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A case of lethal kwashiorkor caused by feeding only with cereal grain (미음 수유만으로 발생한 치명적인 Kwashiorkor 1례)

  • Lee, Hyun Ju;Km, Kyung Hye;Park, Hye Jin;Lee, Kye Hyang;Lee, Gyeong Hoon;Choi, Eun Jin;Kim, Jin Kyung;Chung, Hai Lee;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.329-334
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    • 2008
  • Kwashiorkor is a syndrome of severe protein malnutrition, which manifests itself in hypoalbuminemia, diarrhea, dermatitis, and edema. It can be life-threatening due to associated immune deficiency and an increased susceptibility to infections. Kwashiorkor should be treated early with nutritional support and the control of infection. Dilated cardiomyopathy may develop during the treatment and in such cases a poor prognosis is expected. Kwashiorkor has been known as a common disease of poor countries. To date, in fact, there has been no report of kwashiorkor leading to death in technically advanced countries. We here report a fatal case of a baby girl admitted with kwashiorkor. She had been fed only with cereal grain mixed with juice, without any protein supplement, for 2 months. This diet was deficient not because of poverty, but due to the illiteracy of her parents. The patient suffered from diarrhea, whole body edema, hypothermia, and dermatitis. Laboratory findings revealed an immune-deficient state featuring leukopenia and decreased immunoglobulin. Blood and urine cultures revealed Alcaligenes Xylosoxidans growth. The patient was fed frequent small amounts of protein-containing formula and intravenous albumin and micronutrients were administered for nutritional support. She was also treated with intravenous immunoglobulin and antibiotics in order to control infection. Nevertheless, she developed dilated cardiomyopathy and multi-organ failure and died. We review this case in light of the literature.

A Comparison of Eating Habit, Food Intake and Preference between Juvenile Delinquents and Male High School Students (교정시설 소년수용자와 일반 고등학교 남학생의 식습관, 식품 섭취 및 기호 비교)

  • Park Soon-Seo;Park Mo-Ra
    • Journal of Nutrition and Health
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    • v.39 no.4
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    • pp.392-402
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    • 2006
  • The purpose of this study was to compare the eating habit, food intake frequency and preferred food and taste of juvenile delinquents (100 numbers) and male high school students (100 numbers), using questionnaires from August to October 2004. 1) It was shown that the juvenile delinquents took more unbalanced diet (p<0.05), smoking (p<0.001) and drinking (p<0.001) than general students, while general students had more eating between meals (p<0.01). 2) The intake of food was a significant difference in white rices (p<0.01), bibimbab (p<0.001), kimbab (p<0.001), fried rice (p<0.001), ramen (p<0.001), jajangmyun (p<0.001), jambong (p<0.001), hamburger (p<0.001), pizza (p<0.001) and breads (p<0.05). The juvenile delinquents took more major food than that of general students in all the items except for white rice. It was observed, then, that the juvenile delinquents showed more intake of such subsidiary foods as bulgoki (p<0.001), roasted thin pork chops (p<0.001), grilled pork belly (p<0.001), pork cutlet (p<0.01), sweet and sour pork (p<0.001), chicken with ginseng (p<0.001), fried chicken (p<0.001), kimchi pot stew (p<0.01) and zucchini (p<0.05) than general students, with general students taking more kimchi (p<0.01) and fried or boiled soybean curd (p<0.01). The intake of dessert was a significant difference in yogurt (p<0.01), orange juice (p<0.001), cola (p<0.001), soft drinks (p<0.001), ion drinks (p<0.001), coffee (p<0.001), apple (p<0.01), banana (p<0.001), orange (p<0.001), cake (p<0.001), hot dog (p<0.001), ddokbokgi (p<0.01), mandu (p<0.001), fried fish paste (p<0.05), steamed korean sausage (p<0.001), fried foods (p<0.05), hem & sausage (p<0.001), cheese (p<0.001), ice-cream (p<0.001), candy (p<0.01), chocolate (p<0.001), mayonnaise (p<0.05), jam (p<0.01) and butter & margarine (p<0.01). Then, the juvenile delinquents were shown to entirely have more intake of all the desserts than those of general students. 3) Regarding preference of foods, it was shown that the juvenile delinquents preferred cereals (p<0.05), grilled pork belly (p<0.001), chicken with ginseng (p<0.01), anchovies and small fish (p<0.05), chicken with ginseng (p<0.05), seasoned spinach (p<0.001), seasoned zucchini (p<0.001), milk (p<0.05), coffee (p<0.001) and butter & margarine (p<0.05) while general students did egg (p<0.01), soybean sprout soup (p<0.001), boiled or fried potato (p<0.05), seasoned soybean sprout (p<0.05), boiled or fried soybean curd (p<0.01), fried foods (p<0.01) and snack (p<0.05). For their preference of tastes, hot taste (p<0.01) was higher in the juvenile delinquents. 4) Under general environments there was a change of the difference in their behaviour of pork cutlet (p<0.01) intake in accordance with other family and of milk (p<0.001) and butter & margarine (p<0.05) preference in accordance with growth in a big city between the two groups.

The Structure of Digestive Tract and Histological Features of the Larvae in Sevenband Grouper, Epinephelus septemfasciatus (능성어 (Epinephelus septemfasciatus) 자어의 소화기관 구조 및 조직학적 특징)

  • Park, Jong Youn;Kim, Na Ri;Park, Jae Min;Myeong, Jeong In;Cho, Jae Kwon
    • Korean Journal of Ichthyology
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    • v.28 no.1
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    • pp.9-18
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    • 2016
  • Histological and morphological development of the digestive tract of sevenband grouper were observed from after hatching to 60 days. Fishes were fed with rotifer (Brachionus rotundiformis) and chlorella (Chlorella ellipsoidea) after hatching from 2 to 20 days rotifer and brine shrimp (Artemia salina) in after 20 days rotifer, brine shrimp and semi-dry artificial diet in after 23 days. Histological and morphological development of ten larvae was observed by paraffin embedding method after fixing in 10% neutral buffered formalin. Sevenband grouper RLG showed characteristics of carnivorous fish by average 0.87. Larvae after hatching can't open the mouth and anus digestive tract was observed in a straight line following yolk sac. Larvae was observed feeding activity by opening the mouth and anus. Metamorphosis started 8 days after hatching. Esophagus divided four layer, and goblet cell was observed in esophagus, mid intestine and rectum. Larvae started cannibalism and it was caused by difference of growth. The inside of stomach was differentiated to cardiac orifice, body of stomach, pyloric stomach, and pyloric caeca. Goblet cell was observed all intestine. Gastric gland differentiated after hatching 28 days in stomach. Secretion of gastric juice was found at stomach and mucosal fold pyloric caeca. Even thought the inside of stomach expended and the number of gastric gland increased consistently and goblet cell in intestine and mucosa became longer, histochemical changes follow couldn't be found during transforming juveniles 38 days after hatching.

Analysis of Relationship among the Intake Frequencies of the Food Items on Food Frequency Questionnaire Administered to Middle Aged Korean Males (한국 중년 남성을 대상으로 한 식품 섭취빈도 조사에서 나타난 식품섭취빈도의 상관성 분석)

  • 백희영
    • Journal of Nutrition and Health
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    • v.33 no.2
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    • pp.202-215
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    • 2000
  • Intake frequency of one food is often associated with other food items, but few studies examined the relationship of food intake frequency among food items. Finding the relationship among intake frequencies of different food might be useful to understand the food intake patterns of population and correlated foods would be used as an indicators of another food intake. Relationship of food intake can be also applied to make a more simple and useful form of food frequency questionnaire to assess the association between diet and various diseases. The objective of this study was to examine the correlation of intake frequency among food items in food frequency questionnaire (FFQ). A FFQ with 84 food items was administered to 14533 Korean males who 40-65 years of age participating Korean cancer research survey. Data fromm 7647 subjects who completed FFQ were used to examine correlation among food items with three different methods-log linear regression models, Spearman correlation coefficients and cell frequency distribution. To examine the rank correlation, coefficients were calculated by Spearman correlation after scoring the frequency categories. Three most correlated foods were selected in every food intems by three methods each. In most food items, there was positive correlatin, except cooked rice and cooked brown rice, in intake frequency between foods that belonged to similar food groups. But serveral food items-Sausage (processed fish, cheese), Milk (whilte bread, orange juice), Soymilk(other juices), Cheese (pizza, butter), and Coffee(thick beef soup)-showed correlation among totally different food groups. Two sets of food items which were selected by log linear regression model and Sperman correlation coefficients were compared. There were exactly three common foods in 18 food items, 2 common foods in 47 items, 1 common food in 16 items and no common food in 3 items among 3 ranked foods. Three sets of selected food were compared. There were exactly three common foods in 5 food items, 2 common foods in 21 items, 1 common food in 34items and no common food in 24 items among 3 ranked foods. These results indicate that certain patterns exist among intake frequencies of specific food items in the FFQ. More researches are suggested to understand the relationshiops among the intakes of foods so that this information can be used in developing better FFQ or analyzing missing items from self-administered FFQ.

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The Elderly Health and Dietary Management in Gyeonggi Province II - Comparison with Younger Old and Older Old - (경기지역 노인의 건강과 식생활관리 II - 75세 미만의 젊은 노인과 75세 이상 고령 노인 비교 -)

  • Rhie Seung-Gyo;Choi Mi-Yong;Won Hyang-Rye
    • The Korean Journal of Community Living Science
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    • v.17 no.1
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    • pp.141-154
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    • 2006
  • The purpose of this study is to provide the information of the aged olds for which basic data are almost no available. The subjects were divided on the base of age 75. The elderly under 75 were named 'the young olds' and over 75 were 'the aged olds'. The aim of this research is to promote health and to improve nutrition, and the survey was made for health promotion behaviors, habits against health risk, dietary management status and diet intake. And it was conducted by 24 hr-recall method and analyzed by nutrients intake. 242 subjects were collected in 12 cities or counties in Gyeonggi Province and 20 elderly people (10 male and 10 female) were selected out of 1 village in each district. Questionnaire about health behavior and dietary management was carried out by interview method through regional home extension workers. Statistical analyses were made by SAS (version 8.1) and Chi-square tests and General Linear Models were used. Out of the subjects the aged olds over 75 was 31.9%, elementary school educated (93.5%), with spouse (40.3%), with adult children(28.6%), monthly living cost of 500-1,000 thousand won(40.3%). Mean age was 78.82 years compared with 69.75 years of the young olds. 46.8% of the aged olds used monthly pocket money over 1000 won and it was lower than 63.3% of the young olds. Only half of the aged olds had regular exercise of walking (77.8%) or with athletic equipment (17.8%). However, the young olds did more frequent walking (82.1 %) and less exercise with athletic equipment (4.8 %), which was significantly different. Kinds of disease were different with the young or the aged olds, as more proportion of cardiovascular disease(37.9%) for the young olds and joint lumbago neuralgia(41.6%) for the aged olds. Dietary management was good (3 meals per day: 93.4%, fixed mealtime: 72.4%, and regular amount: 79.9%). But there was significant difference in side dish varieties and kinds of snacks; for the aged olds only 8% had over 5 sorts (compared with 18.8% of the young olds) and the kinds of snacks were cookie, candy, juice, carbonated beverage for the aged olds (compared with noodle, milk, soybean-milk for young olds). The ratio of nutrients intake (energy, riboflavin and niacin) with RDA was significantly higher for the aged olds than that of the young olds. The surveyed subjects had no difficulties in Activities of Daily Living (ADL), but some of the aged olds had difficulties in Instrumental Activities of Daily Living (IADL) like housekeeping, using transportation, going shopping and making phone calls. These results suggest that low quality of life is linked with low economic status of the rural elderly and congregate meal at village hall would be required because of the lack of side dishes variety for the aged olds. And nutrition education program about good snacks and exercise practice would be needed for the aged olds. By operating nutrition education program the aged olds would enjoy better quality life maintaining or ameliorating IADL abilities.

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Leaf Protein Affect the Concentration on Serum Cholesterol and Free Amino Acids in Rats (녹엽단백질 급여가 흰쥐 혈청 콜레스테롤 및 유리 아미노산 농도에 미치는 영향)

  • 조영수;김성규;김도훈;정순재;차재영
    • Journal of Life Science
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    • v.9 no.1
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    • pp.35-43
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    • 1999
  • Leaf protein (LP) was prepared by centrifugation the green juice from Italian ryegrass (Lolium multiflorum Lam.) at acid precipitation. LP was compared with casein and soybean protein isolate for their concentration of serum lipids and free amino acids in Wistar male rats for 2 weeks. Each protein source was incoporated into cholesterol free, low-fat diet to provide a protein level of 20%. A comparison of serum amino acids in leaf protein-fed vs. casein-fed rats showed that, glycine was the only amino acid having a higher concentration whereas concentration of other amino acids were lower in the leaf protein-fed rats compared with the casein-fed rats. Further alanine was significantly lower in the leaf protein-fed rats compared with the casein-fed rats, and the protein-induced differences in glycine and alanine concentration of unfed rats were reproducible. Concentration of several amino acids, rarticularly valine, leucine and tyrosine, also changed when serum cholesterol concentrations varied, but these effects could not be explained by our experiments. The results suggest that a change in serum concentration of glycine and alanine of unfed rats may be related to the change in serum cholesterol concentration. These data also suggest appear to function in a similar way to soybean protein in their hypocholesterolemic action.

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Estimation of Daily Per Capita Intake of Total Phenolics, Total Flavonoids, and Antioxidant Capacities from Fruit and Vegetable Juices in the Korean Diet Based on the Korea National Health and Nutrition Examination Survey 2008 (2008년 국민건강영양조사에 근거한 과채류 주스 음용으로부터 한국인의 일인당 하루 총페놀, 총플라보노이드 및 항산화능 섭취량 추정)

  • Lee, Bong-Han;Kim, Sun-Young;Cho, Chi-Heung;Chung, Dae-Kyun;Chun, Ock-K.;Kim, Dae-Ok
    • Korean Journal of Food Science and Technology
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    • v.43 no.4
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    • pp.475-482
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    • 2011
  • From an analysis of the daily consumption per capita (g/capita/day) in the existing dataset of the Korea National Health and Nutrition Examination Survey 2008, the top seven fruit and vegetable juices (apple, grape, mandarin, orange, pineapple, pomegranate and tomato) commercially available on the Korean market were selected and analyzed. These juices showed a wide range of levels of total phenolics, total flavonoids, and antioxidant capacities. The daily per capita intake of total phenolics from juice consumption was 11.70 mg gallic acid equivalents and that of total flavonoids was 1.65 mg catechin equivalents. The daily per capita intakes antioxidant capacities were 10.42 mg vitamin C equivalents (DPPH assay) and 13.21 mg vitamin C equivalents (ABTS assay). Daily per capita intakes of total phenolics, total flavonoids, and antioxidant capacities were influenced by the compositional content and the daily consumption of fruit and vegetable juices.

The Survey on Food Habits of Boy Students Living in Jeonbuk Region (전북 일부지역의 남자 중${\cdot}$${\cdot}$대학생의 식습관 조사)

  • Chang, Hye-Soon;Kim, Mi-Ra
    • Korean Journal of Human Ecology
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    • v.5 no.1
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    • pp.71-84
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    • 2002
  • The purpose of this study was to investigate food habits of boy students and to know the difference in food habits between boy and girl students. A previous study had been conducted to girl students in 1998 and this study was carried to boy students in Oct. 2000 using the questionnaires. The subjects were 783 boy students in middle school, high school and university students living in Jeonbuk region. The average score of food habits was $4.09{\pm}1.72$ out of a possible 10(middle school students were $4.96{\pm}1.85$, high school students were $4.17{\pm}1.61$ and university students were $3.15{\pm}1.70$). The average is similar $4.11{\pm}1.63$ to girl students in 1998. The correlation coefficient between the score of food habits and standard of living, present residence, taking nutritional supplements, and sort of school was positive. As a staple food, cooked rice was preferred 95.9% of subjects and this result is similar to girl students of previous study. The most preferred side-dishes was different between girl and boy students. Boy students liked stew the best, but girl students liked Kimchi the best. The most preferred snacks was fruits and fruit juice. The portion of eating cooked rice in boy students (87.8%) was decreased than girl students(90.6%) at breakfast. The main meal to have soup & stew was supper and the most delicious meal was also supper, but primary meal skipped was breakfast. The reasons for skipping breakfast were lack of time(38.7%) and no appetite(17.6%), skipping lunch was missing a time to eat(8.4%), and skipping supper was no appetite(10.5%). Substitution food on no preparation of lunch basket was difference between middle and high school students and university students. Middle and high school students ate noodles and university student ate cooked rice. The preference of snack was that chicken(20.3%) was the best. The time of eating snacks was that anytime(38.6%) was the first, after supper(13.7%) was next. In order to improve the nutritional status of boy students, they must establish good food habits by eating three regular meals per day and balancing their diet. Especially university student must build their regular life style, so they would have three regular meals.

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Fermentation and Quality Characteristics of Kwamaegi added Kimchi (과메기 첨가 김치의 숙성과 품질특성)

  • Jung, Yoo-Kyung;Oh, Seung-Hee;Kim, Soon-Dong
    • Food Science and Preservation
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    • v.14 no.5
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    • pp.526-530
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    • 2007
  • The effects of kwamaegi (0, 6, 12 and 18%, all w/w) on the quality characteristics of Kimchi during fermentation at $10^{\circ}C$ were investigated. The mixtures are denoted KK. The late of decrease in pH during KK fermentation was lower than that of control. The number of total microbes (T) in Kimchi controls fermented for 14 days did not differ, and were in the range of $8.64{\sim}8.68\;log\;CFU/g$, whereas the numbers of lactic acid bacteria (L) in KK were higher than in controls. The L/T(%) was 78.41 in control, 85.76 in 6% KK and $93.68{\sim}94.25%$ in the 16% or 18% KK samples. The hardness of tissue ($2.98{\sim}3.66{\times}10^7\;dyne/cm^2$) in KK fermented for 14 days was higher than that of control ($2.67{\times}10^7\;dyne/cm^2$). The content of alcohol-insoluble substances in KK juice (1.281.08 g/100 g) was lower than that of control (1.45 g/100 g). In sensory evaluation, the appearance and texture of KK were better than those of control. Although some fishy flavor was noted in KK, this did not affect acceptability. Sourness was less, whereas ripened taste and overall acceptability were higher in KK (especially 12% KK) compared to control.

Nutritional quality of leaf proteins prepared from crops containing phenolic compounds and polyphenolase (Phenolic compound와 polyphenolase 함유 작물로부터 조제한 녹엽단백질의 영양가)

  • 조영수;차재영
    • Journal of Life Science
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    • v.7 no.3
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    • pp.192-197
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    • 1997
  • Italian ryegrass, red clover, sorghum, and alfalfa were used for leaf protein preparation. Fresh leaves were pulped in the presence or absence of a reducing agent(sodium ascorbate or NaHSO$_{4}$) and green juice was heated and washed with acetone. The biological evaluation of leaf proteins was carried out by the growth method with male rats weighing about 45g. Italian ryegrass, red clover, and sorghum were brown when leaves were pulped in the absence of a reducing agent. On the other hand, alfalfa had neither o-diphenolics nor polyphenolase, and hence the alfalfa leaf protein did not brown during pulping ever in the absence of a reducing agent. The brown leaf protein from Italian ryegrass hd lower digestibility than the leaf protein protected from browning, although there were no difference in growth-promoting effect and protein efficiency ratio(PER)between the two leaf protein. The feeding of brown leaf protein from red clover resulted in the lowering of weight gain, digestibility, and PER, and all the measurement including diet intake were lowered by feeding the brown leaf protein from sorghum. In the case of alfalfa leaf protein, there were no difference in nutritional quality between the two leaf protein made with and without an attempt to prevent browning. The results mentioned above indicate that the occurrence of phenolics and polyphemolase in a crop in responsible for the browning of leaf protein and that the browning of leaf protein caused its nutritional impairment.

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