• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제9권1호
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• pp.14-22
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• 2006

목 적: 아연은 인체의 성장, 발육 및 면역기능에 필요한 미량 영양소이다. 아연의 만성결핍은 장성선단 피부염(acrodermatitis enteropathica)이 알려져 있지만 급성결핍에 관한 보고와 그에 따른 치료 기준은 알려져 있지 않다. 영유아의 급성 장염에서는 섭취량이 감소하고, 설사로 인한 아연의 배설이 증가하여 아연의 체내 영양상태에 대한 평가가 요구된다. 본 연구에서는 급성 장염 영유아에서 아연의 영양 상태 표지자인 혈청 아연농도를 측정하고 이에 영향을 주는 인자들을 알아보고자 하였다. 방 법: 2005년 5월부터 8월까지 이대목동병원 소아 응급실에 급성 장염으로 방문하였거나 입원한 5세 미만의 환아 중 32명(남아 15명, 여아 17명)을 대상으로 하여 임상적, 혈액학적, 생화학적 인자가 아연의 혈청 농도에 미치는 영향을 분석하였다. 아연농도의 측정은 유도결합 플라즈마 발광분광법을 이용하였다. 결 과: 임상적으로 구토 유무, 설사 기간, 탈수 정도, 혈변 유무에 따른 혈청 아연농도의 유의한 차이는 없었다. 혈청 아연농도는 발열 환아에서 열이 없었던 환아보다 유의하게 낮았다($67.0{\pm}25.3$ vs $85.5{\pm}14.2{\mu}g/dL$, p=0.012). 혈청 아연농도는 CRP 양성인 경우에 유의하게 낮았으나($63.9{\pm}25.4$ vs $85.7{\pm}13.8{\mu}g/dL$, p=0.002) 로타바이러스 감염 유무에 따른 차이는 없었다. 혈청 아연농도는 CRP (r=-0.494, p<0.05)와 유의한 음의 상관관계를 보였다. 혈청 아연농도는 헤마토크릿(r=0.370, p<0.05), 총단백질(r=0.474, p<0.05), 알부민(r=0.636, p<0.05)과 유의한 양의 상관관계를 나타내었다. 혈청 아연농도가 $70{\mu}g/dL$ 이상인 군과 미만인 군을 비교하였을 때, $70{\mu}g/dL$ 미만인 군에서 CRP 양성인(91.7% vs 40%) 환아와 CRP 양성이면서 발열이 동반되었던 환아의 빈도(91.7% vs 35%)가 유의하게 많았다(p<0.05). 결 론: 급성 장염 소아에서 혈청 아연농도는 발열, CRP, 헤마토크릿, 총단백질, 알부민 등의 다양한 인자의 영향을 받으므로 체내 아연의 영양 상태를 평가할 때 고려하여야 한다.

• Clinical and Experimental Pediatrics
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• 제49권5호
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• pp.552-557
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• 2006

목 적 : 최근 성조숙증에서 사춘기를 중단시킴으로써 성인신장을 증가시킬 수 있으리라는 기대로 조기 사춘기로 인하여 신장에 대한 예후가 불량한 소아에서 성선자극호르몬 방출호르몬 효능약제의 시도가 이루어졌다. 이에 저자들은 조기 사춘기로 예측 성인신장이 저하된 여아에서 이 약제의 신장 증가효과를 분석하고자 하였다. 방 법 : 소아과 외래에 조기 사춘기와 예측성인신장이 저신장으로 예측되는 36명의 여아를 대상으로 GnRHa를 6개월 이상 사용한 제 1군과 6개월 미만 사용한 제 2군으로 나누어 치료 시작시와 치료 후의 역연령, 골연령, 신장 및 표준편차치, 예측성 인신장 및 표준편차치, 표적키 및 표준편차치, 혈청 IGF-1, IGFBP-3 치를 비교하였다. 결 과 : 1군의 평균 치료기간은 $1.37{\pm}0.92$년, 2군은 $0.41{\pm}0.08$년이었고, 전체적으로는 $0.89{\pm}0.81$년이었다. 치료 시작시 두군 간에 역연령, 골연령, 신장, 표적키, 예측성인신장, 혈청 IGF-1 및 IGFBP-3 치의 차이는 없었고, 마지막 추적시 두 군간에 역연령, 골연령, 신장, 예측성인신장, 혈청 IGF-1 및 IGFBP-3치의 차이도 없었다. 두 군 사이에 성장속도와 치료기간에 따른 예측성인신장의 증가분은 2군이 의미 있게 높았다. 이는 2군이 치료기간이 짧아 사춘기의 성장속도가 충분히 억제되지 않은 결과로 보인다. 치료 시작시에 비하여 마지막 추적시의 예측성인신장은 의미 있게 증가하여 단기간의 치료에도 어느 정도의 효과($3.7{\pm}3.2cm$)는 있었다. 전체 대상아에서 표적키($157.3{\pm}3.1cm$)와 치료 시작시 예측성인신장($148.5{\pm}5.8cm$) 사이에는 의미있는 차이가 있었으며, 마지막 추적시의 예측성인신장($152.2{\pm}5.9cm$) 사이에도 의미 있는 차이가 있었다. 검사 소견에서 혈청 IGF-1과 IGFBP-3는 치료 시작시에 비하여 마지막 추적시에는 의미 있게 감소하여 GnRHa의 사용으로 성장호르몬-IGF 축이 다소간 억제되는 것으로 보인다. 결 론 : 사춘기가 조기에 시작하여 골연령이 역연령에 비하여 증가되어 예측성인신장이 표적키에 못 미치는 경우에 단기간의 GnRHa의 사용으로 예측성인신장은 다소 증가하였으나 표적키에는 미치지 못함을 알 수 있었으며, 성장호르몬-IGF 축의 억제가 동반되는 점에서 GnRHa 치료시 예측성인신장이 표적키에 이르기 위해서는 성장호르몬의 동시 사용이 필요하겠다.

• 대한소아치과학회지
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• 제24권1호
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• pp.204-219
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• 1997

The use of fluoride is one of the most effective methods for caries prevention. Fluoridation of public water supply has been recognized, for many years, as an effective way to reduce dental caries. The fluoride supplement has been recommended when the natural fluoride was unavailable or below the optimal range. However the mechanism of caries prevention by fluoride has not yet been clarified and it is well known that an overdose of fluoride results inacute and chronic toxicity, especially dental fluorosis. Fluoride mouthrinsing solution is widely used in dentistry due to its effectiveness in carrying anticariogenic action. Understanding the effects of fluoride mouthrinsing solution on human gingival fibroblasts will provide the safety rationale for its use during the caries preventive therapy. The purpose of this study was to evaluate the cytotoxic effect of fluoride mouthrinsing solution on the human gingival fibroblast in vitro. The human gingival fibroblasts were cultured from healthy gingiva on the extracted deciduous teeth of children. Cells were inoculated into a 24-well plate with $1{\times}10^4cells/well$ of medium at $37^{\circ}C$, 100% humidity, 5% $CO_2$ incubator for 24 hours. And the cells were counted by using the hemocytometer at each designed study. Human gingival fibroblasts were cultured in growth medium after one minute application range of 0.02%-0.2% NaF solution and 0.1% $SnF_2$ solution. The cells used in this study were between fifth to eighth passage number. The cell morphology was examined by inverted microscope and cell proliferation was measured by incorporating $[^3H]$-thymidine into DNA. DNA synthesis by human gingival fibroblasts was assessed by $[^3H]$-thymidine uptake assays while the cell activity was measured by MTT assay. Each concentrated fluoride mouthrinsing solution was estimated for its biocompatability with fibroblasts by the tissue culture technique. The results of this study were as follows : 1. It was observed that at 0.05%, 0.2% NaF mouthrinsing solution the cytoplasmic processes became globular. When 0.1% $SnF_2$ mouthrinsing solution was applied, the cytoplasmic process and cell morphology were disappeared. 2. DNA synthetic activity was reduced regardless of the concentration of the fluoride mouthrinsing solution. However, the result is statistically insignificant except 0.1% $SnF_2$ mouthrinsing solution(p<0.05). 3. Our results indicate that 0.02%, 0.05% concentrations of NaF mouthrinsing solution caused minimal cytotoxicity. But 0.2% NaF and 0.1% $SnF_2$ concentration were a significant difference between the cell activity in the experimental group and control group (p<0.05). 4. After appling 0.05% & 0.02% NaF fluoride mouthrinsing solution, cell activity was restored to the control groups level according to incubating time. The results suggest that direct exposure to fluoride solution inhibits gingival fibroblast activity. Therefore, for the most effective use of fluoride use, lowering the concentration of fluoride mouthrinsing is advisable because it maintains biocompatability and free ion in the oral fluid.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제21권3호
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• pp.153-160
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• 2010

Objectives: The purpose of this study was to evaluate the prenatal, perinatal, and infancy history of children with autism spectrum disorder (ASD) as compared to unaffected siblings (SIB) and typically developing children (TC). Methods: Subjects with ASD, their SIB, and TC were recruited. All subjects were assessed using both the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R) and the Korean version of Autism Diagnostic Observation Schedule (K-ADOS) and were subsequently identified as affected or unaffected. Prenatal, perinatal, and infancy history was obtained from the primary caregivers and each facet was compared in those with ASD, the SIB, and the TC groups using SPSS ver. 17.0 (p<.05). Results: 70 individuals with ASD (63 males, 87.94${\pm}$37.8months), 53 SIB (27 males, 85.4087.94${\pm}$48.06 months), and 32 TC (19 males, 104.1987.94${\pm}$23.409 months) were analyzed. The ASD group showed significantly higher rates of insufficient vaccination as they aged age ($x^2$=15.54, p=.000). Among the scheduled vaccinations, the DPT vaccination ($x^2$=10.08, p=.006) was insufficient in ASD groups. The ASD group also showed higher rates of sleep disturbances from infancy. Differences in maternal/paternal age at conception, gestational age, and growth parameters at birth were not significantly difference among the three groups. Conclusion: These results do not support the previous controversies regarding the relationship between prenatal/perinatal complications and ASD. However, these results indicate that perinatal and prenatal factors may contribute to the development of ASD.

• Pediatric Infection and Vaccine
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• 제25권3호
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• pp.113-122
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• 2018

목적: 국내에서 cryopyrin-associated periodic syndrome (CAPS) 환자로 진단된 소아들의 임상 양상을 확인하고자 하였다. 방법: 2000년부터 2015년까지 서울대학교 어린이병원에서 CAPS로 진단받은 9명 소아들의 의무기록을 분석하였다. CAPS의 진단은 처음에는 임상 양상과 병력에 근거하였고 CIAS1 유전자의 돌연변이를 통해 최종 확진하였다. 결과:모든환자는재발하는열및두드러기발진이있었다. 9명의환자중 6명은발진이그리고 4명은발열이출생 1일또는 2일 안에 있었다. 근육통을 보인 환자는 8명이었고, 관절통이 있는 환자는 7명이었다. 이들은 방사선학적 소견 상 골단의 과도한 성장, 골감소증 또는 연골의 과성장과 같은 소견을 보였다. 4명의 환자는 뇌위축, 뇌실 확장 또는 자기공명영상에서 연수막 증대 소견을 보였다. 지적 장애가 1명에서 관찰되었다. 5명의 환자가 결막염, 포도막염, 맥락 망막염, 유두 부종으로 시력에 영향을 받았으며 3명은 진행성 난청을 보였다. 9명 모두에서 초기 C-반응성 단백질과 적혈구 침강속도가 증가되었다. 모든 환자는 CIAS1 유전자의 exon 3에서 돌연변이를 보였다. Anakinra 치료 후 발열과 발진이 사라졌으며 C-반응성 단백질과 적혈구 침강 속도가 호전되었다. 결론: 이 연구는 국내에서 처음으로 CAPS 환자들의 임상 증상을 고찰한 논문으로 향후 새로이 환자들을 진단하는데 유용할 것이다. 또한 환자들의 장기적인 합병증을 예방하기 위해 이른 나이부터 발생하는 반복적인 발열과 발진이 있는 소아에서 조기에 CAPS를 진단하고 치료하는 것이 중요하다.

• 대한소아치과학회지
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• 제44권4호
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• pp.455-460
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• 2017

스티븐 존슨 증후군(Stevens-Johnson syndrome, SJS)은 피부와 점막에 광범위한 괴사를 초래하는 매우 심각한 급성 과민반응이다. SJS은 모든 연령대에서 발생할 수 있는 질환으로 원인은 명확하지는 않지만 대부분 약물 알레르기에 의한 것으로 알려져 있으며 그 외에도 세균감염에 의해 유발되기도 한다고 알려져 있다. 전체 표피면적의 10% 이하에서 병변이 발생한 경우를 SJS라 하며 30% 이상에서 발생한 경우를 독성 표피 괴사융해라 정의한다. SJS는 1년에 100만명 인구 당 1 - 2명 미만에서 드물게 발생하나, 성장기 어린아이에게 발생할 경우 치아발육 등에 미치는 영향을 미치게 된다. 6 - 7세경 상하악 제1대구치와 하악중절치의 맹출이 시작되고 이 시기에 치근의 발육이 함께 일어난다. 이 케이스의 환아의 경우 6세경 SJS이 발병하였다. 현재 완치된 상태이나 몇몇 후유증이 남아있는 상태이다. 환아는 이 시기에 발육이 완성되는 치아에 국한되어 발육이상이 관찰되었다. 구강내 특징으로 이러한 전신질환을 진단하고 이로 인한 치아 발육에 대한 영향에 대한 문제점을 인식하고 해결하고자 이 보고서를 쓰는 바이다.

• 한국인구학
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• 제8권1호
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• pp.118-138
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• 1985

This paper is aimed to analyse the recent changes in family planning as a step in an evaluation of the results of the population control policy which has been strenuously pursued by the government since December 1981. The data used in this analysis comes from the 1985 national fertility and family planning survey conducted by the Korea Institute for Population and Health (KIPH) in May 1985. According to the 1985 survey data, there have been great changes in both the contraceptive practice and fertility rates since the strengthening of the government's population control policy in 1 981. The contraceptive practice rate for married women aged 15-44 has increased from 57.7% in 1982 to 70.3% in 1985, an increase of 12.6% points in the short span of only 3 years. During the same period, the total fertility rate has declined from 2.7 in 1982 to the population replacement level which was planned to achieve by 1 988. More than 80% of women aged over 30 or with two children or more are practicing contraception, while the practice rates of women with 0-1 children are 14.0% and 45.1% respectively. The survey has revealed that the increase of contraceptive practice rate during 1982-1985 has mainly attributed to the high acceptance of sterilization procedures which practice rate of the married women has increased from 28.1% to 40.3% for the period. Also, the survey data shows that 24.7% of those women with only one child is practicing contraception for thepurpose of fertility termination. The government, taking into account of rapid changes in contraceptive practice and fertility rates, is formulating a population plan during the sixth fiveyear economic and social development plan (1987-1991) to achieve 1% ofpopulation growth rate by 1993, which was planned to realize by 2000. In order to meet this demographic goal, the existing population control policy measures should be improved to be suited to the recent contraceptive use and fertility changes. From this standpoint, the following considerations should be put forth; 1) improvement of the current program management systems including target allocation and evaluation schems for recruiting new acceptors in the young 20s groups to use contraceptives for birth spacing and to increase high continuation rates through the strengthening of follow-up services for the acceptors, 2) increase of self-supporting contraceptive users by promoting commercial advertisements on contraceptives through mass media including T.V. and radio, 3) development of social support policies including incentive schems, and strengthening of IE & C activities for increasing the proportion of the one-child family, 4) strengthening of population and family planning education in and out school youth, and 5) strengthening of management capabilities at the provincial and local program managers.

• 한국학교ㆍ지역보건교육학회지
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• 제1권1호
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• pp.61-82
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• 2000

The purpose of this study was to find out the general problems of school food service and to explore a way to improve it, by examining elementary school teacher's consciousness and attitude toward it that gave a big impact on children's development of food habit. For attaining the purpose, the following research questions were posed : 1) What's elementary school teacher attitude toward school food service management? 2) What's elementary school teacher attitude toward school food service effect on children? 3) What's elementary school teacher opinion about how to develop school food service? The subjects of study were 328 male or female teachers who served at elementary school in urban and rural area, including eup, myon, or farming and fishing villages, Kyonggi province. A questionnaire survey was conducted over them. The conclusions were as follows: 1) Teacher Attitude Toward School Food Service Management Concerning food service place, the subjects were more satisfied at food service room(73.3%) than at classroom(23.0%). They responded that food service room was more effective, than classroom, for food transportation, distribution and post-arrangement. Their satisfaction at food service place was significantly different. The older teachers considered personnel management and cooking room's sanitary management to be more efficient, and their age made a significant difference to their consciousness of these things. Many teachers(63.1%) thought the measures to prevent and manage group food poisoning were relatively efficient. The male teachers expressed more affirmative view on the efficiency of school food expense management and menu preparation than female teachers, and there was a significant disparity between male and female teachers. 2) Elementary School Food Service Effect School food service was thought to be very effective for physical growth(74.1%) and physical strength improvement(70.1%). Teachers at smaller school revealed more affirmative response toward school food service effect on correcting an unbalanced diet, and older teachers considered its effect on nutrition knowledge acquisition and learning outcome to be more great. Teachers at larger school put less value on its effect on table manners, and school size produced a significant difference. The number of teachers who thought school food service generally raised parent concern and support for school(36.6%) was a little more than that of teachers who didn't think so(15.2%). And the number of teachers who didn't consider its effect on improving parent food life to be good(29.3%) was slightly more than that of teachers who did. 3) School Food Service Reform Measure What's most urgently needed for better school food service management appeared to be an expansion of facilities concerned, followed by more effective food distribution and transport, cooking room's better sanitary management, more successful food poisoning prevention and management, more effective food expense management, and an increase of food service personnel in the order named. The most effective means of school food service education was found to be a creation of link system to family, followed by a development of school food service education program, a development of teaching materials, an insertion of school food service in curriculum, and teacher education in the order named.

• Clinical and Experimental Pediatrics
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• 제53권3호
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• pp.432-436
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• 2010

일과성 신생아 당뇨병은 6번 염색체의 부친 이체성, 부친으로부터 유래한 염색체 6q24의 중복, ZAC 또는 HYMAI 유전자의 CpG 섬의 메틸화 결함에 의해 야기된다. 저자들은 고혈당, 거설증, 자궁내성장지연으로 발현되어 부친으로부터 유래된 HYMA1 유전자만을 보인 일과성 신생아 당뇨병 1례를 경험하였다. 생후 18일된 여아가 거설증과 반복되는 고혈당으로 입원하였다. 거설증과 함께 큰 대천문, 작은 턱, 두드러진 눈을 보였으며 혈중 포도당 농도는 200-300 mg/dL로 유지되다가 입원 2일 후부터 인슐린 투여 없이도 정상 범위로 유지되었다. 모체로부터 유래된 메틸화된 대립유전자 유무를 확인하기 위하여 말초 혈액으로부터 genomic DNA를 추출하여 bisulfite를 처리한 후, 메틸화 특이 중합 효소 연쇄 반응으로 HYMAI 유전자의 일부분을 증폭시키고, 제한 효소 BssHII를 이용한 제한 효소 절편 길이 다형성 (restriction fragment length polymorphism, RFLP) 분석을 이용하여 HYMAI 유전자의 메틸화 여부를 확인한 결과, HYMAI 유전자의 메틸화 결함을 보여 부친에서 유래된 HYMAI 유전자만을 갖고 있음을 확인하였다. HYMAI 유전자의 메틸화 검사를 통해 6번 염색체의 각인된 유전자가 증명되었으며 메틸화 결함으로 인해 일과성 신생아 당뇨병이 발생하였다.

• Child Health Nursing Research
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• 제8권4호
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• pp.449-457
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• 2002

The main purpose of this study is to examine the concepts appeared on researches and provide the future research directions in field of child health nursing. A descriptive study was conducted. 205 studies were included in an analysis the concepts in terms of the domain of client for a total 321 researches. All were originally published between 1990 and 2000 in Korea. An analysis of concepts for this study was used the metaparadigm framework for nursing proposed by H.S. Kim(2000). The concepts for this study were categorized by essentialistic concepts, problematic concepts, health-care experiential concepts with the following results. 1. Based on the four domains suggested Kim (2000), 205 studies(63.9％) belong to the domain of client ; 109 studies(34％) belong to the practice domain of nursing; 3 studies(0.9％) belong to the client-nurse domain; and 4 studies belong to the domain of environment, respectively. 2. In the domain of client, 117(57.1％) studies used concept of parent. Among them, mother was the prevailing research population(103 studies). 64 studies(31.2％) used child population and the developmental stage of children varied from preterm to puberty but school aged children was the most target population(28 studies). Family as a concept of client was used in 20 studies(9.8％) but most primary care provider was the mother. 3. In terms of research design, non-experimental design(83.5％) is the most and among them survey was 159 studies(77.6％). Qualitative research(23 studies) and experimental research(10 studies) methods were used relatively few. 4. In terms of the categories of concepts, 196 (61.4％) studies included the essentialistic concepts like stress and coping(20.4％), mothering role and child care(7.8％), health (5.6％), breast feeding(4.7％). 31 studies included problematic concepts like power-lessness, safety, obesity, pain, anxiety. And 65 studies included health-care experiential concepts like compliance, growth, hope, environment but relatively few. The findings of this study provide the evidence that research related problematic concept and health-care experiential concept should be conducted actively to improve the practice of child health nursing. Also to deeply understand the phenomena of client in field of child health nursing, interpretive research methods should be conducted actively, too.