한국 소아의 성장발육에 관한 연구

Abstract

A Study of Growth and Development of Korean Children

1) Physical Measurement from Newborn to Eighteen Years of Age

2) Skeletal Maturation of the same Age Group

The study of growth and development of the human organism from conception to maturity is the basic science of pediatrics and of prime importance to the general practitioner and others who would attempt to care for infants and children.

"Growth" refers to increase in size, while "Development" refers to increase in function and maturity: this applies to the skeleton too.

Ordinarily growth and development progress together, and while these two aspects are not interchangeable they are, nevertheless, inseparable.

During the past few decades several excellent studies on growth and development have been made in the various countries This has also been done in Korea. However, most of the studies were limited to the cross sectional method and included only simple measurements and weighing. The author collected and summarized data on the measurements of children from six to twenty years of age, including measurements of height and weight and the girth of both head and chest. The findings of this study were published in the Journal of Korean Academy of Pediatrics (1959).

No data or standard is available by which to evaluate the physical growth and skeletal development for Korean children, since foreign standards are not applicable to Korean children. Thus it is strongly urged that physicians working in the field of public health or pediatrics develop a new standard applicable to the evaluation of growth and development of Korean children.

Physical growth and development may be influenced by heredity, race. sax, nutrition, and other factors such as socio-economic and geogaphical environment. Therefore, careful sampling and evaluation is necessary for any scientific study on child growth and development. Bone maturation likewise is influenced by such

factors as race, sex, prematurity, endocrine disturbance, chronic infection, allergic conditions, and medication, Skeletal roentgenograms are a more accurate and reliable aid in assessing the growth and development, since bone age can thus be compared to chronolgical age. There are many procedures and methods of

evaluating skeletal maturation, but one can usually evaluate osseous development for clinical purposes from a roentgenogram of the hand and wrist. although a much more accurate estimate can be obtained if all pertinent ossification centers are x-rayed, rather than relying merely on the wrist.

All the measurements and roentgenograms in this study were made upon healthy korean children from birth to eighteen years of age (Tables 1, 2, 3, and Figs. 1, 2, 3, 4, 5). Only breast-fed children were included. Results of our studies were compared with the standards for foreign children made by other authors (Voght &

Vickers, Stuart, Todd, Francis, and Sontag), from the point of both physical measurement and skeletal development.

The data and results are summarized as follows:

1. The author compiled percentile tables and figures for the measurement and bone age evaluation of Korean children according to age and sex and using various ossification centers.

2. In general, girls are more advanced than boys in osseous development, while boys are slightly mere advanced than girls in physical growth, except for the period between the ages of 11 to 14 years when girls are farther advanced.

3. On comparing the author's standards with the foreign data on skeletal maturation, there were no significant differences during infancy, although Korean babies appear to have somewhat earlier maturation of the bones of the foot according to roentgenoographic studies.

4. However, after the weaning period, physical growth as well as skeletal development in foreign children advanced more rapidly than that of Korean children, and these differences are more marked as age increases; but the increase is not so much that of skeletal development as of physical growth.

5. Breast feeding, early walking, and early menstruation of Korean children seem to be influential factors in the early maturation of osseous development, while on the other hand the ages of eruption of teeth and of closure of the anterior fontanel are net closely related to osseous maturation in healthy children.

6. The range of normal skeletal development is much wider than moat of us have realized.

7. The size of the child does not always correlate with the time of maturation.