Growth hormone treatment and risk of malignancy

채현욱,김덕희,김호성 대한소아청소년과학회 2015 Clinical and Experimental Pediatrics (CEP) Vol.58 No.2

Growth hormone (GH) treatment has been increasingly widely used for children with GH deficiencies as the survival rate of pediatric patients with malignancies has increased. Both GH and insulin-like growth factor-I have mitogenic and antiapoptotic activity, prompting concern that GH treatment may be associated with tumor development. In this review, the authors examined the relationship between GH treatment and cancer risk in terms of de novo malignancy, recurrence, and secondary neoplasm. Although the results from numerous studies were not entirely consistent, this review of various clinical and epidemiological studies demonstrated that there is no clear evidence of a causal relationship between GH treatment and tumor development. Nonetheless, a small number of studies reported that childhood cancer survivors who receive GH treatment have a small increased risk of developing de novo cancer and secondary malignant neoplasm. Therefore, regular follow-ups and careful examination for development of cancer should be required in children who receive GH treatment. Continued surveillance for an extended period is essential for monitoring long-term safety.

Incidence and Prevalence of Type 1 Diabetes Mellitus among Korean Children and Adolescents between 2007 and 2017: An Epidemiologic Study Based on a National Database

채현욱,서기현,송경철,최한샘,서정환,권아름,하상미,김호성 대한당뇨병학회 2020 Diabetes and Metabolism Journal Vol.44 No.6

Background The incidence of type 1 diabetes mellitus (T1DM) among children is high in Europe and the USA and relatively low in Asia, including Korea. The present study aimed to investigate the incidence and prevalence of childhood-onset T1DM in Korea and examine trends in incidence. Methods This study was conducted using the national registry data provided by the Health Insurance Review and Assessment Service in Korea from 2007 to 2017. We included children aged 0 to 14 years who were newly registered with a T1DM diagnosis each year (code E10). Results A total of 29,013 children were registered. The overall incidence of T1DM was 4.45 per 100,000 persons (girls, 4.93; boys, 4.01). The overall incidence of childhood-onset T1DM in Korea increased from 3.70 in 2008 to 4.77 in 2016 (P=0.002). The incidence of T1DM increased from 3.07 in 2008 to 4.89 in 2016 (P<0.001) among boys. Although the incidence of the disease increased significantly among boys aged 5-9 and 10-14 years, it remained constant among girls (4.39 in 2008, 4.64 in 2016). The overall prevalence of childhood-onset T1DM in Korea increased from 32.85 in 2007 to 41.03 per 100,000 persons in 2017 (girls, 35.54 to 43.88; boys, 32.85 to 41.03). Conclusion We calculated relatively accurate incidence and prevalence of childhood-onset T1DM from a nation-based registry. The incidence increased by 3% to 4% every year from 2007 to 2017. The increasing trend is noteworthy compared with previous reports.

Commentary on "Ambient air pollution and endocrinologic disorders in childhood"

채현욱 대한소아내분비학회 2021 Annals of Pediatirc Endocrinology & Metabolism Vol.26 No.3

Longitudinal Standards for Height and Height Velocity in Korean Children and Adolescents: the Kangwha Cohort Study

채현욱,서일,권아름,김예진,김용혁,강대룡,김하얀,오선민,김현창,김덕희,김호성 대한의학회 2013 Journal of Korean medical science Vol.28 No.10

Longitudinal standards for height and height velocity are essential to monitor for appropriate linear growth. We aimed to construct standards in Korean children and adolescents through the population-based longitudinal Kangwha study. Our study was a part of a community-based prospective cohort study from 1986 to 1999 with 800 school children. Height and height velocity were recorded annually from age 6 until final height. Results were compared with cross-sectional data from the 2007 Korean National Growth Charts. Final height was 173.5 cm in boys and 160.5 cm in girls. Although final height was similar between longitudinal and cross-sectional standards, the mean height for age was higher in the longitudinal standard by 1-4 cm from age 6 until the completion of puberty. Using the longitudinal standard, age at peak height velocity (PHV) was 12 in boys and 10 in girls; height velocity at PHV was 8.62 cm/yr in boys and 7.07 cm/yr in girls. The mean height velocity was less than 1 cm/yr at age 17 in boys and 15 in girls. Thus, we have presented the first report of longitudinal standards for height and height velocity in

Sex hormone binding globulin, free estradiol index, and lipid profiles in girls with precocious puberty

채현욱,권아름,Duk-Hee Kim,김호성 대한소아내분비학회 2013 Annals of Pediatirc Endocrinology & Metabolism Vol.18 No.2

Purpose: Sex hormone-binding globulin (SHBG) modulates the availability of biologically active free sex hormones. The regulatory role of SHBG might be important in the relationship between hormone levels and the modification of lipid profiles in girls with precocious puberty. However, few studies have evaluated the relationship of SHBG, free estradiol index (FEI), and lipid levels in these girls. Methods: One hundred and nine girls less than 8 years of age with pubertal development were enrolled. FEI was calculated with SHBG and estradiol (E2). We analyzed SHBG between peak luteinizing hormone (LH)≥5 (IU/L) (group 1) and LH<5(IU/L) (group 2) through a gonadotropin releasing hormone stimulation test. Results: Body mass index (BMI) standard deviation score (SDS) was higher in group 2than in group 1 (P =0.004). Serum SHBG levels did not differ and FEI was not higher in group 1 (P =0.122). Serum cholesterol, HDL, and LDL did not differ; however, triglyceride levels were higher in group 2 (P =0.023). SHBG was negatively correlated with bone age advancement, BMI, BMI SDS, and FEI, and was positively correlated with HDL. However,SHBG was not correlated with E2 or peak LH. Conclusion: Serum SHBG itself might not be associated with precocious puberty in girls, but it might be related to BMI and lipid profiles. Further studies are needed to reveal the relationship between sex hormone and obesity in girls with precocious puberty.

당뇨병성 신증의 조기 예측 인자로서의 혈중 cystatin C 및 β2-microglobulin의 유용성

채현욱,신재일,김범석,김호성,김덕희 대한소아내분비학회 2008 Annals of Pediatirc Endocrinology & Metabolism Vol.13 No.2

Purpose : Early detection of diabetic nephropathy is very important for prevention of renal failure. Determination of microalbuminuria has been suggested as an early predictor of diabetic nephropathy, but it is tend to be erroneous and inaccurate, especially in childhood. The aim of this study is to show clinical values of serum cystatin C and β2-microglobulin in the assessment of renal function in diabetic children and adolescents. Methods : Ninety four type 1 and 2 diabetic patients with normoalbuminuria (n=78), microalbuminuria (n= 15) and macroalbuminuria (n=1) were enrolled. Serum concentration of cystatin C, β2-microglobulin, creatinine, urinary microalbumin levels and creatinine clearances were determined. Results : In patients with microalbuminuria, serum concentration of cystatin C was increased significantly in comparison to patients with normoalbuminuria (P<0.05), while no differences were observed for β2- microglobulin levels. Serum creatinine concentrations were not different between both groups. Serum concentration of cystatin C was positively correlated with serum β2-microglobulin and serum creatinine. The serum concentration of β2-microglobulin was not correlated with the decrease of renal function significantly. Conclusion : Serum cystatin C is a useful endogenous marker in assessment of renal function in pediatric diabetic patients.

Spot Urine Albumin to Creatinine Ratio and Serum Cystatin C are Effective for Detection of Diabetic Nephropathy in Childhood Diabetic Patients

채현욱,신재일,권아름,김호성,Duk-Hee Kim 대한의학회 2012 Journal of Korean medical science Vol.27 No.7

Spot urinary albumin to creatinine ratio (ACR) measurement has been suggested as a surrogate to 24-hr urine collection for the assessment of microalbuminuria, and cystatin C (cysC) is known as an advantageous marker for renal function. The aim of this study was to evaluate the clinical values of spot urinary ACR and serum cysC for the assessment of diabetic nephropathy instead of 24-hr urine microalbumin in children and adolescents with diabetes. A total of 113 children and adolescents (age 12-19 yr, M:F = 47:66) with type 1 or 2 diabetes were enrolled. We evaluated the validity of spot urine ACR and serum cysC,and then compared them to 24-hr urine microalbumin and creatinine clearance. Spot urine ACR was correlated with 24-hr urine albumin excretion (R2 = 0.828, P = 0.001) and creatinine clearance (R2 = 0.249, P = 0.017). The ROC curve analysis of serum cysC demonstrated higher diagnostic accuracy than that of serum creatinine (AUC 0.732 vs 0.615). Both the measurements of spot urine ACR and serum cysC might better predict the presence of diabetic nephropathy than 24-hr urine microalbumin in childhood diabetic patients.

색상 분포 및 인체의 상황정보를 활용한 다중카메라 기반의 사람 대응

채현욱(Hyun-Uk Chae),서동욱(Dong-Wook Seo),강석주(Suk-Ju Kang),조강현(Kang-Hyun Jo) 제어로봇시스템학회 2009 제어·로봇·시스템학회 논문지 Vol.15 No.9

In this paper, we proposed a method which corresponds people under the structured spaces with multiple cameras. The correspondence takes an important role for using multiple camera system. For solving this correspondence, the proposed method consists of three main steps. Firstly, moving objects are detected by background subtraction using a multiple background model. The temporal difference is simultaneously used to reduce a noise in the temporal change. When more than two people are detected, those detected regions are divided into each label to represent an individual person. Secondly, the detected region is segmented as features for correspondence by a criterion with the color distribution and context information of human body. The segmented region is represented as a set of blobs. Each blob is described as Gaussian probability distribution, i.e., a person model is generated from the blobs as a Gaussian Mixture Model (GMM). Finally, a GMM of each person from a camera is matched with the model of other people from different cameras by maximum likelihood. From those results, we identify a same person in different view. The experiment was performed according to three scenarios and verified the performance in qualitative and quantitative results.

소아청소년 연령에서 발생한 2형 당뇨병의 항췌도 자가항체 유무에 따른 임상적 특성

지민철,채현욱,김호성,김덕희 대한소아내분비학회 2010 Annals of Pediatirc Endocrinology & Metabolism Vol.15 No.2

Purpose:The aim of this study is to investigate the differences in clinical characteristics and disease process between autoantibody-positive and -negative patients with type 2 diabetes mellitus (DM). Methods:We investigated 162 patients diagnosed as DM between January 2000 and July 2009. 120 were classified as type 1 and 42 as type 2 DM. The clinical and laboratory data were obtained from medical records, retrospectively. Results:The age at diagnosis, average BMI and serum C-peptide levels were significantly higher in type 2 DM patients than in type 1 DM patients. Type 2 DM patients had a significantly higher family history of diabetes and less frequent ketonuria. There were no significant differences between autoantibody-positive and -negative type 2 DM patients in age at diagnosis, BMI, C-peptide levels, HbA1c levels or family history. During the follow-up period, C-peptide levels were lower in the autoantibody-positive group than in the autoantibody-negative group, while. HbA1c levels were higher in the autoantibody-positive group. However, these differences were not statistically significant. Conclusion:In autoantibody-positive type 2 DM patients, progressive loss of β-cell function leads to reduced insulin secretion and poor glycemic control as the disease progresses, and some may be reclassified as slowly progressive type 1 DM. Ccntinued and careful follow-up is therefore needed. 목 적:최근 들어 전세계적으로 소아청소년기에 2형 당뇨병의 발생이 증가하고 있으며 일부 환자에서 췌장 베타세포에 대한 자가항체가 존재하는 것으로 보고되고 있다. 자가면역기전의 존재 여부에 따라 임상적인 특성 및 질병 경과의 차이를 조사하고자 본 연구를 시행하였다. 방 법:2000년 1월부터 2009년 7월까지 연세의료원 소아청소년과에 내원하여 당뇨병을 진단받은 162명을 대상으로 조사하였으며 1형 당뇨병 환자가 120명, 2형 당뇨병 환자가 42명이었다. 진단시 연령, 체질량지수, 가족력, C-peptide 농도, HbA1c, 케톤뇨증 여부, 당뇨병의 가족력, 체중감소, 다음 및 다뇨의 여부, 항 GAD 항체 및 IAA 양성 여부를 후향적으로 조사하였으며 자가항체 양성군과 음성군간에 차이를 비교하였다. 결 과: 2형 당뇨병 환자는 진단시 연령, 평균 체질량지수, 진단시 C-peptide 평균 농도가 1형 당뇨병 환자에 비해서 유의하게 높았다. 가족력이 있는 경우는 2형 당뇨병 환자에서 유의하게 많았으며 케톤뇨증 및 증상이 있는 경우는 1형 당뇨병 환자에 비해 유의하게 적었다. 항 GAD 항체는 25.0%에서 양성이었고 인슐린 자가항체는 31.7%에서 양성이었다. 항 GAD 항체 양성군과 음성군간에 진단시 평균 연령, 평균 체질량지수, 진단시 C-peptide 평균 농도 및 HbA1c, 가족력에 있어 통계학적으로 유의한 차이는 없었다. IAA 양성군과 음성군간에도 진단시 평균 연령, 평균 체질량지수, 진단시 C-peptide 평균 농도 및 HbA1c, 가족력 여부는 통계학적으로 유의한 차이를 보이지 않았다. 정상체중군, 과체중군, 비만군 간에 자가항체 양성률은 통계학적으로 유의한 차이가 없었다. C-peptide는 진단 후 기간이 경과함에 따라 통계학적으로 유의한 차이는 없었으나 자가항체 양성군에서 음성군에 비해 더 낮은 경향을 보였다. HbA1c는 조사 시점에서 모두 항체 양성군에서 항체 음성군보다 높게 측정되었으며 통계학적으로 유의한 차이를 보이지 않았다. 결 론: 2형 당뇨병 환자의 일부에서 췌장 베타세포에 대한 자가항체가 존재하며 이들 환자에서는 유병 기간이 경과함에 따라 베타세포의 기능 저하로 인해 인슐린 분비가 감소하면서 혈당조절이 어려워지고 일부에서 지진형 1형 당뇨병으로 재분류 될 가능성이 있어 지속적이고 주의 깊은 추적관찰이 필요하다.

호흡기 염증성 가성종양(Pulmonary InflammatoryPseudotumor) 1례

고홍,채현욱,이수진,윤봉식,장광천,강경훈,기정혜 대한 소아알레르기 호흡기학회 2006 Allergy Asthma & Respiratory Disease Vol.16 No.3

저자들은 학교신체 검사상 시행한 흉부 방사선 검사에서 우연히 발견된 좌측 폐문 상부의 종양성 병변을 주소로 내원한 13세 남아에서 종괴제거 수술 후 병리학적 검사로 확진된 폐실질의 염증성 가성종양 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Inflammatory pseudotumor of the lung is considered to be a rare, benign, neoplastic lesion, consisting mainly of spindle mesenchymal cells, sometimes in such a way that its histological appearance mimics that of a spindle cell sarcoma, fibrous histiocytoma or fibrosarcoma. A case of inflammatory pseudotumor of the lung occurring in a 13-year-old boy is reported with pathologic findings, including its ultrastructure. The patient had had no symptoms and accidentally discovered his condition after a chest X-ray examination at a regular school physical check up. The mass was located in the suprahilar area of the left lung. Exploratory thoracotomy revealed a large mass that was removed, together with the left upper lobe of the lung. Microscopically, the mass was composed of numerous interstitial inflammatory cells, mainly lymphoplasma cells. Ultrastructurally, the spindle-shaped mesenchymal cells were arranged haphazadly and the normal pulmonary structure was nearly totally destroyed. Emphasis is given to complete resection of the tumor for both diagnostic and therapeutic purposes.