Clinical Characteristics Associated With Aspiration or Penetration in Children With Swallowing Problem

OBJECTIVE: To evaluate demographic characteristics of children with suspected dysphagia who underwent videofluoroscopic swallowing study (VFSS) and to identify factors related to penetration or aspiration. METHODS: Medical records of 352 children (197 boys, 155 girls) with suspected dysphagia who were referred for VFSS were reviewed retrospectively. Clinical characteristics and VFSS findings were analyzed using univariate and multivariate analyses. RESULTS: Almost half of the subjects (n=175, 49%) were under 24 months of age with 62 subjects (18%) born prematurely. The most common condition associated with suspected dysphagia was central nervous system (CNS) disease. Seizure was the most common CNS disorder in children of 6 months old or younger. Brain tumor was the most important one for school-age children. Aspiration symptoms or signs were the major cause of referral for VFSS in children except for infants of 6 months old or where half of the subjects showed poor oral intake. Penetration or aspiration was observed in 206 of 352 children (59%). Subjects under two years of age who were born prematurely at less than 34 weeks of gestation were significantly (p=0.026) more likely to show penetration or aspiration. Subjects with congenital disorder with swallow-related anatomical abnormalities had a higher percentage of penetration or aspiration with marginal statistical significance (p=0.074). Multivariate logistic regression analysis revealed that age under 24 months and an unclear etiology for dysphagia were factors associated with penetration or aspiration. CONCLUSION: Subjects with dysphagia in age group under 24 months with preterm history and unclear etiology for dysphagia may require VFSS. The most common condition associated with dysphagia in children was CNS disease.

An Association of Serum Cholesterol, Triglycerides, and Impulsiveness in Adolescents / 신경정신의학

OBJECTIVES: Many studies have shown an association between low serum cholesterol concentration and impulsive aggressive behaviors. Recent studies reported that serum triglycerides concentration has been independently associated with impulsive aggressive behaviors regardless of serum cholesterol concentration. However, conflicting results have also been reported. This study was designed to find the relationship between serum lipid levels (cholesterol and triglycerides) and impulsiveness in adolescents. METHODS: Serum cholesterol concentration, serum triglycerides concentration, complete blood count, electrolytes, liver function test, and blood sugar level were measured by overnight fasting blood sampling and urinalysis was also conducted in 450 high school students. Impulsiveness level was measured by Barratt impulsiveness scale(BIS). Serum cholesterol was measured by standard enzymatic assay and serum triglycerides was measured by Boehringer Mannheim method. RESULTS: 1) The cholesterol concentration in high impulsiveness group was found to be significantly lower compared with low impulsiveness group both in male and female separately. Especially, the lower cholesterol concentration was associated with motor impulsiveness, a subscale of BIS. 2) The triglycerides concentration in high impulsiveness group was found to be higher compared with the triglycerides concentration in low impulsiveness group. Above results were still valid even after exclu-ding the factor of sex and of body mass index. CONCLUSION: These results suggest that low cholesterol concentration is associated with an increased impulsiveness, and there is a relationship between serum triglycerides concentration and impulsiveness. These results support the previous hypothesis that serum lipid levels(cholesterol and triglycerides) affect brain serotonin level and human psychologic characteristics.