Reference Values of Hematologic and Biochemical Parameters of Nutrition around Weaning Period

PURPOSE: To determine the reference values of hematologic and biochemical parameters of nutrition around the weaning period. METHODS: From February 1996 to March 1997, several nutritional laboratory values were evaluated in 130 healthy babies and 120 inpatients in the recovery stage of acute illness at six general hospitals. RESULTS: Reference values in 9-month-old healthy babies(range : 6-12 months) were hemoglobin 11.8+/-0.9g/dL, hematocrit 30.9+/-0.7%, serum ferritin 25.7+/-15.4ng/mL, total protein(TP) 6.5+/-0.5g/ dL, albumin 4.6+/-0.5g/dL, prealbumin 15.6+/-3.9mg/L, cholesterol 154.7+/-22.4mg/dL, calcium 10.1+/-0.5mg/dL, phosphorus 6.1+/-0.9mg/dL, alkaline phosphatase(ALP) 235.1+/-66.4U/L. Reference values in 15-month-old healthy babies(range : 13-18 months) were hemoglobin 12.3+/-1.0g/dL, hematocrit 30.9+/-0.4%, serum ferritin 20.4+/-11.2ng/mL, TP 6.8+/-0.6g/dL, albumin 4.7+/-0.5g/dL, prealbumin 18.1+/-4.6mg/L, cholesterol 163.1+/-24.2mg/dL, calcium 9.3+/-1.0mg/dL, phosphorus 6.0+/-0.8mg/dL and ALP 254.5+/-64.0U/L. Most reference values were significantly lower in inpatients than the healthy babies, except for serum ferritin level which was the opposite. There were no significant differences in reference values according to feeding and weaning practices. Incidence of anemia(hemoglobin200mg/dL) was 8.6% in 15-month-old healthy babies. CONCLUSION: This study presented the reference values of hemoglobin, hematocrit, serum ferritin, total protein, albumin, prealbumin, cholesterol, calcium, phosphorus and alkaline phosphatase around the weaining period. The current nutritional status of Korean babies around the weaning period was appropriate except for borderline iron deficiency.

Reference Values of Hematologic and Biochemical Parameters of Nutrition around Weaning Period

PURPOSE: To determine the reference values of hematologic and biochemical parameters of nutrition around the weaning period. METHODS: From February 1996 to March 1997, several nutritional laboratory values were evaluated in 130 healthy babies and 120 inpatients in the recovery stage of acute illness at six general hospitals. RESULTS: Reference values in 9-month-old healthy babies(range : 6-12 months) were hemoglobin 11.8+/-0.9g/dL, hematocrit 30.9+/-0.7%, serum ferritin 25.7+/-15.4ng/mL, total protein(TP) 6.5+/-0.5g/ dL, albumin 4.6+/-0.5g/dL, prealbumin 15.6+/-3.9mg/L, cholesterol 154.7+/-22.4mg/dL, calcium 10.1+/-0.5mg/dL, phosphorus 6.1+/-0.9mg/dL, alkaline phosphatase(ALP) 235.1+/-66.4U/L. Reference values in 15-month-old healthy babies(range : 13-18 months) were hemoglobin 12.3+/-1.0g/dL, hematocrit 30.9+/-0.4%, serum ferritin 20.4+/-11.2ng/mL, TP 6.8+/-0.6g/dL, albumin 4.7+/-0.5g/dL, prealbumin 18.1+/-4.6mg/L, cholesterol 163.1+/-24.2mg/dL, calcium 9.3+/-1.0mg/dL, phosphorus 6.0+/-0.8mg/dL and ALP 254.5+/-64.0U/L. Most reference values were significantly lower in inpatients than the healthy babies, except for serum ferritin level which was the opposite. There were no significant differences in reference values according to feeding and weaning practices. Incidence of anemia(hemoglobin200mg/dL) was 8.6% in 15-month-old healthy babies. CONCLUSION: This study presented the reference values of hemoglobin, hematocrit, serum ferritin, total protein, albumin, prealbumin, cholesterol, calcium, phosphorus and alkaline phosphatase around the weaining period. The current nutritional status of Korean babies around the weaning period was appropriate except for borderline iron deficiency.

A Study as Epidemiologic and Clinical Aspect of Mycoplasma pneumoniae Pneumonia during the Last 5 Years / 소아알레르기및호흡기학회지

PURPOSE: It is not surprising that serologically based epidemiologic studies have documented the high incidence of mycoplasma respiratory infection throughout the world. We studied the epidemiologic and clinical aspects of mycoplasma pneumonia in children if there is any differences in the peak age-related incidence, seasonal predominance and clinical manifestations in compare with other studies reported in Korea. METHODS: We reviewed 1004 cases of Mycoplasma pneumoniae pneumonia diagnosed by clinical manifestations and positive serologyc tests, retrospectively, who were admitted to the department of pediatrics in four university hospitals in Seoul and Inchon during the last 5 years from 1993 to 1997. RESULTS: 1) The age distribution of mycoplasma pneumonia showed highest incidence in children 4-6 years old. There was no difference in sex distribution at any age group. 2) Although there was little difference in annual distribution, it was highest in 1997. 3) Cough was the most prevalent prodromal symptom. 4) Vomiting, Nausea, Abdominal pain and headache were noted as the extrapulmonary manifestations. 5) Pulmonary infiltration was noted mostly in lower lobe lobes on chest X-ray. They showed interstial involvement in 34.5%, lobar involvement in 30.0%, and pleural effusion in 7.8% of the total. 6). As the complications, aggravate or trigger the asthma attack were noted in 4.0%, development of sinusitis in 3.5% and otitis media in 1.4% of the total. There were four cases of aseptic meningitis and one case of lung abscess. CONCLUSIONS: In our survey, there was little or no epidemiologic differences in the incidence of Mycoplasma pneumoniae pneumonia. We can find the increasing tendency of lobar pattern of involvement on chest X-ray in mycoplasma pneumonia in children.

A Case of Incontinentia Pigmenti with Destructive Encephalopathy

Becker muscular dystrophy is a X-linked recessive disease with the affected gene at locus Xp21, characterized by progressive muscular weakness. Without the definite family history, it has been known that the diagnosis of this disease is almost impossible on clinical grounds alone. We reviewed the muscle pathology of two casses of genetically confirmed Becker muscular dystrophy to know the diagnositc significances of this study. The first case, a 20 year old man, is the classical one with definite family history of X-linked recessive heredity. The muscle pathology of the biceps showed dystrophic muscular changes, including increased internal nuclei, marked variation of fiber sizes and mild endomysial fibrosis. The dystrophin stain of the muscle was also confirmative for the diagnosis. The second case was a 32 year old man who has been biopsied his left vastus lateralis 5 years before this genetic diagnosis. This case is a sporadic one without the family history. The diagnosis at the time of muscle biopsy was limb-girdle muscular dystorphy or inclusion body myositis because of the typical rimmed vacuoles and marked variation of fiber sizes. The dystophin stain was not available at that time. Our conclusion is that the molecular genetic study and/or dystrophin protein test of muscle biopsy should be done in every clinically suspected patient, including limb-girdle muscular dystorphy, inclusion body myositis or rimmed vacuolar myopathies.

A Survey on the Factors Related to the Failure of Breast-feeding The Nutritional Committee of The Korean Pediatric Association

Objective : The breast-feeding rate has decreased in Korea despite of the active encouraging effort of breast-feeding for the last 10 years. So we investigated the factors that are related to breast-feeding failure. METHOD: 1807 specific questionares of mothers who visited the six university hospitals in Seoul from October 1993 to December 1995 were analysed by ANOVA and multiple logistic regression using SAS program. RESULTS: 1) Exclusive breast-feeding rate for the first 6 months was 20.0%. The factors of breast feeding success were antenatal plan for breast-feeding, the first successful breast-feeding and breast-feeding in the hospital after delivery (P<0.01). 2) The duration of breast-feeding was 5.2+/-4.4 months. It was significantly longer in the first successful breast-feeding (P<0.01). The earlier the first breast-feeding, the longer the breast-feeding duration (P<0.01). 3) The breast feeding rate for the first feeding after delivery was significantly higher in normal delivery (46.5%) and the rooming-in (57.4%) than in Cesarean section (37.1%) and the nursery (39.1%) (P<0.01). 4) The first time of breast-feeding was 64.8+/-62.8 hours after delivery and was significantly earlier in the local clinic, normal delivery and rooming-in than in the hospital, Cesarian section and the nursery (P<0.01). The first breast-feeding was successful in 46.9% and was significantly higher in antenatal education (P<0.01). 5) The reasons for the breast-feeding failure within postnatal one month were the insufficient milk (37.1%), the physician' s recommendation (18.8%), the inverted nipple (12.1%), the baby's poor suckling power (10.5%) and thin breast-milk (7.0%). The reasons to switch the successful breast-feeding to formula-feeding before 6 months of age were the return to work (25.1%), the convenience of formula-feeding (17.4%), the excellency of formula (10.0%) and maternal conveniency (6.2%). 6) The reasons to consider the breast milk insufficient were too frequent feeding with crying (38.7%) and poor sleeping with irritability (19.0%). The reasons to consider the breast milk thin were the loose stool (51.1%) and watery nature of breast milk (48.9%). The effort to increase the breask milk was present in 68.2%. The most frequent effort was to increase the maternal intake (67.6%) instead of the frequent baby' s suckling (25.6%). 7) Persons who recommended to stop breast feeding were family members 62.7%, pediatricians 25.5%, obstetricians 10.7%, nurses 1.1%. The maternal diseases to stop breast feeding by physician such as mastitis (11.1%), hepatitis B (4.9%) and tuberculosis (2.5%) were relatively appropriate. But the baby' s diseases such as jaundice (29.9%), loose stool (22.2%) and vomiting (2.8%) were inappropriate. CONCLUSIONS: To increase the breast-feeding rate, we recommend the antenatal plan for breast-feeding, the early breast-feeding as soon as possible and the exclusive breast-feeding in the hospital after delivery. The mothers should make an effort to increase the breast milk by frequent suckling. The physicians should be better prepared to assist the breast-feeding mothers and monitor continuously to resume even after the temporary hold of breast-feeding.

The study of serum lipids in grossly obese elementary school students in Seoul

Our study surveded 418 obese first grade elementary school children(279 male and 139 female), in seoul, and measured levels of serum total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride were measured in addition to the measurement of body weight and height. The following results were obtained. 1) Obesity index was catergorized into mild, moderate, and severe, and the percentage of mild was 6.8%, moderate 48%, severe 45.7% respectively in surveyed children. 2) The average level of total cholesterol was 1.66.60 27.63mg/dl, HDL cholesterol 50.22+/-0.68mg/dl, LDL cholesterol 82.23+/-1.26mg/dl. 3) Atherogenic index was calculated, and obtained value was 2.45+/-0.48. It showed higher statstical significance in boys than in girls(p<0.05). 4) There was no significant difference in average level of total cholesterol, LDL cholesterol, and triglyceride in accordance of the severity of obesity. 5) Statistical significance was found in different average ievels of HDL cholesterol and atherogenic index according to obesity index (p<0.05). 6) There was a statistical significance in the average values of Kaup index and Rohrer index in accordance with obesity index (p<0.000). 7) There was no correlation between abnormal levels of total cholesterol, HDL cholesterol, and LDL cholesterol and the severity of obesity. 8) Abnormal levels of triglyceride, atherogenic index, Rohrer index and Kaup index had a statistical significance since their levels. 9) There was a correlation between atherogenic index and body measurement. Total cholesterol level showed correlation with obesity index, and HDL cholesterol with Kaup index and arm circum ference.