Age and Dosage-related Longitudinal Changes in Body Mass Index on Epileptic Children Treated with Topiramate / 대한소아신경학회지

PURPOSE: The objective of this prospective study is to assess changes in body mass index(BMI, weight in kilograms/height in meters2) according to age and dosage on epileptic children treated with topiramate. METHODS: From January 2006 to December 2008, prospective studies have been performed on 63 children with epilepsy aged below 15 old who had been treated with topiramate. Patients were classified into 3 groups according to age: 2-5 years as a group 1; 6-10 years as a group 2; 11-15 years as a group 3;, and classified into 2 groups according to dosage: from 2 to 5 mg/kg/day as group A, more than 5 mg/kg/day to 8 mg/kg/day as group B. We have checked BMI of patients four times and evaluated the changes in BMI of each group. RESULTS: BMI at initial presentation and follow-up periods of 6, 12, and 24 months is as follows: 16.3+/-1.25, 14.3+/-1.8, 14.2+/-2.4, and 15.7+/-2.1 in the group 1, 18.5+/-1.23, 15.2+/-1.24, 14.8+/-2.27, and 16.8+/-2.5 in the group 2, 21.6+/-2.31, 16.5+/-2.17, 15.4+/-2.56, and 15.1+/-1.3 in the group 3. Comparing with group A and B is as follows: 19.3+/-2.35 and 18.1+/-1.89 at initial presentation, 15.5+/-2.45 and 15.1+/-1.15 at 6 months, 14.9+/-2.15 and 14.7+/-1.91 at 12 months, 15.9+/-1.28 and 16.0+/-1.12 at 24 months. CONCLUSION: The effect of topiramate on changes of BMI shows difference according to age. In groups of 2-10 years old, BMI was rebounded from lowest value after 12 months, however, in the group of 11-15 years old, BMI kept decreasing at 24 months. And dosage of topiramate does not affect to BMI significantly.

Complete rooming-in care of newborn infants / 소아과

PURPOSE: In Kyung Hee East-West Neo Medical Center, Seoul, Korea, efforts to raise rooming-in care success rate have been undertaken since when the hospital was established in 2006. We intended to analyze our experience over the past 3 years of period and to discuss the advantages of rooming-in. METHODS: We analyzed the rooming-in practice rate, failure rate, and the breast feeding rate. Subjects were 860 normal healthy neonates from June 2006 to June 2009. RESULTS: Among these 860 cases, 83 babies were required separation out of rooming-in in the middle of the course. Among these 83 cases, 70 cases had to stop the course due to poor condition of babies and 13 cases due to maternal condition. 70 cases of infant's causes consist of 68 cases of NICU admission and 2 cases of poor feeding support. The other 13 cases of separation include refusal by maternal condition. Therefore the success rate of rooming-in for the last 3 years was 90.3%, that is 777 cases among the total 860 cases. The percentage of exclusive breast feeding was 64%, that of mixed feeding with breast and formula feeding was 25%, and formula feeding only was 11%. CONCLUSION: We experienced successful rooming-in care for the last 3 years. Nursery facilities should educate and encourage the advantages of rooming-in, including the good formation of attachment between mother and infant, emotional stability, protection from infection, and increased breast feeding rate so that rooming-in care can be fully established.

A report on operating a nationwide human milk bank in Korea / 소아과

PURPOSE: A human milk bank collects, processes, eliminates, and stores breast milk from donors and provides breast milk to those in need. The authors hereby present the experiences and the objective lessons obtained through operating a nationwide human milk bank over a period of 2 years. METHODS: The characteristics of the donors and the recipients and the amounts of breast milk donated, processed, and received at the East-West Neo Medical Center Human Milk Bank were investigated from August 2007 to August 2009. RESULTS: The donor pool consisted of 131 first-time donors and 39 repeat donors who made 341 and 127 donations, respectively. Seventy-nine percent of the donors resided in the Seoul-Kyunggi area, and 60% of the donors were in their 30s. Most information and motivation came from the Internet (66%) or television (14%). A total of 2,736 L of breast milk was collected, and 1,979 L were processed. The cumulative number of recipients was 160 preterm or full-term infants and 21 adults, each group receiving the breast milk 337 and 41 times, respectively. In total, infants received 1,663 L and adults received 179 L. CONCLUSION: Through the present study, the role and importance of a human milk bank in collecting, pasteurizing, and storing surplus breast milk in through sanitary, medically proven methods and providing this breast milk to recipients could be appreciated and reevaluated. The authors believe that a national support system is necessary to expand this practice to a nationwide scale.

A Study on Risk Factors of Recurrent Otitis Media / 소아감염

PURPOSE: Recurrent otitis media (ROM) is usually defined as > or =3 distinct and well-documented episodes within 6 months or > or =4 episodes within 12 months. ROM is sufficiently important to warrant consideration of chemoprophylaxis, tympanostomy tube placement. There also is evidence that children with ROM are at risk for both hearing loss and speech delay. However, studies of ROM have been notably insufficient. In addition, even though environmental, racial, and sociocultural differences can affect risk factors, few studies have been conducted with regard to recurrent otitis media in Korea. METHODS: This study was conducted from July 2009 to January 2010 with infants and children who were younger than 60 months old, who visited the out-patient clinics at Han-Il General Hospital and Kyunghee University Hospital. Data were collected by interview using a pre-formed sheet. Among a total of 892 infants and children, 457 were excluded, and the remaining 435 were allocated to 104 with ROM and 331 as a control group. RESULTS: Attendance at daycare centers (P<0.001, OR=2.85), allergic rhinitis (P=0.026, OR=2.32), past history of bronchiolitis (P=0.003, OR=2.33), and low socioeconomic status (P=0.005, OR=2.00) were found to have a close significant correlation with ROM. Risk factors such as sex, having a sibling, breast-feeding, use of pacifiers, atopy, pneumococcal vaccination, influenza vaccination, smoking of parents, and indoor smoking are not relevant. CONCLUSION: Attendance at daycare centers, allergic rhinitis, past history of bronchiolitis, and low socioeconomic status have been identified as risk factors for ROM.