Korean Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Update on Non-alcoholic Fatty Liver Disease in Children","authors":"K. Lee","doi":"10.5223/KJPGN.2009.12.SUPPL1.S62","DOIUrl":"https://doi.org/10.5223/KJPGN.2009.12.SUPPL1.S62","url":null,"abstract":"","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130855333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection and Genotyping of Viruses Detected in Children with Benign Afebrile Seizures Associated with Acute Gastroenteritis","authors":"H. Yang, Y. Jee, J. Ko, J. Seo","doi":"10.5223/KJPGN.2009.12.2.183","DOIUrl":"https://doi.org/10.5223/KJPGN.2009.12.2.183","url":null,"abstract":"목 적: 로타바이러스, 노로바이러스, 아스트로바이러스, 장 아데노바이러스는 소아에서 급성 위장관염을 일으키는 주요 원인 바이러스이다. 일부 소아에서는 급성 위장관염 경과 중에 무열성 경련을 보이는 것으로 알려져 있다. 본 연구에서는 급성 위장관염 및 급성 위장관염에 병발하는 양성 무열성 경련(BIS-MG) 소아 환자의 대변에서 검출한 바이러스와 바이러스 유전자형을 분석하고자 하였다. 방 법: 2004년 8월에서 2005년 7월까지 분당서울대병원 소아청소년과에 급성 위장관염으로 입원한 311명 소아 환자를 대상으로 하였다. 모든 대상 환자의 대변에서 로타바이러스, 노로바이러스, 아스트로바이러스, 아데노바이러스에 대한 검사를 실시하여 장염 원인 바이러스를 검출하였고, 217명의 소아에서 분자유전학적 검사에 의하여 각 바이러스의 유전자형을 분석하였다. 결 과: 급성 위장관염 소아 환아 217명(남아 121명, 여아 96명, 평균 연령 20.6 ${pm}$ 15.4개월) 중에서 로타바이러스가 109명(50.2%), 노로바이러스가 28명(12.9%), 아데노바이러스가 13명(6.0%), 아스트로바이러스가 2명 (0.9%)에서 검출되었다. 로타바이러스의 유전자형 분석결과 P[8]G3가 36명, P[4]G2 21명, P[6]G4 10명, P[4]G4 9명, P[8]G9과 P[8]G1 6명, P[4]G3 4명, P[4]G93명, P[6]G2 2명이었다. 노로바이러스의 유전자형은 GII-4가 27명, GII-6 1명이었다. 16명의 소아가 급성 위장관염에 병발하는 양성 무열성 경련으로 진단되었으며, 로타바이러스가 13명, 노로바이러스가 2명에서 검출되었고, 나머지 1명은 아무런 바이러스도 발견되지 않았다. BIS-MG군에서 검출된 로타바이러스 유전자형은 P[8]G3 6명, P[4]G2 2명, P[4]G9 1명이었으며, 노로바이러스 유전자형은 2명 모두 GII-4였다. 결 론: 급성 위장관염에 병발하는 양성 무열성 경련을 보인 소아 환자의 대변에서 시행한 바이러스 분석결과 로타바이러스와 노로바이러스가 중요한 원인 바이러스였으며, 향후 이에 대한 지속적인 연구가 필요할 것이다. 【Purpose: Rotaviruses, noroviruses, astroviruses, and enteric adenoviruses cause acute gastroenteritis (AGE) in children. Some children with AGE have afebrile convulsions associated with viral gastroenteritis. The purpose of this study was to detect and genotype viruses from children with AGE or benign infantile seizures associated with mild gastroenteritis (BIS-MG). Methods: Between August 2004 and June 2005, 311 children with AGE were included. Four viral agents, including rotavirus, norovirus, astrovirus, and adenovirus, were analyzed from stool specimens of each patient using the latex agglutination method, enzyme immunoassay, and reverse transcriptase polymerase chain reaction. Genotyping of each virus was performed in 217 of the 311 children. Results: Among 217 children (male, 121; female, 96; mean age, 20.6 ${pm}$ 15.4 months), rotavirus was detected in 109 (50.2%), norovirus in 28 (12.9%), adenovirus in 13 (6.0%), and astrovirus in 2 children (0.9%). Genotyping of rotavirus revealed positive results in 97 children; P[8]G3 in 36, P[4]G2 in 21, P[6]G4 in 10, P[4]G4 in 9, P[8]G9 in 6, P[8]G1 in 6, P[4]G3 in 4, P[4]G9 in 3, and P[6]G2 in 2. Genotyping of norovirus showed GII-4 in 27 of 28 children and GII-6 in 1 child. Sixteen children were diagnosed with BIS-MG. Rotavirus was detected in 13 of 16 children with BIS-MG, and norovirus in 2 children. Genotyping of rotavirus detected in children with BIS-MG revealed P[8]G3 in 6 children, P[4]G2 in 2 children, and P[4]G9 in 1 child. Conclusion: Analysis of viruses from stool specimens indicates that both rotavirus and norovirus are the main viruses related to BIS-MG in children.】","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133326820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient Intestinal Ileus in Neonate: A Study of Comparison with Hirschsprung's Disease","authors":"K. Choi","doi":"10.5223/KJPGN.2009.12.2.194","DOIUrl":"https://doi.org/10.5223/KJPGN.2009.12.2.194","url":null,"abstract":"Purpose: Severe abdominal distension is not uncommon symptom in the neonate. Two major causes of this symptom are benign transient intestinal ileus (BTII) and Hirschsprung`s disease (HD). But it is difficult to differentiate BTII from HD based on the symptoms and simple abdominal x-ray findings. The aim of this retrospective study was to assess the clinical aspects and diagnostic tests differencing two diseases. Methods: From August 2004 to March 2009, nineteen patients with severe abdominal distension, who underwent barium enema, anorectal manometry, and rectal suction biopsy (triple tests) due to a suspicion of HD, were enrolled. A comparison of clinical data associated with BTII and HD based on the clinical features and results of triple tests. Results: The age of onset of symptom was between 2 and 6 weeks in BTII and within 3 weeks in HD. On the barium enema, transitional zone revealed in 6 (50%) patients in BTII and 4 (57.1%) in HD. On anorectal manometry, the anorectal inhibitory reflex was present in 11 (91.7%) patients in BTII and 1 (14.3%) in HD. On rectal suction biopsy, ganglion cell was present in 9 (75%) patients in BTII and 0 (0%) in HD. Abdominal distension was improved within 3 months of life in all cases of BTII. Conclusion: We think that anorectal manometry may be more simple and useful diagnostic method than barium enema and rectal suction biopsy for differential diagnosis of transient intestinal ileus and Hirschsprung’s disease. (Korean J Pediatr Gastroenterol Nutr 2009; 12: 194∼198)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"161 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125895884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"한국 소아청소년에서 로마 III 기준을 이용한 기능성 위장관 질환의 진단: QPGS (Questionnaire on Pediatric Gastrointestinal Symptoms)의 유용성","authors":"김동순, 노한내, 김규리, 이희우, 윤지현, 엄지현","doi":"10.5223/KJPGN.2009.12.2.120","DOIUrl":"https://doi.org/10.5223/KJPGN.2009.12.2.120","url":null,"abstract":"목 적: 저자들은 한국 소아청소년의 기능성 위장관 질환을 진단하는 데 로마 III 기준을 기초로 한 소아 위장관 증상에 관한 설문(QPGS)이 유용한 지 알아보고자 하였으며, 로마 III 기준을 이용하여 소아 청소년의 기능성 위장관 질환의 유병률을 살펴보았다. 방 법: 소아 소화기 전문의의 문진과 신체검진을 통한 진단과 소아 위장관 증상에 관한 설문(QPGS)을 기초로 한 진단의 일치 정도를 비교하였다. 138명의 환자와 그들의 보호자들이 설문지를 완성해주었다. 진단의 일치도는 카파(Kappa) 값을 구하여 측정하였다. 결 과: 소아 소화기 전문의의 진단에서 유병률은 기능성 소화불량(39.1%), 과민성 장 증후군(38.4%), 기능성 복통(18.8%) 순이었다. 설문을 기초로 한 진단에서는 과민성 장 증후군 (39.1%), 기능성 소화불량(29.7%), 기능성 복통(21.7%) 순이었다. 진단 일치도는 높았으며 ( ${kappa}$ =0.72, p=0 0.72, p=0.00), 진단이 일치되지 않은 경우는 대부분 대변 형태 및 대변 횟수에 관한 항목에서의 차이 때문이었다. 결 론: 소아 청소년 기능성 위장관 질환 진단의 선별 검사로서 로마 III 기준을 기초로 한 소아 기능성 위장관 증상에 관한 설문(QPGS)은 비교적 유용한 것으로 생각되며 특히 우리나라처럼 짧은 시간에 많은 환자를 진료해야 하는 환경에서 도움이 될 것으로 보인다. 【Purpose: We diagnosed pediatric functional gastrointestinal disorders in Korean children and adolescents using Rome III criteria and investigated the clinical validity of QPGS-Rome III. Methods: Diagnosis based on QPGS was compared with the physician's diagnosis based on Rome III criteria. One hundred and thirty eight children and their parents completed the QPGS. Agreement rates were measured using Kappa method. Results: In physician's diagnoses, the most prevalent disorders were functional dyspepsia (39.1%), irritable bowel syndrome (38.4%), and functional abdominal pain (18.8%). Among QPGS based diagnoses, the most prevalent disorders were irritable bowel syndrome (39.1%), functional dyspepsia (29.7%), and functional abdominal pain (21.7%). The agreement rate was substantial ( ${kappa}$ =0.72, p=0 0.72, p=0.00). Diagnostic disagreements probably resulted from different patient responses to bowel movement form and bowel frequency. Conclusion: Functional dyspepsia, irritable bowel syndrome, and functional abdominal pain were the most common disorders by Rome III criteria in the Korean pediatric and adolescent patients. The agreement rate between physician's diagnoses and QPGS based diagnoses supported the validity of the QPGS-Rome III in Korean pediatric and adolescent patients. QPGS seems to be useful in diagnosis of patients with functional gastrointestinal disorders by Rome III criteria.】","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114665126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence of Obesity and Metabolic Abnormalities in Korean Pediatric Population","authors":"H. Nho, C. Kim, J. Uhm, Jeong Tae Kim, Sunyeong Jin, J. Seo, Hye Won Hahn, H. Park, H. Yoon, Y. Ahn, Keun Chan Shon","doi":"10.5223/KJPGN.2009.12.2.207","DOIUrl":"https://doi.org/10.5223/KJPGN.2009.12.2.207","url":null,"abstract":"목 적: 식생활의 서구화와 운동량의 감소로 우리 나라에서 소아 비만은 증가하고 있는 추세이며 비만아에서는 고혈압, 이상 지질 혈증, 비알코올성 지방간 및 당뇨 등의 합병증이 발생할 수 있다. 이에 저자들은 비만의 유병률 및 비만아에서 동반되는 대사 이상의 유병률을 알아보고 비만의 정도에 따른 대사 이상의 유병...","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125869583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Analysis of Recurrent Intussusception and the Pathologic Lead Point in a Single Center","authors":"Kun-Song Lee, Y. Park","doi":"10.5223/KJPGN.2009.12.2.163","DOIUrl":"https://doi.org/10.5223/KJPGN.2009.12.2.163","url":null,"abstract":"Purpose: Intussusception is the most common cause of intestinal obstruction in young children. Although intussusceptions are easily treated, some intussusceptions with or without a pathologic lead point (PLP) often recur. In this study, we analyzed the clinical characteristics and prognosis of recurrent intussusceptions (RI), the frequency of the PLP, and correlation between RI with PLP. Methods: The medical records of 144 patients, among 590 patients with intussusceptions who had been admitted to the Department of Pediatrics and Pediatric Surgery of Dankook University Hospital between May 1994 and June 2009 were reviewed retrospectively. Results: The overall recurrence rate of intussusceptions in this study was 9.2%. The mean interval between the initial occurrence and the first recurrent attack was 130 ± 175 days (range, 12 hours to 3 years). There was no statistically significant difference in the recurrence rate among patients who underwent air, barium, and manual reduction ( p =0.131). Eighty-seven cases (92.6%) of RI had a successful reduction by the use of non-operative techniques. A PLP was present in 18 patients (3.0%). The most common PLP was intestinal lymphoid hyperplasia, followed by Meckel’s diverticulum, duplication cyst, intestinal polyp, and adenomyoma. The mean number of intussusceptions was 4.7 ± 1.9 in 7 patients with PLP, which was significantly higher than (2.4 ± 0.9) patients without a PLP ( p =0.023). The mean duration of recurrences was 17.4 ± 19.8 months (range, 2 days to 72 months). Conclusion: A careful search for a PLP should be performed to prevent recurrence of intussusception, especially when intussusception has recurred more than three times. (Korean J Pediatr Gastroenterol Nutr 2009; 12: 163 ∼ 170)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129993077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weaning Food Practice and Assessment in Children with Iron Deficiency Anemia","authors":"김부영, 최은혜, 강성길, 전용훈, 홍영진, 김순기","doi":"10.5223/KJPGN.2009.12.2.215","DOIUrl":"https://doi.org/10.5223/KJPGN.2009.12.2.215","url":null,"abstract":"목 적: 최근 모유수유의 장점이 알려지며 모유수유 아들이 늘고 있다. 이유기 영유아의 가장 흔한 영양장애인 IDA (Iron deficiency anemia)가 모유수유아와 다른 형태의 수유아에서 어떻게 나타나고 있는지 알아보고 IDA와 대조군의 이유식 진행 상황 및 이유지식 등에 대해 알아보았다. 방 법: 2006년 3월부터 2009년 1월까지 인하대병원에 내원한 6~24개월의 영유아 중 IDA를 진단받은 70명과 IDA가 없는 140명의 보호자에게 수유 형태, 이유식 진행 상황 및 이유지식을 묻는 설문을 시행하였다. IDA군의 자료와 함께 IDA가 없는 군을 대조군으로 하여 분석하였다. 결 과: IDA군은 IDA가 없는 군에 비해 이유식을 늦게 시작하며 IDA군에의 모유수유아 비율이 대조군에 비해 높은 것으로 나타났다(p 【Purpose: Recently, the favorable merits of breast feeding have received widespread attention and the number of breast feeding children is increasing. We investigated the weaning practices between breast feeding infants and non-breast feeding infants with respect to iron deficiency anemia (IDA). Methods: Between March 2006 and January 2009, we surveyed 70 parents, the children of whom had been medically diagnosed with IDA, and 140 parents, the children of whom did not have IDA, about how they feed their children and how much they know about the weaning process. The infants and children were 6∼36 months of age and attended the Inha University hospital. Results: IDA patients started weaning later than non-IDA patients. Also, breast feeding in IDA patients was more frequent than in non-IDA patients (82% vs. 30%). The breast feeding group began weaning at approximately 6.4 months of age, which was statistically meaningfully compared to non-breast feeding infants. There were no differences in knowledge between the two groups of parents. Conclusion: According to our research, we assume that if weaning begins at 6 months, we cannot supply sufficient iron to meet the infant's needs, which increase sharply around 6 months of age because of depletion of stored iron. Thus, infants need to initiate weaning from breast feeding at 4 months of age to furnish an ample amount of iron or take iron-containing supplements. These methods would be expected to prevent IDA in breast feeding infants.】","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125451415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics of Childhood Henoch-Schönlein Purpura with Duodenal Involvement by Upper Gastrointestinal Endoscopy","authors":"Sun Hee Park, Y. Nam, Sang Hui Park, S. Sim, B. Eun, D. Choi, Yonghan Sun, K. Cho, E. Ryoo, D. Son, I. Jeon, H. Tchah","doi":"10.5223/KJPGN.2009.12.2.156","DOIUrl":"https://doi.org/10.5223/KJPGN.2009.12.2.156","url":null,"abstract":"Purpose: The aim of this study was to investigate the clinical usefulness of upper gastrointestinal (GI) endoscopy in children with Henoch-Schönlein purpura (HSP). Methods: We retrospectively analyzed the clinical, endoscopic, and histopathologic records of children with HSP who had been admitted to the Department of Pediatrics of Gil Hospital and underwent upper GI endoscopy between January 2002 and June 2009. Patients were classified into the following two groups for statistical analysis: duodenal involvement (+) and duodenal involvement (−). Results: Fifty-one children with HSP underwent upper GI endoscopy; the mean age was 7.2±2.9 years. The upper GI endoscopy showed abnormalities of the duodenum in 38 cases (74.5%), 22 of which had duodenal ulcers. Among the biopsy specimens obtained from the duodenum of 37 cases, 13 cases (35.1%) had leukocytoclastic vasculitis, neutrophil debri, and/or extravasation of RBCs. Steroid use was more frequent in the duodenal involvement (+) group (86.8%) than the duodenal involvement (−) group (53.8%; p=0.02). The mean length of hospitalization was 13.9±8.43 days in the duodenal involvement (+) group and 8.1±4.62 days in the duodenal involvement (−) group (p=0.003). The recurrence rate was significantly higher in the duodenal involvement (−) group than the duodenal involvement (+) group (p=0.027), whereas none of the other study parameters, such as the age of onset, renal involvement, and steroid use, led to significantly higher or lower recurrence rates. Conclusion: These results suggest that duodenal involvement can influence the clinical course and prognosis of HSP in children. (Korean J Pediatr Gastroenterol Nutr 2009; 12: 156∼162)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"140 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116045771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Significance of the Nutritional Support Team for Preterm Infants in a Neonatal Intensive Care Unit","authors":"H. Yang, Chang Won Choi, B. Kim, J. Seo, Sungmin Choi, So Yeon Kim","doi":"10.5223/KJPGN.2009.12.1.39","DOIUrl":"https://doi.org/10.5223/KJPGN.2009.12.1.39","url":null,"abstract":"목 적: 영양지원팀(nutritional support team, NST)은 영양부족이 위험성이 있는 환자에게 영양을 효율적으로 제공하기 위해 운영된다. 미숙아는 소화, 흡수의 미숙, 비축된 영양의 부족, 요구량의 증가, 다양한 질환에의 이환으로 인하여 영양 불균형의 위험성이 높으며 경구영양이 완전히 진행되기까지는 총정맥영양(total parenteral nutrition, TPN)에 의존하므로 적극적인 영양지원을 필요로 한다. 이에 본 연구에서는 NST 활동이 신생아중환자실에 입원하여 TPN을 투여 받는 미숙아들의 임상경과에 미치는 영향을 검토함으로써 NST의 임상적 의의를 평가하고자 하였다. 방 법: 2003년 7월에서 2006년 7월까지 분당서울대 병원 신생아중환자실에 입원하여 TPN을 시행 받은 미숙아 48명을 대상으로 하여 후향적으로 의무기록을 검토하였다. 대상 환아들을 NST 활동 여부에 따라 각각 NST 설립 이전 시기인 2003년 7월에서 2005년 2월까지 입원한 미숙아군과 NST 활동 시기인 2005년 3월에서 2006년 7월 사이에 입원한 미숙아군으로 나누어 각 군에서의 임상 지표들을 비교분석하여 NST 활동이 미치는 영향을 평가하였다. 통계학적 분석을 위해 Mann-Whitney 검정과 Fisher's exact test를 적용하였고, pvalue 0.05 미만을 통계적으로 유의하다고 판정하였다. 결 과: 대상 환아 48명(남아 27명, 여아 21명)의 재태기간은 평균 $28^{+1}$ 주(범위: 25주~ $32^{+6}$ 주), 출생체중은 평균 1,008.5 ${pm}$ 242.5 g (범위: 520~1,490 g), 재원기간은 평균 74 ${pm}$ 40일(범위: 26~274일)이었다. 영양사, 약사 또는 NST가 환아의 TPN에 개입하기까지의 기간이 NST 활동 전에는 14.8 ${pm}$ 21.0일 소요되었으나 NST 활동 이후 0.5 ${pm}$ 2.0일로 유의하게 감소하였다(p=0.000). TPN 투여기간은 NST 활동 전의 41.5 ${pm}$ 26.2일에서 NST 활동 후에는 20.5 ${pm}$ 16.6일로 유의하게 감소하였다(p=0.001). TPN을 통해 투여된 칼로리는 NST 활동 전후로 각각 88.1 ${pm}$ 19.0 kcal/kg/day와 98.8 ${pm}$ 8.2 kcal/kg/day로서 유의하게 상승하였고(p=0.016), 단백 투여량은 각각 2.74 ${pm}$ 0.50 g/kg/day와 3.36 g/kg ${pm}$ 0.34 g/kg/day (p=0.000), 지방 투여량은 각각 2.53 ${pm}$ 0.86 g/kg/day와 3.40 g/kg ${pm}$ 0.52 g/kg/day로서 두 군 간에 유의한 차이를 보였다(p=0.000). 환아들의 금식기간이 NST 활동 전후 각각 10.5 ${pm}$ 11.3일과 5.9 ${pm}$ 7.3일로서 NST 활동 시작 후 유의하게 감소하였으며(p=0.017), 환자들이 완전 경장영양으로 진행하기까지 소요된 기간도 각각 44.7 ${pm}$ 26.1일과 24.0 ${pm}$ 17.6일로 NST 활동 후 의미 있게 감소하였다 (p=0.001). 항생제 투여기간도 NST 활동 전의 34.8 ${pm}$ 30.8일에서 NST 활동과 더불어 15.6 ${pm}$ 15.2일로 유의하게 감소하였다(p=0.007). 결 론: 신생아중환자실에 입원한 미숙아에게 있어 NST 활동에 의한 적극적인 영양지원은 적절한 영양을 공급하여 영양상태를 개선하는 측면과 더불어 임상적 측면에서도 장점이 있으므로 미숙아의 영양지원에 있어 NST 활동이 갖는 의의가 크다고 하겠다. 【Purpose: Preterm infants are very susceptible to malnutrition because of a lack of storage of nutrients, immature digestion and metabolism, and accompanying diseases associated with prematurity. The purpose of this study was to evaluate the effects of nutritional support by the pediatric nutritional support team (pNST) on the clinical course of preterm infants in the neonatal intensive care unit (NICU). Methods: Between July 2003 and July 2006, 48 preterm infants who were admitted to the NICU at Seoul National University Bundang Hospital were included. The subjects were divided into the following two subgroups according to the presence of NST activity; pre-NST group (n=23) and NST group (n=25). Hospital records were reviewed retrospectively. Results: Forty-eight preterm babies were included (M：F=27：21; gestational age, 25~33 weeks). A dietician, pharmacists, or the pNST participated in the prescription of total parenteral nutrition (TPN) more rapidly in the NST group (p=0.000). The fasting periods and TPN administration periods were significantly decreased in the NST group compared to the pre-NST group (p=0.017 & p=0.001, respectively). The doses of calories, protein, and lipids administer","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122417071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Hepatobiliary Disorders from a Nationwide Survey ofDischarge Data in Korean Children and Adolescents","authors":"H. Park, Chang Gyun Shin, J. Moon, Chong-Guk Lee","doi":"10.5223/KJPGN.2009.12.1.16","DOIUrl":"https://doi.org/10.5223/KJPGN.2009.12.1.16","url":null,"abstract":"Purpose: To update the epidemiologic information of hepatobiliary diseases in pediatric inpatients using cross-sectional survey data throughout the Republic of Korea. Methods: Nationwide cross-sectional survey was obtained from the 85 residency training hospitals in Korea to gather the final diagnosis on discharge. The surveyed periods were from 2004 to 2006. All the reports regarding the diagnosis were based on ICD-10 system. In this study, we focused on hepatobiliary diseases. Results: A total of 826,896 cases with discharge data were collected, of which 4,151 (5.0%) hepatobiliary cases were identified; 2,385 cases (57.4%) of hepatobiliary disease were hepatitis, which was the most common hepatobiliary disease. Other diseases included congenital hepatobiliary diseases (524 cases [12.6%]) and biliary diseases (315 cases [7.6%]). The prevalence of hepatobiliary disease according to age differed. Biliary atresia was the most common hepatobiliary disease in the neonatal period, whereas the prevalence of hepatitis increased in adolescents. The total number of hepatobiliary operations was 416 cases. With the comparison of annual data, there was no definite difference in the total number of hepatobiliary cases. The average duration of hospital stay appeared to decrease gradually. Conclusion: In this study, we have summarized the recent epidemiology of hepatobiliary disorders in Korean children based on discharge data. Hepatobiliary disorders in pediatric inpatient units consisted of diverse disorders with a low prevalence, so multi-center approaches should be considered to enhance the clinical and public health outcomes. To improve this nationwide survey, a new data collecting system should be developed. (Korean J Pediatr Gastroenterol Nutr 2009; 12: 16 ∼ 22)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"52 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129459844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}