This study investigated the relationship between the stimulated peak growth hormone (PGH) level and comprehensive metabolic markers for glucose and lipid metabolism, and liver steatosis in prepubertal children with GH deficiency (GHD).

Sixty-nine prepubertal children with GHD were divided into overweight/obesity (body mass index [BMI]≥85th percentile) and normal BMI groups. The associations between PGH level and metabolic parameters including homeostatic model assessment-insulin resistance (HOMA-IR), lipid profiles, AST, and ALT were evaluated.

The LDL cholesterol level was significantly higher in the overweight/obesity group than in the normal BMI group. PGH level was negatively associated with the BMI SD score (SDS) (r=−0.26, P=0.029) and ALT (r=−0.36, P=0.004) levels, whereas it was positively associated with the HDL-cholesterol (HDL-C) level (r=0.38, P=0.002). In multivariate analyses, PGH level was positively associated with HDL-C level (P=0.002) and negatively associated with ALT level (P=0.028) after adjusting for age, sex, BMI SDS, HOMA-IR, and TG level.

PGH level in pre-pubertal children with GHD was positively and negatively associated with HDL-C and ALT, respectively, even if they were within normal range, regardless of BMI.

To conduct a comparative study of children’s health in South Korea versus North Korea focusing on air pollution.

We used annual mortality rate, prevalence, and environmental indicators data from the World Bank and World Health Organizations (WHO). Trend analysis of the two Koreas was conducted to evaluate changes in health status over time. Spearman’s correlation analysis was used to find out the correlation between environmental indicators and children’s health status.

We found a distinct gap in children’s health status between the two Koreas. While North Korea reported a higher death rate of children than South Korea, both showed a decreasing trend with the gap narrowing from 2000 to 2017. The prevalence of overweight and obesity increased and that of thinness decreased in both Koreas. Except PM_2.5 exposure, South Korea reported higher figures in most indicators of air pollutant emissions (South Korea, mean (SD)=28.3 (2.0); North Korea, mean (SD)=36.5 (2.8), P-value=0.002).

This study empirically discovered the gaps and patterns of children’s health between South Korea and North Korea. North Korean children experienced more severe health outcomes than children in South Korea. These findings imply that epigenetic modification caused by environmental stressors affect children’s health in the two Koreas despite similar genetic characteristics. Considering the gaps in children’s health between the two Koreas, more attention and resources need to be directed towards North Korea because the necessary commodities and services to improve children’s health are lacking in North Korea.

This study aims to investigate the domographic characteristics, main clinical problems, diagnoses and treatments of child and adolescent psychiatric outpatients.

The statistical analyses were based on the clinical reports and medical records of 111 child and adolescent psychiatric patients who wisited to the outpatient clinic during current 6 months.

1)The sex ratio(male : female) of these 111 patients was 1.1:1 and the most frequent age group was adolescent period(13-18 years of age). In sibling order, the first born child was more prevalent. Almost all the patients had both parents and was accompanied by a mother on the first visit. The most living place of the patients was in Seoul. 2) The main problems visiting our coinic were in following order : somatic symptoms, learning problems, anxiety, fear & restlessness, attention deficits, conduct problems and substance abuse etc. 3) Diagnostic distribution of the patients was in following order : conduct disorder, mood disorder, organic mental disorder, attention deficit hyperactivity disorder, anxiety disorder etc. 4) The patients who visited to the outpatient coinic above 5 times were more frequent. The more frequently used method for treatments was in the sequence of pharmacotherapy combined with psychotherapy and behavior therapy.

These results suggest that the necessity of the space of special therapy(such as play and behavior therapy) for the children and division of child and adolescent psychiatry is very important in current situation.

Acute appendicitis is very rare in infancy and early childhood. Delayed diagnosis of appendicitis may result in catastrophic outcome with perforation. We performed a retrospective analysis of clinical and radiologic findings of acute appendicitis occurring in the first 2 years of life.

Nine patients of acute appendicitis who were are less than two years of age proved by surgery and pathology were analyzed in terms of clinical symptoms and signs, and findings on preoperative plain abdominal roentgenography(9 cases), barium or gastrografin enema(6 cases), ultrasonography(8 cases) and abdominal CT scan(1 case).

All patients presented with nonspecific clinical symptoms and signs, such as vomiting and fever. All were complicated with perforation. Six were associated with periappendiceal abscess, and four with appendicolith. Plain abdominal roentgenogram showed generalized paralytic ileus and increased density on right lower quadrant in all cases, and diffuse for right lower abdominal wall bulging in some cases. Most cases of perforated appendicities and periappendiceal abscess were diagnosed by ultrasound and some cases by contrast enema or abdominal CT scan.

When the patients less than 2 years of age have nonspecific acute abdominal symptom with the roentgenographic findings of aggravating ileus and haziness in the right lower abdomen, ultrasonography might be considered as a helpful diagnostic tool for the early diagnosis of appendicitis. CT and contrast enema also might be helpful.

This study was performed to evaluate the usefulness of quantitative measurement of C-reactive protein(C-RP) and ESR in the differentiation between Rotaviral and Salmonella gastroenteritis in children.

On admission quantitative C-RP measurement by nephelometry, stool culture for slmonella and shigella, stool latex agglutination test for rotavirus(slidex rota-kit 2), stool occult blood, stool WBC and CBC with ESR were performed.

Of sixty seven children, 40(59.7%) children had Rotaviral gastroenteritis, and 27(40.3%) had Salmonella gastroenteritis. The C-RP levels and ESR of the patients with Salmonella gastroenteritis differed significantly from the Rotaviral gastroenteritis. At the level of 0.8 mg/dL, C-RP gave the best balance of sensitivity(84.6%) and specificity(87.5%).

The quantitative measurement of C-RP levels may be a useful tool for predicting Salmonella gastroenteritis in children.

This study was performed to investigate the prevalence of abnormal behavior, ada-ptability and intelligence of child and adolescents and the usefulness of KAS(Korean Attitude System) as a screening method to detect the psychopathology of child and adolescents.

478 child and adolescents were completed the instruments of KAS that focused on development of behavior, adaptability and intelligence at the children's medical examination center.

The most influenced subcategories to the disturbance of behavior of the subjects were leadership, cooperation, and emotion (in order). The preference of adaptability was high in the fields of literature, law, technology, medicine and sociology. The mean I.Q. of the subjects was high average and not different in both sex. The subjects with below average of I.Q. were three cases(0.6%) and the two of them were boderline and only one case was mild mental retardation. The total number of patients referred to the department of psychiatry was eight cases(1.7%) and revealed the disturbance of behavior, affect, and thought.

Finally the authors concluded that KAS test performed at the children's medical examination center was useful primary screening method to detect the psychopathology of child and adolescents.

This study investigated the correlations between childhood sexual abuse and the severity of psychopathology symptoms in adulthood and the usefulness of adult psychiatric symptoms, diagnoses, and medications as factors in the identification of patients who have been sexually abused in childhood.

The subject of this study were 21 childhood sexually abused female inpatients and 22 nonabused female inpatients(psychiatric control group). All subjects were interviewed and completed self report instruments that focused of childhood sexual histoy of trauma, and current general psychiatric symptoms, dissociative symptoms.

Sexually abused broup showed significantly higher rates of divorce than psychiatric control group. Relative to psychiatric control group, sexually abused group have more hospitalization, higher proportion of more suicidal symptoms and more often major pharmacological tratment. Sexually abused group manifested significantly higher levels of dissociative symptoms and general psychiatric symptoms, including interpersonal sensitivity, psychoticism, obsessive compulsive and global severity index.

Findings suggest that childhood sexual abuse is associated with adult psychiatric symptoms, especially dissociative symptoms and work as etiology of psychopathology of boderline personalitiy disorder.

We aimed to compare and distinguish the characteristics of anaphylaxis and angioedema, especially with oral mucosal involvement and treatment of patients who visited the Pediatric Emergency Department.

We retrospectively analyzed patients under age 18-year-old who were diagnosed with anaphylaxis and angioedema with oral mucosal involvement and treated with epinephrine from May 2008 to May 2013 in a single Pediatric Emergency Department in Seoul, Korea. We evaluated their past history, possible triggering causes, symptoms, vital signs and treatment and discharge with education.

During the study period the total cases of anaphylaxis were 79 and angioedema with oral mucosal involvement were 218. The age of patients with anaphylaxis was significantly higher (6.6±4.9 years vs. 4.1±3.3 years). The heart rate relative to age was significantly higher in the anaphylaxis group (49.4% vs. 36.2%). After discharge from the Emergency Center, 3.8% of anaphylaxis patients were prescribed an epinephrine injection. Education to avoid the triggering factor was provided in 32.9% of anaphylaxis group and 17.4% in the angioedema group.

Besides blood pressure, we should pay attention to the heart rate in pediatric patients with severe allergic reactions. More active follow-up of anaphylaxis and angioedema with oral mucosal involvement is needed to educate parents and prescribe emergency medication.

Obesity, the most common health problem facing children, is known to have been ascribed to multifactors. Our research is aimed at finding out if there exists any relation of children's obesity with their family and also with their daily habits.

The study included 145 obese children and 44 non-obese children, who visited our pediatric clinic from January 2006 to December 2008. The children were divided into three groups according to body mass index(BMI)(group I:non-obese control children, group II:children with BMI between 85 and 94 percentile, group III:children with BMI above 95 percentile). Research was performed in three groups by measuring of body weight, height and questionnaires.

There was no significant difference in sex and age. The parental BMI of the obese children were higher than those of non-obese children. Obesity of children was more highly related to maternal BMI than partenal BMI. Birth weight and birth order in the obese children showed no remarkable difference from those of non-obese children. The sleeping hours of the obese children were much longer than those of non-obese children. Television viewing hours of the obese children showed no remarkable difference from those of non-obese children. Family members with group III children had many complications which developed from obesity.

The development of obesity in children is attributed to the hereditary factors of their parents and daily habits such as sleeping hours. Therefore, family-based weight control is important to treat childhood obesity.

Acute disseminated encephalomyelitis(ADEM) is an acute demyelinating autoimmune inflammatory disease of the central nervous system which develops after infection of vaccination. It may be fatal, and produce a permanent residual static disability or fully recover. We retrospectively studied 14 cases to investigate the clinical findings and outcome of ADEM.

14cases of ADEM diagnosed at Ewha Womans University Mokdong Hospital from 1998 to 2003 were retrospectively reviewed.

The age of onset was 5 years±7.8 months and no seasonal clustering was found. The time of onset of symptoms was between 3 to 30 days. The preceding events were nonspecific upper respiratory infections in 9 cases, aseptic meningitis in 4 cases, and gastroenteritis in one case. The initial symptoms were seizure, altered consciousness, hemiparesis, fever, headache, and vomiting. Brain MRI showed multifocal high signal intensity lesions on T2 weighted image mainly in the cerebral whith matter, basal ganglia and periventricular white matter. EEG was performed in some cases and showed generalized or focal slow waves and only one case showed focal spikes. Patients were treated with IV globulin and methylprednisolone and the symptoms improved within 3-7 days after treatment. All patients were followed up for more than 2 months and most of them fully recovered except two.

ADEM presents in various clinical manifestations depending on its involvement of the brain lesions. Most cases recovered fully but in some cases, residual permanent neurologic sequelae remained.

The purpose of study is to assess the clinical characteristics of complicated Meckel's diverticulum in children.

A retrospective review of pediatric cases of complicated Meckel's diverticulae that were surgically treated at Ewha Womans University Hospital from 1985 was performed. The charts were reviewed for the age and sex of the patients, operation finding, treatment, and outcome.

A total 13 patients with a complicated Meckel's diverticulum were identified. There were 8 boys(61.5%) and 5 girls (38.5%) with a mean age of 5.3 years (range, 1month to 14years). Presenting signs and symptoms included digestive hemorrhage (6), intestinal obstruction(4), perforation (1), intussusception due to inverted Meckel's diverticulum (1) and diverticulitis (1). A^99m technetium pertechnetate scintiscan was positive in 3 of 4 patients. Barium contrast studies and colonoscopys were not diagnostic. The mean distance from the ileocecal valve to the diverticulum was 47.0±15.7cm. Average length of the diverticulum was approximately 4.7±3.0cm. Segmental small bowel resection including Meckel's diverticulum (84.6%) or wedge excision(15.4%) was done for treatment. In the bleeding group, ectopic gastric mucosa was present in 5 of 6 patients. Postoperative morbidity and mortality was each 0%.

The results of this study draw attention to the fact that the complicated Meckel's diverticulum must be suspected in children with acute abdomen or gastrointestinal bleeding.

Preoxygenation is recommended in order to prevent hypoxemia with hypoventilation or apnea during induction of anesthesia. The purpose of this study was to determine the duration of preoxygenation required to achieve an end-tidal oxygen fraction(FE'O₂) of 0.9 in children and adults.

In 24 healthy children and adults breathing 100% oxygen, end tidal oxygen and carbon dioxide concentration have been measured at 15 seconds interval from the start of liter per minute. The gas sampling line of the Capnomac II(Datex, Helsinki, Finland) was placed in the nasal cavity.

The study showed that all children attained an FE'O₂ of 0.9 within 75s of preoxygenation, but adults had not reached an FE'O₂ of 0.9 within 180s.

More oxygen wash-in would be expected in children. We suggested that at least 3 min of preoxygenation should be performed before intravenous induction of anesthesia in children.