Influenza Vaccine Effectiveness among Elementary School Students in Korea during the 2016-2017 Seasons: a Cross-Sectional Survey

The Characteristics and Outcomes of Abernethy Syndrome in Korean Children: A Single Center Study / 대한소아소화기영양학회지

PURPOSE: Abernethy malformation is a rare condition, which was first described in 1793 as a congenital extrahepatic porto-systemic shunt (CEPS) directing splanchnic blood flow into the inferior vena cava. Eighty cases have been published so far that reported CEPS, while in Korea, very few cases have been reported. Through this study, we present 6 cases of patients diagnosed with CEPS at Samsung Medical Center and compare these with other such cases published in France and China. METHODS: We reviewed clinical, laboratory, and imaging data of 6 children with CEPS in our pediatric clinic between 2004 and 2017. RESULTS: A total of 6 children with CEPS was included in this study, namely, one with type 1a, two with type 1b, and three with type 2 CEPS. The most common presenting symptom was gastrointestinal bleeding (50.0%). Therapeutic interventions included shunting vessel ligation (16.7%) in type 2 CEPS and liver transplantation (16.7%) in type 2 CEPS patient with suddenly developed hepatic encephalopathy. CONCLUSION: There is no consensus guideline for the optimal management of patients with CEPS. Large-sample studies regarding CEPS are needed to evaluate the characteristics of patients with CEPS and determine the treatment guideline for CEPS.

Evaluation of the meal variety with eating breakfast together as a family in Korean children: based on 2013 ~2015 Korean National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: The aim of this study was to identify the nutritional status in Korean children eating breakfast together as a family or skipping breakfast from the 2013 ~ 2015 Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: A total of 1,393 subjects (boys = 731, girls = 662), aged 6 ~ 11 years, were presented with a 24 hr-recall method, and classified according to their eating breakfast together as a family or skipping breakfast; and eating breakfast together as a family (EBF group; boys = 580, girls = 548), eating breakfast alone (EBA group; boys = 100, girls = 67), and skipping breakfast (SB group; boys = 51, girls = 47). RESULTS: In the boys, the SB group had a significantly lower carbohydrate (p = 0.0198) and vitamin C (p = 0.0219) density, and a higher fat (p = 0.0020) density than the EBF and EBA groups. In both boys and girls, the EBF and EBA groups showed a significantly larger number of dishes in breakfast than the SB group (p < 0.0001, respectively). In boys, the EBF group showed a significantly higher number of foods in breakfast than the EBA and SB groups (p < 0.0001). CONCLUSION: Children eating breakfast together as a family may be associated with a variety of food intake than children eating breakfast alone and skipping breakfast.

A comparative study of established z score models for coronary artery diameters in 181 healthy Korean children / 소아과

PURPOSE: The aim of this study was to investigate the statistical properties of four previously developed pediatric coronary artery z score models in healthy Korean children. METHODS: The study subjects were 181 healthy Korean children, whose age ranged from 1 month to 15 years. The diameter of each coronary artery was measured using 2-dimensional echocardiography and converted to the z score in the four models (McCrindle, Olivieri, Dallaire, and Japanese model). Descriptive statistical analyses and 1-sample t tests were performed. RESULTS: All calculated z scores had P values of ≥0.050 using the Kolmogorov-Smirnov test. The one sample t test showed that the mean z scores did not converge to zero except in 1 model, and the mean right coronary artery (RCA) z score was less than zero in all 4 models. The smaller RCA diameter in this study could be associated with the more distal measuring point used to avoid the conal branch. The percentage of subjects with extreme z score values (≥2.0 and ≥2.5) for the left main coronary artery (LMCA) seems to be higher in the Dallaire (4.9% and 3.3%) and Japanese models (7.1% and 3.8%). CONCLUSION: All 4 models showed statistical feasibility of normal distribution. More precise instructions would be needed for the measurement of the RCA. The higher percentage of extreme z scores for the LMCA is compatible with the basic understanding of anatomic variation in the LMCA.

Association between GABA3 Gene Polymorphisms and Attention Deficit Hyperactivity Disorder in Korean Children

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is common disorder of the school-age population. ADHD is familial and genetic studies estimate heritability at 80–90%. The aim of the present study was to investigate the association between the genetic type and alleles for gamma-aminobutyric acid receptor subunit beta-3 (GABA3) gene in Korean children with ADHD. METHODS: The sample consisted of 180 ADHD children and 159 control children. We diagnosed ADHD according to DSM-IV. ADHD symptoms were evaluated with Conners' Parent Rating Scales and Dupaul Parent ADHD Rating Scales. Blood samples were taken from the 339 subjects, DNA was extracted from blood lymphocytes, and PCR was performed for GABA3 rs2081648, rs1426217 and rs981778 Polymorphism. Alleles and genotype frequencies were compared using the chi-square test. We compared the allele and genotype frequencies of GABA3 gene polymorphism in the ADHD and control groups. RESULTS: This study showed that there was a significant correlation among the frequencies of the rs2081648 (OR=0.71, 95% CI=0.51–0.98, p=0.040) of alleles of MAO, but the final conclusions are not definite. Follow up studies with larger patient or pure subgroups are expected. CONCLUSION: These results suggested that GABA3 might be related to ADHD symptoms.

Nutrition in Chinese-Korean Children and Adolescents / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the nutrition habits among Chinese-Korean children and adolescents in Yanbian Autonomous Prefecture, Jilin, China.</p><p><b>METHODS</b>Data were obtained from the Chinese National Survey on Students' Constitution and Health in 1995, 2000, 2005, and 2010 for Chinese-Korean children and adolescents aged 7-18 years. The number of the subjects included was 4789, 4704, 5875, and 5315, respectively.</p><p><b>RESULTS</b>The rate of the occurrence of stunting showed a declining trend from 1995 to 2010 (for boys: urban, 6.3%; rural, 12.7% in 1995 and 3.5% for both in 2010. For girls: urban, 7.8%; rural, 13.4% in 1995 and 4.2% and 5.5%, respectively, in 2010). Although the ratio of wasting did not show significant differences between the urban and rural children and adolescents in 1995, 2000, 2005, and 2010 respectively, the ratio of occurrence of overweight or obesity increased (for boys: urban, 7.3% and 1.3% in 1995, 17.6% and 12.9% in 2010; rural, 7.0% and 1.3% in 1995, 14.6% and 12.8% in 2010, respectively. For girls: urban, 8.1% and 1.0% in 1995, 17.3% and 8.6% in 2010; rural 5.7% and 0.7% in 1995, 16.4% and 7.4% in 2010, respectively).</p><p><b>CONCLUSION</b>The ratio of malnutrition in children and adolescents in Chinese-Korean areas declined from 1995 to 2010, and the distinction in malnutrition between the urban and rural areas was negligible in 2010. Further, the ratio of overweight and obesity increased over this period.</p>

Gender Differences in the Relationship between Social Jet Lag, Depression, and Obesity in Korean Children and Adolescents

OBJECTIVES: A majority of South Korean adolescents experience chronic sleep-deprivation due to social jet lag. In this study, we investigated gender differences in the relationship between social jet lag, depression, and obesity in Korean children and adolescents. METHODS: Our sample consisted of 4,380 adolescents (elementary school cohort n=2,141, middle school cohort n=2,239) who participated in the Korean Children and Youth Panel Survey. In order to analyze the gender differences in the relationship between sleep time difference, obesity and depression, t-test and chi-square test were utilized. RESULTS: Both cohorts revealed that the difference in weekday/weekend sleep duration (2.19+/-1.42 vs. 1.68+/-1.36, p2 hours). Both elementary school [chi2 (1)=8.73, p<0.05] and middle school cohorts [chi2 (1)=61.29, p<0.001] showed significant gender differences. CONCLUSIONS: There were especially more girls who reported a discrepancy of 2 or more hours of weekday/weekend sleep duration. In summary, intervention for social jet lag may be important to consider in adolescents.

Dental caries pattern in primary dentition among Korean children / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to analyze the dental caries pattern in primary dentition of Korean children aged 2-5 years old. METHODS: The dental caries pattern in primary dentition was analyzed using data from the Korea National Oral Health Survey, 2006. Subjects for this study were 582 children aged 2-5 years old. Statistical analysis was conducted with frequency analysis, correlation analysis, cluster analysis, and multiple correspondence analysis. RESULTS: The tooth with highest prevalence of caries experience at 5 years old was the tooth 85 and the tooth 75 was followed. When dentition was divided on the basis of quadrants, the correlation of caries occurrence was more related to the relationship between the left and right teeth rather than the upper and lower teeth. In particular, the correlation of left and right caries occurrence was high in the mandible. In order to analyze the dental caries pattern under the age of 5 years, we divided the teeth into four clusters, i.e., deciduous incisors, first deciduous molars, mandibular second deciduous molars, and maxillary second deciduous molars. In children aged 2 and 3 years, severe early childhood caries pattern (ECC pattern) was observed. If it was divided into two clusters at age 4, the pattern was visible in which teeth were divided into anterior and posterior caries. Our multiple correspondence analysis results did not perfectly match those of the cluster analysis, but it was helpful to visually identify the teeth showing a similar caries pattern. CONCLUSIONS: Differences in the dental caries pattern in primary dentition was age dependent. Information on caries pattern in primary dentition by each tooth can be useful for study on caries in primary dentition and clinical care.

IgE mediated food allergy in Korean children: focused on plant food allergy

Food allergy (FA) is a worldwide problem, with increasing prevalence in many countries, and it poses a clearly increasing health problem in Korea. In Korea, as a part of International Study of Asthma and Allergy in Childhood (ISAAC), a series of nation-wide population studies for prevalence of allergic disease in children were carried out, with the Korean version of ISAAC in 1995, 2000, and 2010. From the survey, the twelve-month prevalence of FA showed no significant differences from 1995 to 2000 in both age groups (6-12 years-old, 6.5% in 1995 and 5.7% in 2000; 12-15 year-olds, 7.4% in 1995 and 8.6% in 2000). The mean lifetime prevalence of FA which had ever been diagnosed by medical doctor was 4.7% in 6-12 year-olds and 5.1% in 12-15 year-olds respectively in 2000. In Korean children, the major causes of FA are almost same as in other countries, although the order prevalence may vary, a prime example of which being that peanut and tree nut allergies are not prevalent, as in western countries. Both pediatric emergency department (ED) visits and deaths relating to food induced anaphylaxis have also increased in western countries. From a study which based on data from the Korean Health Insurance Review and Assessment Service (KHIRA) from 2001 to 2007, the incidence of anaphylaxis under the age of 19 was 0.7-1 per 100,000 person-year, and foods (24.9%) were the most commonly identified cause of childhood anaphylaxis. In another epidemiologic study, involving 78889 patients aged 0-18 years who visited the EDs of 9 hospitals during June 2008 to Mar 2009, the incidence of food related anaphylaxis was 4.56 per 10,000 pediatric ED visits. From these studies, common causes of food related anaphylaxis were seafood, buckwheat, cow's milk, fruits, peanut and tree nuts. Although systematic epidemiologic studies have not reported on the matter, recently, plant foods related allergy has increased in Korean children. Among 804 children with moderate to severe atopic dermatitis, we reveals that the peanut sensitization rate in Korea reaches 18%, and that, when sensitized to peanut, patients showed a significant tendency to have co-sensitization with house dust mites, egg white, wheat, and soybean. The higher specific IgE to peanut was related to the likelihood of the patient developing severe systemic reactions. In another study, based on the data analysis of 69 patients under 4 years of age who had suspected peanut and tree nut allergy, 22 (31.9%) were sensitized to walnut (>0.35 kU/L, 0.45-27.4 kU/L) and 6 (8.7%) experienced anaphylaxis due to a small amount of walnut exposure. Furthermore, in this review, clinical and immunological studies on plant food allergies, such as buckwheat allergy, rice allergy, barley allergy, and kiwi fruit allergy, in Korean children are discussed.

The Posterior Choroidal Profiles Measured by Spectral Domain Optical Coherence Tomography in Healthy Korean Children

PURPOSE: We assessed changes of the choroidal thickness in healthy Korean children using enhanced depth imaging (EDI) optical coherence tomography (OCT) and evaluated the association of choroidal thickness and axial length. METHODS: Seventy-nine eyes (79 children) within +/-1 diopter spherical equivalent underwent horizontal and vertical scan using EDI OCT. Two observers determined independently the choroidal thickness at 1 mm intervals from 3 mm nasal and 4 mm temporal to the fovea and 1 mm superior and inferior to the fovea using the manual caliper provided by the device software. Statistical analysis was performed to evaluate variations of choroidal thickness at each location and to correlate choroidal thickness and axial length. Intraclass correlation coefficient (ICC) was calculated. RESULTS: The subjects' mean age was 7.67 years. The mean axial length was 22.96 mm and mean subfoveal choroidal thickness was 296.13 microm. The thinnest choroidal thickness was 160.57 microm at 3 mm nasal to the fovea and the thickest was 319.49 microm at 4 mm temporal to the fovea. The choroidal thickness at 1 mm superior (294.70 microm) and inferior (287.11 microm) to the fovea showed no statistical significance compared with the subfoveal choroidal thickness. The mean choroidal thickness was thicker at 3 mm and 2 mm nasal to the fovea in eyes with shorter than the mean axial length (p < 0.05). For the assessment of intra-observer reproducibility, the ICC ranged from 0.995 to 0.998 (p < 0.001). CONCLUSIONS: The choroidal thickness increased from the nasal to the temporal direction at the posterior pole and eyes with shorter axial lengths tended to present thicker choroids at the nasal area in healthy Korean children.

Comparison of Food and Nutrient Consumption Status between Displaced North Korean Children in South Korea and South Korean Children / 대한지역사회영양학회지

Many displaced North Koreans (NK) are living in South Korea (SK); however nutrition research with the displaced NK is limited. This study examined food and nutrient consumption status of displaced NK children (6-18 year-old) currently living in SK. A total of 154 children were recruited, and a pre-tested dietary behavior questionnaire, food frequency questionnaire, 24-hr recall method were used. Sex- and age-matched SK children (n = 462) randomly selected from 2009-2010 Korea National Health and Nutrition Examination Survey were used as the comparison group. This study found that more NK children skipped breakfast (37%) and dinner (11%), and ate breakfast (38.8%) and dinner (18.2%) without family members than SK children. Many NK children reported that they rarely ate bread, rice cake, hamburger, pizza, fried food, candy. NK children consumed significantly less energy and nutrients (except calcium) and obtained more energy from fat and protein than SK children. Overall index of nutrient quality in NK children, however, was generally good. Length of stay in SK and breakfast skipping rates were significantly associated with lower diet quality. Therefore, nutrition education with displaced NK children should target those who recently came to SK. How to incorporate "new" foods, generally high in energy, sugar, or fat, in healthy ways and importance of breakfast should be emphasized. The growth patterns of the displaced NK children who were born and raised in food-deprived environments and will grow in food-affluent environments of SK should be monitored for health promotion of the NK children and for nutrition policy of the future united Korea.

The Relationship between High Energy/Low Nutrient Food Consumption and Obesity among Korean Children and Adolescents / 대한지역사회영양학회지

Consumption of foods with high energy and low nutrient values has been linked to various health issues including obesity and chronic diseases. This study investigated the high-energy/low-nutrient food consumption status and its relationship with obesity status and intake of energy and nutrients, using the Korea National Health and Nutrition Examination Survey (KNHANES) and the Korea Youth Risk Behavior Web-based Survey (KYRBWS). The prevalence of overweight and obesity among 2-18 year-olds was 8.4% and 10.8% in 2008 and 8.5% and 9.0% in 2009, respectively, in KNHANES. The prevalence of obesity among 12-18 year-olds was 13.9% in 2008 and 11.4% in 2009 in KNHANES, while it was 8.1% in 2008 and 8.2% in 2009 in KYRBWS. Consumption patterns of high-energy/low-nutrient foods were diverse depending on the particular food type. High-energy/low-nutrient foods such as cookies were most often consumed more frequently (2~3 times per week), but fast food type foods were generally consumed less frequently (once per week or less). No significant relationships between high-energy/low-nutrient food consumption and level of energy and nutrient intakes were found in either datasets. Adolescents who were not obese more frequently consumed ramen (p < 0.001), cookies (p < 0.001) and fast food (p < 0.001) than those who were obese in KYRBWS, however, such relationships were not found in KNHANES. This direction of the relationship could be probably attributed to the cross-sectional nature of the datasets. This study was limited by the cross-sectional nature of the data, therefore, further longitudinal research using various study techniques would be necessary to understand the effects of high-energy/low-nutrient foods on child obesity.

The impact of HLA matching on unrelated donor hematopoietic stem cell transplantation in Korean children

BACKGROUND: The impact of HLA matching on outcomes of unrelated donor (URD) hematopoietic stem cell transplantation (HSCT) varies in different racial or ethnic groups. Since little is known about the impact of such matching on URD HSCT in Korean children, we analyzed this issue. METHODS: We analyzed the outcomes of 142 patients who underwent URD HSCT at 4 Korean medical centers. All patient donor pairs were fully typed for HLA-A, -B, -C, and -DR alleles. RESULTS: At a median follow-up of 22 months, 3-year survival rates for patients with 8, 7, and < or =6 matched alleles were 88.4%, 70.7%, and 53.6%, respectively. A single mismatch (Mm) at HLA-B or -C was associated with lower survival compared with that associated with 8 matched alleles. No significant differences were observed between single-allele and single-antigen Mms with respect to survival rate or acute graft-versus-host disease (aGVHD) incidence rates. HLA disparity had a greater impact on the survival of patients with high-risk malignancy than of those with low-risk malignancy. Among pairs with a single Mm, only locus A showed a significant association and higher risk of grade III-IV aGVHD compared to those in patients with 8 matched alleles. CONCLUSION: Disparity in HLA class I, regardless of antigen or allele Mm, adversely affected both survival and grade III-IV aGVHD development. An increased number of HLA Mms was associated with a higher risk of post-transplantation complications. Further investigations using larger cohorts are required to confirm the effects of HLA mismatching on URD HSCT patient outcomes.

Anatomical Brain Connectivity Map of Korean Children

PURPOSE: The purpose of this study is to establish the method generating human brain anatomical connectivity from Korean children and evaluating the network topological properties using small-world network analysis. MATERIALS AND METHODS: Using diffusion tensor images (DTI) and parcellation maps of structural MRIs acquired from twelve healthy Korean children, we generated a brain structural connectivity matrix for individual. We applied one sample t-test to the connectivity maps to derive a representative anatomical connectivity for the group. By spatially normalizing the white matter bundles of participants into a template standard space, we obtained the anatomical brain network model. Network properties including clustering coefficient, characteristic path length, and global/local efficiency were also calculated. RESULTS: We found that the structural connectivity of Korean children group preserves the small-world properties. The anatomical connectivity map obtained in this study showed that children group had higher intra-hemispheric connectivity than inter-hemispheric connectivity. We also observed that the neural connectivity of the group is high between brain stem and motorsensory areas. CONCLUSION: We suggested a method to examine the anatomical brain network of Korean children group. The proposed method can be used to evaluate the efficiency of anatomical brain networks in people with disease.

The estimated daily manganese intake of Korean children aged 11-12

The purpose of this study was to estimate the daily manganese (Mn) intake of Korean children. This study was done using a three-day dietary intake survey of 257 Korean children (boys 123; girls 134). The Mn intake values were calculated based on a database that provides the Mn content of the frequently consumed Korean foods, alongside the food composition table provided by the Korean National Rural Living Science Institute. The average age, height, weight and body mass index of our subjects were 11.9 years, 155.4 cm, 48.9 kg and 20.2 kg/m2 in boys and 11.9 years, 154.1 cm, 43.5 kg and 18.3 kg/m2 in girls. The average daily energy intakes were 2,249.2 kcal in boys and 2,044.5 kcal in girls. Boys consumed significantly more Mn than girls, based on intake estimates of 4,585.3 microg (117.6% of adequate intake) and 4,029.3 microg (117.1% of adequate intake), respectively (P < 0.001). Boys had a Mn intake of 2,041.1 microg per 1,000 kcal of energy consumption, whereas for girls this was at 1,983.9 microg per 1,000 kcal. Neither group exceeded the tolerable upper intake level for Mn. The major food groups which contributed to Mn intake in our subjects were cereals (50.8%), vegetables (21.0%), seasonings (8.9%), and pulses (7.7%). Notably, boys derived a higher Mn intake through cereals and vegetable than did girls (P < 0.001, P < 0.05). The key food sources of Mn, in descending order, were rice, soybean curd, kimchi, black rice and cereals. We propose that the results of our study may be used as a basis for follow-up studies that examine the Mn intake of children.

Establishment of One Portion Size of Foods Frequently Consumed by Korean Children Aged 6-11 Using 2005 Korea National Health and Nutrition Examination Survey and Its Comparison with Adults / 대한지역사회영양학회지

The purpose of this study was to define a one portion size of food frequently consumed by Korean children aged 6-11 for convenient use in food selection, diet planning, nutritional evaluation, and nutrition education. We analyzed using the original data on 889 persons (9.96%) aged 6-11 years among 8,930 persons to whom NHANES 2005 and selected food items consumed by the intake frequency of 10 or higher among the 500 most frequently consumed food items. A total of 172 varieties of food items of regular use were selected. Also the portion size of food items was set on the basis of the median (50 percentile) of the portion size for a single intake by a single person was analyzed. The portion size of cereals was 5 g for prosomillet to 120 g for hamburger. As for vegetables, it posted 1 g for red pepper to 50 g for nabakkimchi. The portion size of meats and products was 15 g for luncheon meat to 120 g for beef feet soup. In comparison of children's portion size with adults', the children's portion sizes of every food groups, with the exception of meats and eggs, were lower than those of adults. The portion size of the regular food items of children in this study will be conveniently and effectively used by children, children's diet planners and researchers in selecting food items for a nutritionally balanced diet and in assessing the children's diet intake.

Clinical Characteristics and Epidemiology of Nonpolioenteroviral Infections, including Enteroviruis 71 in Children in Jeju-do, Korea between April and June 2000 / 소아감염

PURPOSE:We undertook this study to improve our understanding of the epidemiologic and clinical features of non-polioenterovirus (NPEV) infections, especially enterovirus 71 (EV71) infections, in Korean children. METHODS:Between April and June 2000, NPEVs were detected by RT-PCR and cultures of specimens obtained from patients with aseptic meningitis, acute respiratory disease, and acute gastroenteritis which were associated with enteroviral exanthem and vesicular pharyngeal enanthem, such as herpangina, and hand, foot, and mouth disease (HFMD). EV71 was identified by sequencing the VP1 gene. The clinical and epidemiologic data were analyzed retrospectively after all 87 NPEV-positive patients were divided into 4 groups, according to the clinical manifestations. Sixteen patients who mainly had symptoms of acute gastroenteritis were in group A, 21 patients with symptoms and signs of lower respiratory tract infections were in group B, 42 patients with a HFMD rash only were in group C with or without fever, and 8 patients with aseptic meningitis or paralysis were in group D. For the 11 EV71-positive patients, 1 was in group A, 2 were group B, 7 were in group C, and 1 was in group D. RESULTS:There were 87 NPEV infections, including 11 EV71 infections. The mean age of the patients was 2 years and 11 months, ranging from 1 day to 15 years. There were no fatal cases among a total of 87 NPEV infections and no significant differences in clinical severity between the EV71 and other NPEV infections. CONCLUSION:NPEV infections in children were common during the 3 months in the spring of 2000. Unlike in southeast Asia, where fatal EV71 infection outbreaks have occurred since 1997, the clinical features of EV71 infection in Korean children are mild.

Ocular Findings in Children with Down's Syndrome

In order to identify the characteristic ocular findings in Down's syndrome(DS), 123 Korean children with DS prospectively underwent ocular examination, including visual acuity assessment, slit-lamp biomicroscopy, ocular motility, cycloplegic refraction, and ophthalmoscopy. The ocular findings in decreasing prevalence were the following:upward slanting of the palpebral fissure(78 patients, 63%), epicanthus(75 patients, 61%), epiblepharon(66 patients, 54%), astigmatism(38 patients, 31%), hyperopia(35 patients, 28%), myopia(31 patients, 25%), strabismus(31 patients, 25%, 18 esotropia and 13 exotropia), nystagmus(27 patients, 22%), nasolacrimal duct obstruction(21 patients, 17%), blepharoconjunctivitis(20 patients, 16%), retinal abnormalities(18 patients, 15%), cataract(4 patients, 13%), and glaucoma(1 patient, 0.8%). Brushfield spots and keratoconus were not found. The ocular findings in Korean children with DS are characterized as an unreported, high incidence of epiblepharon, the highest rate of exotropia as reported, and no cases of Brushfield spots. The difference in the incidence of these ocular abnormalities according to race and age should be considered in every patient with DS.

Characteristics of the 3D Gait Analysis in Gait Maturation Process in Korean Children

OBJECTIVE: To find out the characteristics of gait maturation process in Korean normal children. METHOD: Three dimensional kinematic gait analysis using Vicon 370 system from Oxford Metrics Company was performed for 72 children (33 females) without known gait anomalies aging between one and six years old. The data were compared with those from 41 normal adults which were collected previously using the same method, and with those from study by Sutherland et. al. RESULTS: 1. The initial heel contact, initial flexion wave of the knee joint during the early stance phase and reciprocal arm swing were found before the age of 3.5. 2. Pelvic motion in transverse plane, hip joint motion in all the three planes, knee joint motion in coronal plane, and ankle joint motion in transverse plane remained greater than those of Caucasian children of Sutherland et. al. 3. Single stance period remained shorter than that of Caucasian children. 4. Internal rotation of hip joint and varus motion of the knee joint remained greater than those of Caucasian children. CONCLUSION: The difference between Korean and Caucasian children were 1. Development of muscles' ability which stabilize the large leg joints during gait seems slower among Korean children than Caucasian children. 2. These differences are probably from the anthropometrical characteristics of Korean and Caucasian growing children. Also, the different definition of angle systems between the Korean and Caucasian data might case some erroneous effect on the interpretation of result.

A Study for Causes of Death in Korean Children

PURPOSE: Analyzing of the causes of childhood death will provide us with the basis to understand prevalent diseases and to make the best possible health plan according to the studies. The National Statistical Office (NSO) of Korea has released an annual report of nationwide death. However, it could have underestimated the death toll of children because of delayed or missing reports of infants who died during the neonatal period. The death reports by pediatricians at hospitals could compensate for the dropped number of infantile death reported by the NSO. METHODS: We collected the death records for children under 15 years of age from the 136 secondary or tertiary referral hospitals over the country from January 1 through December 31, 1995. Then we tried to make a compilation of the records from both the NSO and our committee to finalize the cause of death. RESULTS: According to the records of the 136 hospitals, the total number of childhood death was 3,900 in 1995, including 1,790 deaths in the first 28 days of life. Most deaths occurred in the hospital (89.0%), which were confirmed either by a pediatrician (6.2%) or by a pediatric resident (58.8%). We were compiling 6,735 deaths according to the NSO and 3,415 of our own, with 846 overlaps. Seventeen deaths recorded by the NSO occurred in the first 6 days of life, compared to 1,292 from our own. After the first year, 4,762 deaths recorded by the NSO and 790 of ours were observed. CONCLUSION: The death records from hospitals could be enough to compensate for the dropped number of neonatal deaths recorded by the NSO, depicting more accurately the real pattern of death for Korean children in 1995.