• Title/Summary/Keyword: Pediatric Growth

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Diagnosis and Management of Chronic Kidney Disease-Mineral Bone Disease in Children

  • Suh, Jin-Soon
    • Childhood Kidney Diseases
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    • v.24 no.1
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    • pp.14-18
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    • 2020
  • Chronic kidney disease-mineral bone disorder (CKD-MBD) is a systemic disorder of mineral and bone metabolism caused by CKD. Patients with early-stage CKD who present with disordered regulation of bone and mineral metabolism may be asymptomatic. However, if untreated, the condition can be a significant barrier in achieving optimal bone strength, linear growth, and cardiovascular health in pediatric patients with CKD. Thus, the current study evaluated the definition, pathogenesis, diagnosis, and management of pediatric CKD-MBD.

Cyclin-Dependent Kinase Inhibitor 2A is a Key Regulator of Cell Cycle Arrest and Senescence in Endothelial Colony-Forming Cells in Moyamoya Disease

  • Seung Ah Choi;Youn Joo Moon;Eun Jung Koh;Ji Hoon Phi;Ji Yeoun Lee;Kyung Hyun Kim;Seung-Ki Kim
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.642-651
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    • 2023
  • Objective : Endothelial colony-forming cells (ECFCs) have been reported to play an important role in the pathogenesis of moyamoya disease (MMD). We have previously observed stagnant growth in MMD ECFCs with functional impairment of tubule formation. We aimed to verify the key regulators and related signaling pathways involved in the functional defects of MMD ECFCs. Methods : ECFCs were cultured from peripheral blood mononuclear cells of healthy volunteers (normal) and MMD patients. Low-density lipoproteins uptake, flow cytometry, high content screening, senescence-associated β-galactosidase, immunofluorescence, cell cycle, tubule formation, microarray, real-time quantitative polymerase chain reaction, small interfering RNA transfection, and western blot analyses were performed. Results : The acquisition of cells that can be cultured for a long time with the characteristics of late ECFCs was significantly lower in the MMD patients than the normal. Importantly, the MMD ECFCs showed decreased cellular proliferation with G1 cell cycle arrest and cellular senescence compared to the normal ECFCs. A pathway enrichment analysis demonstrated that the cell cycle pathway was the major enriched pathway, which is consistent with the results of the functional analysis of ECFCs. Among the genes associated with the cell cycle, cyclin-dependent kinase inhibitor 2A (CDKN2A) showed the highest expression in MMD ECFCs. Knockdown of CDKN2A in MMD ECFCs enhanced proliferation by reducing G1 cell cycle arrest and inhibiting senescence through the regulation of CDK4 and phospho retinoblastoma protein. Conclusion : Our study suggests that CDKN2A plays an important role in the growth retardation of MMD ECFCs by inducing cell cycle arrest and senescence.

Review of Clinical Researches for Herbal Medicine Treatment in Pediatric Growth - Focusing on recent national studies - (국내 소아성장 한약치료에 대한 고찰)

  • Kweon, Ji Hyeon;Cho, Sung Woo;Yu, Sun Ae
    • The Journal of Pediatrics of Korean Medicine
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    • v.32 no.4
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    • pp.103-112
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    • 2018
  • Objectives The purpose of this study is to provide clinical evidences on effectiveness of herbal medicine treatment regarding pediatric growth based on recent clinical studies. Methods Selected 17 clinical studies since January 1998 to June 2018 from the Journal of Pediatrics of Korean Medicine and OASIS Traditional Medicine Knowledge Portal were reviewed. Results Medications that strengthening spleen and stomach (健脾胃藥), digestant (消導藥), supplementing kidneys (補 腎藥), and lungs (補肺藥) were frequently used. Frequently used herbs were Hoelen (茯?), Citri Pericarpium (陳皮), Glycyrrhizae Radix (甘草), Atractylodis Rhizoma Alba (白朮), Dioscoreae Rhizoma (山藥), Angelicae Gigantis Radix (當歸), Amomi Fructus (砂仁), Rehmanniae Radix Preparata (熟地黃). Conclusions This study showed that Korean herb medicine treatment can be effective for pediatric growth.

Enteral Nutrition in Pediatric Patients

  • Yi, Dae Yong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.1
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    • pp.12-19
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    • 2018
  • Pediatric patients require specialized attention and have diverse demands for proper growth and development, and thus need a different approach and interest in nutritional assessment and supply. Enteral nutrition is the most basic and important method of nutritional intervention, and its indications should be identified. Also, the sites, modes, types, and timing of nutritional intervention according to the patient's condition should be determined. In addition, various complications associated with enteral nutrition supply should be identified, and prevention and treatment are required. This approach to enteral nutrition and proper administration can help in the proper growth and recovery of pediatric patients with nutritional imbalances or nutritional needs.

Enteral Nutrition and Its Clinical Application (장관 영양제의 임상적 적용)

  • Kim, Yong Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.sup1
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    • pp.27-36
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    • 2009
  • Some pediatric patients who can not eat orally depend on enteral tube feedings, and some patients require more nutrients and calories to achieve the catch-up growth. If a patient is counting on the parenteral nutrition, early initiation of enteral feeding, orally or enterally, is a very good for the intestinal mucosal maturity and motility. There are numerous kinds of formulas and supplements for the enteral feeding for neonates, infants, and children. Depending on the intestinal symptoms, allergic symptoms, requirement of special nutrients, we can choose regular infant formula (milk-based, soy-based), protein hydrolysate formula, amino acid hydrolysate formula, elemental formula. Proper use of these formulas would help for the pediatric patients to recover from their diseases, to facilitate the intestinal mucosal maturity and to achieve their goal of growth.

Safety of a New Synbiotic Starter Formula

  • Vandenplas, Yvan;Analitis, Antonis;Tziouvara, Chara;Kountzoglou, Athina;Drakou, Anastasia;Tsouvalas, Manos;Mavroudi, Antigoni;Xinias, Ioannis
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.3
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    • pp.167-177
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    • 2017
  • Purpose: Breastfeeding is the best way to feed all infants, but not all infants can be (exclusively) breastfed. Cow's milk based infant formula is the second choice infant feeding. Methods: The safety of a new synbiotic infant formula, supplemented with Bifidobacterium lactis and fructo-oligosaccharides, with lactose and a whey/casein 60/40 protein ratio was tested in 280 infants during 3 months. Results: The median age of the infants at inclusion was 0.89 months. Weight evolution was in accordance with the World Health Organization growth charts for exclusive breastfed infants. The evolution of all anthropometric parameters (weight-for-length z score and body mass index-for-age z score) was within the normal range. The incidence of functional constipation (3.2%), daily regurgitation (10.9%), infantile crying and colic (10.5%) were all significantly lower than the reported median prevalence for a similar age according to literature (median value of 7.8% for functional constipation, 26.7% for regurgitation, 17.7% for infantile colic). Conclusion: The new synbiotic infant starter formula was safe, resulted in normal growth and was well tolerated. Functional gastro-intestinal manifestations (functional constipation, regurgitation and colic) were significantly lower than reported in literature. Synbiotics (Bifidobacterium lactis and fructo-oligosaccharides) in cow's milk based infant formula bring the second choice infant feeding, formula, closer to the golden standard, exclusive breastfeeding.

The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects

  • Kim, Jae Hyun;Yun, Sungha;Hwang, Seung-sik;Shim, Jung Ok;Chae, Hyun Wook;Lee, Yeoun Joo;Lee, Ji Hyuk;Kim, Soon Chul;Lim, Dohee;Yang, Sei Won;Oh, Kyungwon;Moon, Jin Soo
    • Clinical and Experimental Pediatrics
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    • v.61 no.5
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    • pp.135-149
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    • 2018
  • Growth charts are curves or tables that facilitate the visualization of anthropometric parameters, and are widely used as an important indicator when evaluating the growth status of children and adolescents. The latest version of the Korean National Growth Charts released in 2007 has raised concerns regarding the inclusion of data from both breastfed and formula-fed infants, higher body mass index (BMI) values in boys, and smaller 3rd percentile values in height-for-age charts. Thus, new growth charts have been developed to improve the previous version. The 2006 World Health Organization Child Growth Standards, regarded as the standard for breastfed infants and children, were introduced for children aged 0-35 months. For children and adolescents aged 3-18 years, these new growth charts include height-for-age, weight-for-age, BMI-for-age, weight-for-height, and head circumference-for-age charts, and were developed using data obtained in 1997 and 2005. Data sets and exclusion criteria were applied differently for the development of the different growth charts. BMI-for-age charts were adjusted to decrease the 95th percentile values of BMI. Criteria for obesity were simplified and defined as a BMI of ${\geq}95th$ percentile for age and sex. The 3rd percentile values for height-for-age charts were also increased. Additional percentile lines (1st and 99th) and growth charts with standard deviation lines were introduced. 2017 Korean National Growth Charts are recommended for the evaluation of body size and growth of Korean children and adolescents for use in clinics and the public health sector in Korea.

Nutritional Management of Failure to Thrive (성장 장애아의 영양 보충)

  • Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.sup1
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    • pp.41-45
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    • 2009
  • Optimal nutrition in infancy and early childhood is the success behind good health, growth, and development of children. Failure to thrive may be the end point of any combination of a nutritional disorder, poor growth, and psychosocial deprivation. Hospital admission is rarely necessary and may be counterproductive. Day attendance, for investigation and observation of child-parent interaction, may be more valuable. Nutritional supplementation, together with nutritional counseling, can improve food intake and growth in children with failure to thrive.

LONGITUDINAL STUDY OF CRANIOFACIAL GROWTH BY LATERAL CEPHALOMETRIC ANALYSIS (정상교합 아동의 두개안면부 성장에 관한 종적 연구)

  • Yang, Kyu-Ho;Park, Chang-Hun;Son, Jung-Soo;Kim, Nak-Hyun;Choi, Nam-Ki;Kim, Seon-Mi;Kim, Ki-Baek;Shin, Hye-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.3
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    • pp.412-419
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    • 2009
  • The purpose of this study was to provide the reference data evaluating the treatment effect of orthopedic appliances. The skeletal and dental growth increments were measured in 24 normal mixed dentition children (boys: 14, girls: 10) by three serial lateral cephalograms: initial mean age: 9${\pm}$1.3 years, mean observation period: 13${\pm}$1.3 months. Cephalometric changes were analysed. The results were as follows: 1. In boys, the maxilla showed forward and downward growth pattern and the mandible showed forward growth pattern (p<0.05). In girls, the maxilla and mandible showed forward and downward growth pattern(p<0.05). 2. Horizontal growth of both maxilla and mandible in girls was superior to those in boys (A point; girls: 2.39mm, boys: 1.26mm, with p<0.05), whereas vertical growth of both maxilla and mandible in boys was similar to those in girls. 3. The change in tooth axis showed labioversion of upper incisor (p<0.01) and comparatively stable lower incisor position.

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The Cyclosporine-A Treatment does not have Harmful Effect on the Linear Growth of Pediatric Patients with Steroid-dependent and Steroid-resistant Nephrotic Syndrome

  • Lee, Sang Soo;Kim, Ji Hoon;Kim, Chung Ho;Cho, Byoung-Soo;Kim, Deog Yoon;Hong, Il Ki;Suh, Jin-Soon
    • Childhood Kidney Diseases
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    • v.20 no.2
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    • pp.45-49
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    • 2016
  • Purpose: This study was performed to evaluate the effects of cyclosporine-A (CsA) on linear growth in pediatric patients with steroid-dependent (SDNS) or resistant nephrotic syndrome (SRNS). Methods: Thirty-five pediatric patients with SDNS or SRNS undergoing glucocorticoid (GC) and/or CsA treatment were retrospectively reviewed. Seventeen patients were treated with GC alone and 18 were treated with GC and CsA. The cumulative doses of GC and CsA were quantified (mg/kg/day). Linear growth during the follow-up period was defined as the difference in Z-score between the initial and final height according to the follow-up period (${\Delta}$ height Z score/year). The associations between linear growth and clinical parameters were analyzed. Results: The linear growth of patients in the two groups was not significantly different (P=0.262). The ${\Delta}$ height Z score/year did not show a significant correlation with the cumulative doses of CsA, but was negatively correlated with the cumulative dose of GC and positively correlated with the Z score for height at the time of diagnosis. Conclusion: In children with SDNS or SRNS undergoing GC therapy, added CsA treatment may not have harmful effects on linear growth.