, Il Tae Hwang Cardiovascular disease (CVD) is the most common cause of death worldwide, and dyslipidemia is a major risk factor. Atherosclerosis can begin in childhood and continue into adulthood, thereby contributing to CVD development. Obesity is the most common cause of dyslipidemia, and the prevalence of childhood obesity and dyslipidemia is increasing worldwide, making it a public health concern. As clinical evidence has accumulated, guidelines for dyslipidemia in children have been continuously revised since 1992. The limitations of screening tests for individuals with a family history of dyslipidemia emphasize the necessity of universal screening, and non-HDL cholesterol assessment is recommended as a screening test for dyslipidemia in children. The guidelines for dyslipidemia in Korean children and adolescents published in 2017 recommend that non-HDL cholesterol screening tests be performed in non-fasting conditions at 9–11 years and 17–21 years of age. The main purpose of this article is to describe the history and rationale of lipid screening recommendations in children and adolescents and to review the currently recommended screening methods and treatments for dyslipidemia. (Ewha Med J 2022;45(3):e4)
, Jeonghyun Koo, Jeong Soo Suh, Chungsik Rhee 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.
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.
, Eun Ae Park, Eun Sun Yoo, Hae Soon Kim, Se Jung Sohn, Jeong Wan Seo, Seung Joo Lee, Hoo Jae Han 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.
, Guie Yong Lee, Jong In Han, Dong Yeon Kim, Rack Kyong Chung, Jong Hak Kim, Chi Hyo Kim, Choon Hi Lee 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.
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