• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.27 no.3
• /
• pp.168-175
• /
• 2024

Purpose: The presence of alcoholic stool in biliary atresia (BA) patients is the basis of a stool color card (SCC), a screening tool that has led to more patients receiving Kasai portoenterostomy earlier. This study aimed to evaluate the color image processing of stool images captured using smartphones. We propose that measuring digital color parameters is a more objective method for identifying BA stools and may improve the sensitivity of BA screening. Methods: A prospective study was conducted in five hospitals in Thailand between October 1, 2020, and December 31, 2021. Stools from infants presenting with jaundice, acholic stool, or dark-colored urine were photographed. Digital image color analysis was performed, and software was developed based on the color on the original SCC. Sensitivity and specificity for predicting BA stools were compared between the SCC and the software. Results: Of 33 infants eligible for data collection, 19 were diagnosed with BA. Saturation and blue were two potential digital color parameters used to differentiate BA stools. The receiver operating characteristic curve was used to determine the optimum cutoff point of both values, and when saturation ≤56 or blue ≥61 was set as a threshold for detecting BA stool, high accuracy was achieved at 81.8% and 78.8%, respectively. Conclusion: Digital image processing is a promising technology. With appropriate cutoff values of saturation in hue, saturation, value and blue in red, green, blue color models, BA stools can be identified, and equivocal-colored stools of non-BA patients can be differentiated with acceptable accuracy in infants presenting with jaundice.

• Clinical and Experimental Pediatrics
• /
• v.50 no.6
• /
• pp.536-542
• /
• 2007

Purpose : We investigated the effects of restricted fluid in the first 7 days of life on the risk of bronchopulmonary dysplasia (BPD) or patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants. Methods : Eighty three VLBW infants who lived more than 28 days were selected. The amount of daily maintenance fluid was determined by calculation of insensible water loss (IWL) and urine output (UO). Seventy to 80 percent of calculated amount was given to the ventilated infants. Subjects were grouped into low (<25th%), moderate (25-75th%), and high (>75th%) fluid groups for the first 24 hours, 3 days and 7 days. Chi square tests analyzed proportions of subjects with or without morbidities across fluid groups. Multivariate logistic regression was used to analyze the effect of fluid intake on BPD or PDA, controlling for factors that are significantly associated with BPD or PDA by univariate analysis. Results : Rates of BPD and PDA were not significantly associated with fluid groups on each time period. The result was the same after controlling for factors that are significantly associated with BPD or PDA by univariate analysis. For the first 3 and 7 days, fluid intakes were positively related with maximal weight loss, urine output and mechanical ventilation duration. Conclusion : In VLBW infants, when given based on needs reflected from IWL and UO versus intake, relatively low fluid intakes in the first week of life do not decrease the risk of BPD or PDA, and vice versa. We suggest that calculation of daily fluid based on IWL and UO is appropriate for VLBW infants.

• Analytical Science and Technology
• /
• v.33 no.3
• /
• pp.151-158
• /
• 2020

Alcohol, which can easily be obtained in the same way as ordinary beverages, is harmful enough to cause death due to excessive drinking and chronic alcohol intake, so it is important to maintain a proper amount of drinking and healthy drinking habits. In addition, the incidence of behavioral disturbances and impaired judgments that can be caused by chronic alcohol drinking of more than adequate amounts of alcohol is also significant. Accordingly it is very useful for forensic science to check whether the person involved is drunken or is alcoholism state in various accidents. Currently, in Korea, alcohol consumption is determined by detecting the level of alcohol or alcohol metabolism 'ethyl glucuronide (EtG)' in blood or urine samples. However, analysis of alcohol or EtG in blood or urine can only provide information about the current state of alcohol consumption because of a narrow window of detection time. Therefore, it is important to analyze the EtG as a long-term direct alcohol metabolite bio-marker in human hair and to investigate relationship between alcohol consumption and EtG concentration for the evaluation of chronic ethanol consumption. In this study, we established an analytical method for the detection of EtG in Korean hair efficiently and validated selectivity, linearity, limits of detection (LOD), limits of quantification (LOQ), matrix effect, recovery, process efficiency, accuracy and precision using liquid chromatography tandem mass spectrometry (LC-MS/MS). In addition, the assay performance was evaluated in Korean social drinker's hair and the postmortem hair of a chronic alcoholism. The results of this study can be useful in monitoring the alcohol abuse of Korean in clinical cases and legal procedures related to custody and provide a useful tool to evaluate postmortem diagnosis of alcoholic ketoacidosis in forensics.

• Journal of Nutrition and Health
• /
• v.42 no.5
• /
• pp.486-495
• /
• 2009

The purpose of this study was to analyze the performance evaluation index for a salt reduction project. Questionnaires were developed in order to investigate salt reduction programs nationwide. The evaluation index and programs were analyzed through the case study of a salt reduction program in public health centers. The validity of the salt reduction program's evaluation index was determined based on study of the Delphi survey and on discussion with nutrition and health care professionals. The Delphi survey showed that daily salt intake was the most valid nutritional evaluation index. Stroke mortality and stomach cancer mortality were good health care evaluation indexes. The method for measuring salt intake that had the greatest validity was a 24-hour urine collection. However, 24-hour urine collection had the lowest score for ease of performance. The combined scores of validity and ease of performance showed that the survey method for dietary attitude and dietary behavior, dietary frequency analysis (DFQ 15), and a salty taste assessment, in that order, were proper methods. The high reliability of the salty taste assessment indicated that the percentage of the population that exhibits proper salt intake (2,000 mg sodium or less daily) and the percentage of the population that consumes low-salt diets as nutritional evaluation indexes also will be helpful to evaluate performance of salt reduction programs.

• Journal of Radiation Protection and Research
• /
• v.38 no.2
• /
• pp.68-77
• /
• 2013

Derived Investigation levels(DILs) were calculated to protect the workers from the effects of both radiological hazard and chemical toxicity by uranium intake. Investigation Levels(ILs) of committed effective dose of 2 mSv $y^{-1}-6$ mSv $y^{-1}$ and uranium concentration of 0.3 ${\mu}g$ $g^{-1}$ in kidney, based on Korean Nuclaer Safety Act, Korean Occupational Safety and Health Act and current scientific studies of uranium intake were assumed. DILs of radiological hazard and chemical toxicity were then calculated based on the concentration of uranium in air of workplace, the lung monitoring and urine analysis, respectively. As a result, in case of the nuclear fuel fabrication plant where 3.5% enriched uranium is handled, derived investigation level(DIL) for the control of the concentration of uranium in the air of workplace assumed with 15-min acute inhalation was 0.6 mg $m^{-3}$ for all types of uranium. DILs for the control of the average concentration of uranium in air of workplace, assuming an 8-hour workday, were 15.21 ${\mu}g$ $m^{-3}$ of Type F uranium, 0.41-1.23 Bq $m^{-3}$ and 0.13-0.39 Bq $m^{-3}$ for Type M and Type S uranium, respectively. DILs for the lung monitoring assumed with a period of 6-month interval were 0.37-1.11 Bq and 0.39-1.17 Bq in acute and chronic inhalation for Type M, respectively and 0.30- 0.91 Bq and 0.19-0.57 Bq in acute and chronic inhalation for Type S, respectively. Since a detection limit of typical germanium detector for the measurement of 235U activity is 4 Bq, DILs calculated for the lung monitoring were not appropriate. DILs for urine analysis, for which an interval was assumed to be 1 month, were 14.57 ${\mu}g$ $L^{-1}$ based on chemical toxicity after acute inhalation. In addition, acute and chronic inhalation of Type M were calculated 2.85-8.58 ${\mu}g$ $L^{-1}$ and 1.09-3.27 ${\mu}g$ $L^{-1}$ based on the radiological hazard, respectively.

• Childhood Kidney Diseases
• /
• v.16 no.2
• /
• pp.73-79
• /
• 2012

Purpose: The association of mitochondrial DNA (mtDNA) mutations, deletions and copy number with progressive changes in patients with some glomerular disease and end-stage renal disease have been reported. In this study, we performed mtDNA mutation analysis in children with IgA nephropathy to investigate its role in progressive clinical course. Methods: Seven children with IgA nephropathy were involved in this study. MtDNA isolated from platelet was amplified by PCR and sequenced entirely. Results: The mean age at renal biopsy was $11.5{\pm}2.2$ year and the mean age at latest evaluation was $17.9{\pm}3.2$ year. The mean follow-up period were $7.8{\pm}3.1$ years. Patients was divided into 2 groups according to the amount of proteinuria at presenting manifestation. Group 2 patients were nephrotic syndrome. Renal function reveals within normal range in all patients. In group 2 patients, the mean serum albumin level was significantly lower than those of group 1 ($3.7{\pm}0.6g/dL$ vs. $4.7{\pm}0.2g/dL$, P=0.0241) and the mean total cholesterol level was significantly higher than those of group 1 ($222.7{\pm}35.7mg/dL$ vs. $148.3{\pm}29.1mg/dL$, P=0.0283). In Group 2 patients, total amount of protein of 24 hour collected urine also significantly higher than those of group 1 ($1,466.0{\pm}742.5mg$ vs. $122.5{\pm}48.1mg$, P=0.0135). Pr/Cr ratio in random urine sample was also higher in group 2 than those of group 1 but the statistical significance was not noted ($1.8{\pm}1.6$ vs. $0.2{\pm}0.2$, P=0.0961). Deletion of mtDNA nt 8272-8281 were observed in two patients, one patient in each groups, respectively. This is noncoding lesion. No patients demonstrated the mtDNA mutations. Conclusions: We have identified a deletion of mtDNA nt 8272-8281 in two children with IgA nephropathy. Further studies are needed to clarify the role of mitochondrial function in the progressive change of IgA nephropathy.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.17 no.2
• /
• pp.69-76
• /
• 2017

Citrin deficiency is an autosomal recessive disorder caused by mutations in the SLC25A13 gene on chromosome 7q21.3, and a type of urea cycle disorder that causes hyperammonemia. Although neonatal intrahepatic cholestasis and adult-onset type II citrullinemia, a type of citrin deficiency, have been described well in many articles for several decades, failure to thrive and dyslipidemia caused by citrin deficiency (FTTDCD), the other type of citrin deficiency, has been only identified recently. There was previously no case report about FTTDCD in Korea. Patients with FTTDCD could present with loss of appetite, fatigue, failure to thrive, hypoglycemia, hypercitrullinemia, dyslipidemia, and an increased lactate/pyruvate ratio. Routine evaluation may not reveal the cause of hypoglycemia caused by citrin deficiency. We recently had a case that presented with recurrent hypoglycemia in a 30-month-old boy. Chemistry profiling, urine organic acid analysis, plasma acylcarnitine analysis, and hormone studies indicated values within the normal range or non-specific findings. Mutation analysis to identify the cause of hypoglycemia identified the subject as a compound heterozygote carrying each of the c.852_855del ($p.Met285Profs^*2$), and c.1177+1G>A mutant alleles. We report here on this unusual case of citrin deficiency presenting with FTTDCD for the first time in Korea.

• Korean Journal of Clinical Laboratory Science
• /
• v.48 no.4
• /
• pp.296-303
• /
• 2016

This study was performed to evaluate the effect of hemoglobin (Hb) on bone mineral density (BMD) in university students by performing a quantitative analysis. The subjects included healthy university students aged 20 to 30 years. Although osteoporosis has traditionally been considered as a disease of aging women, it is becoming an increasingly concerning male health problem. Diagnosis of osteoporosis is calculated with a quantitative assessment of BMD. Laboratory blood and urine tests are mainly used with low BMD or fragility fractures to identify any possible causes of bone metabolism disorders. In this study, there was no difference in BMD according to gender. The average red blood cell (RBC), Hb, and Hematocrit (HCT) were significantly higher in males (p<0.01). The correlation between lumbar spine, skeletal muscle mass (SMM), and basal metabolic rate (BMR) was statistically significant (p<0.01). Hb showed a 51.7% statistical influence on BMD by multiple regression analysis. These findings are useful to understand the relationship between BMD and Hb; lower Hb level is associated with lower BMD. The Hb level was the strongest predictor of abnormal BMD. In conclusion, this study showed that a low Hb value was significantly correlated with low bone mass, suggesting that a low Hb value is a risk factor for changes in bone turnover that leads to a decrease bone density.

• Journal of Nutrition and Health
• /
• v.20 no.2
• /
• pp.90-103
• /
• 1987

A study was conducted to measure nitrogen intake and excretion in young korean women on their normal diet and leading normal activity level. Dietary survey by food record, fecal and urinary samples were collected for 3 days in 19 healthy female college students in Korea. On one of the 3 days, duplicate of one-day diet was collected from each subjects. Mean daily intakes of energy and protein were calculated from food recorded. Duplicate diet samples and pooled fecal samples were analyzed for N content. Pooled urine samples were analyzed for total N, urea N, and creatinine content. Apparent N absorption, apparent N balance and urea N/creatinine N were calculated to evaluate protein nutritional status. The results obtained are summarized as following ; 1) Accordingly to food record, mean daily intakes of energy, protein, carbohydrate and far were 1535.2 $\pm$53.78Kcal, 55.95$\pm$2.97g(total nitrogen 8.95$\pm$0.45g), 254.13$\pm$10.31g and 39.24$\pm$2.76 g, providing 14.6%, 66.2%, 19.2% of total energy respectively. 2) Nitrogen intake by chemical analysis was 7.16$\pm$0.31g/day (protein 44.75$\pm$1.94kg/day) providing 82.39$\pm$4.58% of nitrogen intake by food record. The difference of total nitrogen intake between food record and chemical analysis in diets was significant(p<0.05). 3) Mean daily fecal nitrogen excretion was 1.38$\pm$0.10g and then mean apparent digesbility of protein was 80.53$\pm$5.21%. 4) Mean daily urinary nitrogen excretion, urea N excretion and creatinine excretion were 6.03$\pm$0.30g, 4.52$\pm$0.22g, and 0.88$\pm$0.04g respectively. Urinary urea nitrogen was 75.2$\pm$1.38% of total urinary nitrogen excretion and urinary nitrogen was 85.4$\pm$3.56% of total nitrogen intake by chemical analysis. 5) Mean urea N/creatinine N ration was 14.01$\pm$0.77. 6) Mean nitrogen balance was -0.244$\pm$0.33g/day. From the above results, it is concluded that the subjects in this study seem to be in marginal protein nutritional status and therefore should increase dietary protein intake.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.15 no.3
• /
• pp.147-154
• /
• 2015

Purpose: 3HB and AcAc are two ketone bodies that can be used as energy source in brain via succinyl-CoA:3-ketoacid CoA transferase (SCOT) and mitochondrial acetoacetyl-CoA thiolase (beta-ketothiolase, T2), called ketolysis. In case of malfunction of these enzymes, ketolysis cannot occur fluently causing various clinical manifestations. We want to know the numbers of patients and clinical manifestations of ketolytic defects in Korea. Material: For 67 patients of ketolytic defects out of 2794 patients that have done urine organic acid analysis, we analyzed clinical manifestations and age distribution. The study period was from January 2007 to September 2015. Method: To confirm persistency of ketonuria, repeated and loading organic acid analysis were done at least 1 week period interval. SPSS was used for statistical analysis. Result: Thirty patients in infantile period (2 M-2 Y), 31 patients in childhood period (2 Y-12 Y), 5 patients after adolescent period (>12 Y) and 1 in neonatal period were diagnosed during the study period. The most frequent chief complaint was seizure followed by seizure with developmental delay and developmental delay only. Conclusion: Ketolytic defects were not so rare in Korea. Major clinical manifestations are seizure and developmental delay or mental retardation.