follow-up periods). Conclusion : The majority of children with HS nephritis (histopathologic grade I, II, III) improved within 3-4 years and persistent heavy proteinuria was seen only in a kw of children with initial clinical presentation of heavy proteinuria.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.18-27
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• 2006

Background: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly, but is one of the most common causes of myocardial ischemia which would result in high mortality within the first year of life. This is our early result of the surgical management for these patients. Material and Method: From June 1989 to July 2003, 6 patients with ALCAPA and one patient with ARCAPA (Anomalous origin of the Right coronary artery from the pulmonary artery) underwent surgical repair. We have reviewed the all medical records, electrocardiogram, chest X-ray and echocardiography retrospectively. Result: Three of the patients were boys and four were girls. The median age at the operation was 5.4 months (Range: 3$\∼$33 months). The average body weight of at the operation was 6.7 kg (Range: 3.7$\∼$11.3 kg). A mean follow up period was 18 months. Only 3 patients were initially diagnosed as ALCAPA. And 3 patients had moderate mitral regurgitation. Immediate coronary artery reimplantation on diagnosis with the aim of restoring a two-coronary system circulation was done. The average bypass time was 114$\pm$37 minutes, and the average aortic cross clamping time was 55$\pm$22 minutes. The average stay of intensive care unit was 5$\pm$3 days, the mean mechanical ventilator time was 38$\pm$45 hours and the hospital stay after operation was 12$\pm$5 days. There were significant improvements in electrocardiogram and chest X-ray of the all patients except one late death patient. The ventricular function showed almost normal recovery after operation; the EF (Ejection Fraction) increased from 41.2$\pm$ 10.3$\%$ to 60.5$\pm$ 15.8$\%$ within 1 month and to 59.8$\pm$13.9$\%$ within 1 year after operation, the SF (Shortening Fraction) increased from 23.6$\pm$4.7$\%$ to 38.6$\pm$8.4$\%$ within 1 month and to 37.4$\pm$7.9$\%$ within 1 year after operation, LVEDDI (Left Ventricular End-diastolic Dimension Index) decreased from 100.8$\pm$25.6 mm/$m^{2}$ to 90.3$\pm$ 19.2 mm/$m^{2}$ within f month and to 79.3$\pm$ 15.8 mm/$m^{2}$ within 1 year after operation. Concomitant mitral repair was done in two patients with anterior mitral leaflet prolapse. In every patient, mitral valve showed less than mild regurgitation during follow up. One late death occurred in which patient Dor procedure was applied 10 months after initial operation due to the dilated cardiomyopathy Conclusion: In the management of this rare and could be fatal Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), early suspicion and correct diagnosis is of most important. But, after diagnosis, immediate restoration of 2 coronary systems could result in good outcome.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.2
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• pp.169-177
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• 1999

Purpose: To evaluate the efficacy of interferon alpha therapy with or without prednisolone in children with chronic hepatitis B. Methods: Twenty-eight children (22 boys, 6 girls, mean age 130 months) had seropositive results for HBsAg, HBeAg and HBV DNA; 11 had chronic persistent hepatitis and 17 had chronic active hepatitis. The patients were divided into two groups depending upon their inflammatory activity on liver biopsy, pretreatment serum ALT levels and HBV DNA levels. Fourteen children (group 1: chronic active hepatitis, ALT ${\geq}$ 100 IU/L and HBV DNA ${\leq}$ 100 pg/$300\;{\mu}L$) received interferon alpha 2a 5 $MU/m^2$ of body surface three times weekly for 6 months. Fourteen children (group 2: chronic persistent hepatitis or chronic active hepatitis with ALT < 100 IU/L or HBV DNA > 100 pg/$300\;{\mu}L$) received prednisolone in decreasing daily doses of 60 mg/$m^2$, 40 mg/$m^2$, and 20 mg/$m^2$, each for 2 weeks, followed after 2 weeks by interferon alpha 2a on the same schedule. At the end of therapy, 3 end points were analyzed: HBeAg seroconversion, serum ALT normalization rate and clearance of serum HBV DNA. Results: At the end of treatment, HBe antigen-to antibody seroconversion was higher but not more significant in group 1 than group 2 (71.4% vs. 50.0%). Only one patient in group 2 who lost HBeAg, also cleared HBsAg. ALT normalization was similar in both groups (64.3% in group 1 vs. 55.6% in group 2). Clearance of serum HBV DNA was observed in 78.6% of patients in group 1 and 64.3% in group 2, but no significant differences. Complete response was similarly achieved in both groups (57.1% in group 1 vs. 50.0% in group 2). Interferon alpha therapy with prednisolone priming was well tolerated and all children finished therapy. Conclusion: The combined therapy with prednisolone followed by interferon alpha may be safe and effective in inducing a serological and biochemical remission of the disease in approximately 50% of children with chronic hepatitis B and with a high level of viral replication and less active disease. However, a controlled study should be performed to confirm these results.

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.166-173
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• 2003

Purpose : The cause and pathogenesis of $Henoch-Sch\"{o}nlein$ purpura has been studied for many years but the results are disappointing. Recently the hypothesis that abnormalities involving the glycosylation of the hinge region of immunoglobulin Al(IgAl) may have an important role in the pathogenesis of $Henoch-Sch\"{o}nlein$ purpura is being approved. $Henoch-Sch\"{o}nlein$ purpura is the most common vasculitis Ihat affects children and the prognosis is good. But if kidney invovement occurs, the course may be chronic and troublesome. So we evaluated children with $Henoch-Sch\"{o}nlein$ purpura especially from the point of epidemiology and clinical manifestations. Methods : Investigation of 124 children who were diagnosed with $Henoch-Sch\"{o}nlein$ purpura at Inje University Ilsan Paik Hospital from December 1999 to July 2003 was performed retrospectively through chart review. Efforts were made to get informations about the profile, epidemiology, clinical manifestations, progress of the disease and recurrence rate of patients. Results : The patients were 69 boys and 55 girls, with a mean age of $6.1{\pm}2.7$ years at the time of data collection. The male to female ratio was 1.25 : 1. The occurrence rate was much higher in autumn(from September to November, 31.5%) and winter(from December to February, 28.2%) than in spring and summer, with a peak in November. Joint involvement was shown in 66.9% of patients mostly on the foot/ankle(75.9%), knee(39.8%). Seventy(56.5%) out of 124 patients had abdominal pain and 10 patients(8.1%) showed bloody stools. Renal involvement was observed in 24 patients(19.4%) after 21.1 days on the average. IgA was elevated in 10 of 21 patients(47.6%). $C_3$ and $C_4$ levels were normal in 40 of 49 patients (81.7%) and 47 of 48 patients(97.9%), respectively Antistreptolysin-O(ASO) titer was elevated over 250 Todd units in 29 of 62 Patients(46.8%). Mycoplasma antibody titer was elevated in 21 of 49 patients(42.9%) equal or greater than 1:80. Radiologic studies were peformed in 23 patients. Seven patients(30.4%) showed bowel wall thickening and one of them received intestinal resection and anastomosis operation due to terminal ileum necrosis. Eighty four patients took steroid 1.4 mg/kg/day in average. Recurrence rate was 2.5 in 37 patients(29.8%). Conclusion : $Henoch-Sch\"{o}nlein$ purpura in childhood appears most in about 6 years of age. The occurrence rate is much higher in autumn and winter relatively. Diagnosis can be made through the perspective history taking and the inspection of clinical manifestations, but the laboratory findings are not of great help. A small portion of the patients might show abdominal pain or arthritis before purpura develops, therfore various diagnosis can be made. Radiologic evaluation should be performed to avoid surgical complications in cases accompanying abdominal pain, and long term follow up should be needed especially in patients suffering from kidney involvement. In about 30% of the patients $Henoch-Sch\"{o}nlein$ purpura would recur. Steroid can be used safely without side effects.