Thyroid function in obese Korean children and adolescents: Korea National Health and Nutrition Examination Survey 2013–2015

PURPOSE: In recent years, there has been an increasing focus on thyroid function in pediatric obese patients, but no nationwide study evaluating the relationship between thyroid function and obesity has yet been conducted in Korea. We aimed to evaluate thyroid dysfunction in obese Korean children. METHODS: We analyzed the associations between obesity and thyroid hormone levels among 975 Korean boys and girls aged 10–18 years and who participated in the Korean National Health and Nutrition Examination Survey VI (2013–2015). RESULTS: Average serum thyrotropin (TSH) and serum free thyroxine (fT4) levels in the nonobese group were 2.7±0.1 μIU/mL and 1.3±0.0 ng/dL, respectively, and those in the overweight group were 3.1±0.2 μIU/mL and 1.2±0.0 ng/dL. Serum TSH level was significantly higher in the abdominal obesity group than in the normal group (P=0.023). fT4 level was significantly lower in both the overweight and abdominal obesity groups than in the normal group (P < 0.001, P=0.014). Serum TSH level was associated positively with abdominal obesity and levels of high-density lipoprotein cholesterol and triglyceride. Serum fT4 level was negatively correlated with abdominal obesity (P=0.014). CONCLUSIONS: Korean children with abdominal obesity showed increased TSH and decreased fT4 levels compared to normal children.

Characteristics and Clinical Correlations of Staphylococcus aureus Discovered in Stools from Children Hospitalized at a Secondary Hospital

PURPOSE: Research on the clinical role of Staphylococcus aureus as a pathogen in acute gastroenteritis (AGE) in children has been scarce. This study aimed to clarify the prevalence and clinical correlation of S. aureus detection in children with AGE. METHODS: Fecal samples were collected from children with symptoms of AGE who visited a secondary hospital between January 2012 and December 2015. The samples were sent to the Seoul Metropolitan Government Research Institute of Public Health and Environment to test for pathogenic organisms. Clinical patterns were analyzed through medical record review. RESULTS: Among the 663 participants, the bacteria detection rate was 26.2% (n=174), the virus detection rate was 29.7% (n=197), and the non-detection rate was 43.1% (n=286). S. aureus was tested positive from 102 cases and was confirmed as a single pathogen in 53 cases. It was the third most common pathogen. The prevalence by age was highest (45.3%) in 0–2 year-olds. Most cases occurred in summer. Symptoms included diarrhea (71.7%), vomiting (67.9%), fever (49.1%), and abdominal pain (37.7%). Only vomiting showed a significant difference between the S. aureus group and the non-detection group (67.9% vs. 43.0%; P=0.001). Among enterotoxins, the higher incidence of vomiting was associated with classical staphylococcal enterotoxins (SEA, SEB, SEC, SED, and SEE) and SEH (P=0.027). CONCLUSIONS: S. aureus was the bacteria commonly isolated from children with AGE. Our study identified cases of staphylococcal AGE in children based on fecal samples and confirmed the characteristic symptoms, affected age groups, seasonal distribution, and correlation with enterotoxins.

The effect of low-dose intravenous bisphosphonate treatment on osteoporosis in children with quadriplegic cerebral palsy / 소아과

PURPOSE: Quadriplegic children with cerebral palsy are more susceptible to osteoporosis because of various risk factors that interfere with bone metabolism. Pamidronate is effective for pediatric osteoporosis, but there are no guidelines for optimal dosage or duration of treatment in quadriplegic children with osteoporosis. We aimed to evaluate the efficacy of low-dose pamidronate treatment in these patients. METHODS: Ten quadriplegic patients on antiepileptic drugs (6 male, 4 female patients; mean age, 10.9±5.76 years), with osteoporosis and gross motor function classification system level V, were treated with pamidronate (0.5–1.0 mg/kg/day, 2 consecutive days) every 3–4 months in a single institution. The patients received oral supplements of calcium and vitamin D before and during treatment. The lumbar spine bone mineral density (BMD) z score and biochemical markers of bone metabolism were measured regularly during treatment. RESULTS: The main underlying disorder was perinatal hypoxic brain damage (40%, 4 of 10). The mean cumulative dose of pamidronate was 4.49±2.22 mg/kg/yr, and the mean treatment period was 10.8±3.32 months. The BMD z score of the lumbar spine showed a significant increase from −4.22±1.24 before treatment to −2.61±1.69 during treatment (P=0.008). Alkaline phosphatase decreased during treatmentn (P=0.037). Significant adverse drug reactions and new fractures were not reported. CONCLUSION: Low-dose pamidronate treatment for quadriplegic children with cerebral palsy increased lumbar BMD and reduced the incidence of fracture.

Iron Contents in Rice Food Derived from the Iron Pot, and In Vitro Study Regarding Heme Oxygenase-1 Activity / 임상소아혈액종양

BACKGROUND: Iron pots have long been used for cooking in several countries. Early studies have shown that the use of such iron pots can increase the iron content of food cooked in them and that this increased iron content has some effect on iron uptake. This study was designed to evaluate the iron content in rice cooked in a traditional iron pot and study the iron uptake by macrophages through heme oxygenase-1 (HO-1).METHODS: The iron pot used in this study was round-shaped and had no legs. The iron content of rice cooked in the iron pot was measured. Thereafter, the bioavailability of iron was measured using western blot analysis.RESULTS: A total of 35 samples were analyzed for iron concentrations, which were 10.94±18.08 mg/L (range: 0.18–56.53 mg/L). The biochemical activity in most of materials was 1.5–9 times that of the activity observed in the control group.CONCLUSION: The iron concentration of rice cooked in iron pots were found to be relatively high. The introduction of iron pots in routine cooking practices may be a promising way of increasing the supply of iron, especially for people with severe iron deficiency anemia. Further, increased activity of HO-1, induced by supplementation of iron from the cast iron, may help in maintaining iron homeostasis.

Iron Contents in Rice Food Derived from the Iron Pot, and In Vitro Study Regarding Heme Oxygenase-1 Activity / 임상소아혈액종양

BACKGROUND: Iron pots have long been used for cooking in several countries. Early studies have shown that the use of such iron pots can increase the iron content of food cooked in them and that this increased iron content has some effect on iron uptake. This study was designed to evaluate the iron content in rice cooked in a traditional iron pot and study the iron uptake by macrophages through heme oxygenase-1 (HO-1). METHODS: The iron pot used in this study was round-shaped and had no legs. The iron content of rice cooked in the iron pot was measured. Thereafter, the bioavailability of iron was measured using western blot analysis. RESULTS: A total of 35 samples were analyzed for iron concentrations, which were 10.94±18.08 mg/L (range: 0.18–56.53 mg/L). The biochemical activity in most of materials was 1.5–9 times that of the activity observed in the control group. CONCLUSION: The iron concentration of rice cooked in iron pots were found to be relatively high. The introduction of iron pots in routine cooking practices may be a promising way of increasing the supply of iron, especially for people with severe iron deficiency anemia. Further, increased activity of HO-1, induced by supplementation of iron from the cast iron, may help in maintaining iron homeostasis.

An Outbreak of Mumps in a High School, Seoul, 2013

PURPOSE: This study investigated an outbreak of mumps affecting students in a high school (S high school) in Seoul, with an evaluation of the diagnostic utility of the mumps polymerase chain reaction (PCR) assay. METHODS: S high school students that presented to health care providers with mumps symptoms between April 2013 and July 2013 were surveyed for the monthly distribution of symptom onset and their grade level. Mumps PCR assays were performed using buccal swabs from some of these students. RESULTS: During the survey period, 77 students presented with suspected cases of mumps. The monthly distribution of symptom onset was as follows: one in April, 17 in May, 54 in June, and five in July. With regard to grade level, 26 students were in their first year, 28 were in their second year, and 23 were in their third year. Of the 18 students tested with PCR assays, five had positive results. Samples were collected within 3 days of symptom onset in 15 of the 18 students, and positive PCR results were obtained in five of these 15 students. The PCR results of the remaining three students from whom samples were collected more than 3 days after the onset of symptoms were negative (P=0.24). CONCLUSIONS: We evaluated the epidemiological aspects of an outbreak of mumps in a high school. Mumps PCR might be epidemiologically useful if performed within 3 days of the onset of symptoms in suspected cases.

Papillary Endothelial Hyperplasia of the Sella, Cavernous Sinus, Ethmoid and Sphenoid Sinus

Papillary endothelial hyperplasia(PEH), usually originates in extracranial soft tissue, is considered a reactive proliferation of endothlium and an unusual form of thrombus organization. However the occurance of PEH in the cranial cavity is very rare. The authors report a case of a PEH involving intracranial sella, parasella, cavernous sius, ethmoid and sphenoid sinus in an 11-year-old boy. The patient was presented with sudden right visual disturbance. Magnetic resonance image showed a well-enhanced mass in the right cavernous sinus extending into the ethmoid and sphenoid sinus. The cerebral angiography demonstrated a vigorous tumor staining supplied by both internal and external carotid arteries. The right fronto-temporal craniotomy and subtotal resection of the tumor were performed. The mass was comprised in a highly vascular red-black nodular tissue associated with a mixture of fresh and organizing thrombi. The histopathological examination revealed papillary structures lined by endothelium within vascular space with organized thrombus. While the patient was waiting for second operation in order to remove remaining small tumor in the ethmoid and sphenoid sinues, the lesion exhibited rapid regrowth and the size became to the preoperative size at three months after operation. At reoperation, gross total removal was accomplished by a combination of trans-cranial and trans-sphenoidal approaches. Postoperative radiotherapy was given.