• Pediatric Infection and Vaccine
• /
• v.27 no.3
• /
• pp.158-170
• /
• 2020

Purpose: We evaluated the incidence and characteristics of Clostridioides difficile infection (CDI) in Korean children. Methods: Medical records of patients aged 2-18 years and diagnosed with CDI at a tertiary hospital between 2009 and 2018 were analyzed. The patients were classified into three CDI groups: community-acquired (CA), community onset-health care facility-associated (CO-HCFA), and healthcare facility onset (HO). Results: The incidence of CDI increased from 1.00 to 10.01 cases per 10,000 admissions from 2009 to 2018 (P<0.001). As compared to the CA group, the HO group had a higher frequency of operation and malignancy as predisposing factors (40.4% vs. 0.0%, P=0.001; and 27.7% vs. 0.0%, P=0.027, respectively), frequency and number of previous antibiotic use (97.9% vs. 31.3%, P<0.001; and 2 vs. 0, P<0.001, respectively), and median postdiagnosis hospital stay (13 vs. 5 days, P=0.008). The CO-HCFA group had a lower median age and higher frequency of malignancy than the CA group (5 vs. 13 years, P=0.012; and 30.8% vs. 0.0%, P=0.030, respectively). As compared to the HO group, the CA group had a higher frequency of abdominal pain and hematochezia (56.3% vs. 10.6%, P=0.001; and 50.0% vs. 10.6%, P=0.002, respectively), inflammatory bowel disease (68.8% vs. 2.1%, P=0.001), and intravenous metronidazole treatment (37.5% vs. 2.1%, P=0.001). Conclusions: With the increasing incidence of pediatric CDI, awareness regarding its epidemiology and clinical characteristics is important to manage nosocomial infections.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.20 no.2
• /
• pp.55-62
• /
• 2020

A 22-month-old girl who had taken iron supplements due to iron deficiency anemia, presented bloody mucoid stool for one month. She had a bruise at the right periorbital area due to minor trauma and hepatosplenomegaly. Laboratory studies showed anemia, thrombocytopenia, elevated alkaline phosphatase (ALP), hypophosphatemia, decreased haptoglobin, hypocomplementemia, negative direct/indirect Coomb's test, normal vitamin D3 level and high PTHi. Wrist x-ray showed no signs of rickets. The abdominal ultrasound showed only accessory spleen. Tandem mass spectrometry was normal. During follow up, bloody stool regressed after seven days of withdrawal of iron supplement and cow milk, and the total CO2 level had been within 15-20 mEq/L with normal anion gap. NGS (next generation sequencing) panel test for evaluation of renal tubular acidosis showed negative results. After low dose steroid and vitamin D supplements under the impression of hypocomplementemic vasculitis, thrombocytopenia, C3/C4, decreased haptoglobin, and elevated ALP level became normal. At 57 months of age, laboratory findings showed elevated liver enzyme, ALP and gamma-glutamyl transferase again. And liver cirrhosis with splenomegaly and diffuse renal disease were reported with abdomen CT scan. Liver biopsy reported macro- and micronodular cirrhosis. Urine organic acid profile showed elevated succinylacetone level. Whole exome sequencing revealed novel compound heterozygous mutations (NM_00137.2:c.107T>C, NM_00137, 2:c.614T>C) in FAH gene and confirmed by Sanger sequencing. Consequently, the patient was diagnosed as chronic hereditary tyrosinemia type I. She started low phenylalanine/tyrosine diet and nitisinone treatment. Our case had presented symptoms very slowly, which is the first case of chronic tyrosinemia type I in South Korea.

• Journal of the Korean Society of Radiology
• /
• v.17 no.1
• /
• pp.157-165
• /
• 2023

Ultrasound imaging uses sound waves of frequencies to cause physical actions such as reflection, absorption, refraction, and transmission at the edge between different tissues. Improvement is needed because there is a lot of noise due to the characteristics of the data generated from the ultrasound equipment, and it is difficult to grasp the shape of the tissue to be actually observed because the edge is vague. The edge enhancement method is used as a method to solve the case where the edge surface looks clumped due to a decrease in image quality. In this paper, as a method to strengthen the interface, the quality improvement was confirmed by strengthening the interface, which is the high-frequency part, in each image using an unsharpening mask and high boost. The mask filtering used for each image was evaluated by measuring PSNR and SNR. Abdominal, head, heart, liver, kidney, breast, and fetal images were obtained from Philips epiq5g and affiniti70g and Alpinion E-cube 15 ultrasound equipment. The program used to implement the algorithm was implemented with MATLAB R2022a of MathWorks. The unsharpening and high-boost mask array size was set to 3*3, and the laplacian filter, a spatial filter used to create outline-enhanced images, was applied equally to both masks. ImageJ program was used for quantitative evaluation of image quality. As a result of applying the mask filter to various ultrasound images, the subjective image quality showed that the overall contour lines of the image were clearly visible when unsharpening and high-boost mask were applied to the original image. When comparing the quantitative image quality, the image quality of the image to which the unsharpening mask and the high boost mask were applied was evaluated higher than that of the original image. In the portal vein, head, gallbladder, and kidney images, the SNR, PSNR, RMSE and MAE of the image to which the high-boost mask was applied were measured to be high. Conversely, for images of the heart, breast, and fetus, SNR, PSNR, RMSE and MAE values were measured as images with the unsharpening mask applied. It is thought that using the optimal mask according to the image will help to improve the image quality, and the contour information was provided to improve the image quality.

• Journal of Nutrition and Health
• /
• v.55 no.1
• /
• pp.120-140
• /
• 2022

Purpose: The purpose of the study was to investigate whether adherence to the Korea Healthy Eating Index (KHEI) was associated with metabolic syndrome and risk markers. Methods: The participants included 8,345 adults, aged 20-59 years, who took part in the 7th Korea National Health and Nutrition Examination Survey (KNHANES). The data were analyzed using a complex-sample t-test, the Rao Scott χ²-test, and logistic regression analysis on the SPSS v. 26.0 software. The participants were divided into four groups by quartiles of KHEI scores. Results: The average KHEI score was 61.06 points out of 100, and the women's score (62.50 points) was significantly higher than that of men (59.63 points). The KHEI quartiles status showed significant differences by age (p < 0.001), household income (p < 0.001), smoking status (p < 0.001), and food security. Specifically, the KHEI quartiles in the men showed significant differences in education (p < 0.001) and economic activity (p < 0.001) whereas those of women showed significant differences in alcohol-consumption (p < 0.001), depression (p < 0.01) and eating-out (p < 0.001). As the KHEI scores increased, the proportion of subjects with an energy intake below the estimated energy requirement (EER) was lower, and significantly better levels of intake were observed for carbohydrate, protein, vitamin C, calcium, vitamin B₁, vitamin B₂, and niacin. The incidence of the metabolic syndrome risk factors, hypertriglyceridemia and hyperglycemia for men and hypertension, and hyperglycemia for women showed significant differences. The KHEI scores were inversely associated with abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, hyperglycemia, hypertension, and metabolic syndrome. Conclusion: Based on these results, we conclude that higher adherence to the KHEI was associated with lower metabolic syndrome risk factors and incidence of the metabolic syndrome.

• Journal of Gastric Cancer
• /
• v.23 no.1
• /
• pp.3-106
• /
• 2023

Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

• The Journal of Internal Korean Medicine
• /
• v.43 no.6
• /
• pp.1105-1121
• /
• 2022

Objectives: The purpose of this study is to explore the effectiveness and safety of frequently used clinical herbal medicines (Yijung-tang [Lizhong-tang, LJT], Pyeongwi-san [Pingwei-san, PWS], and Shihosogan-tang [Chaihu Shugan-tang, SST]) in patients with functional dyspepsia (FD) when administered according to herbal medicine and Korean medicine pattern identification. The results of this study will be used to standardize the diagnostic instrument used in Korean medicine and to investigate biomarkers of Korean medicine pattern identification. Methods: This study will be a randomized, assessor-blind, 3-arm, parallel, open-label, multi-center clinical trial. A total of 300 FD participants will be recruited from 3 Korean medical hospitals and assigned to the LJT (n=100), PWS (n=100), and SST (n=100) groups according to FD pattern identification. The patients will take the medication for 8 weeks, 3 times a day, before or between meals. The primary outcome will be total dyspepsia symptom (TDS) and the secondary outcomes will be adequate relief (AR) for dyspepsia, overall treatment effect (OTE), visual analogue scale (VAS), functional dyspepsia-related quality of life (FD-QoL), gastrointestinal symptom score (GIS), and pattern identification questionnaires. For the exploratory outcomes, we will analyze blood and fecal metabolome profiles, microbiota from fecal and saliva samples, single nucleotide polymorphism (SNP), and results of Korean medicine diagnosis device measurements (heart rate variability, and tongue, pulse, and abdominal diagnosis). Conclusions: The results of this study will prove objectivity for Korean medicine pattern identifications, and the effectiveness and safety of herbal medicines for the population with FD.

• Journal of Practical Agriculture & Fisheries Research
• /
• v.16 no.1
• /
• pp.93-103
• /
• 2014

This experiment was conducted to investigate the effects of different fat source feeding on growth performance, visceral organ weight, meat color, excreta microflora and blood profiles in broilers. A total of 768 1-d-old ROSS 308 broilers (mixed gender) with an initial average body weight of 39.68 ± 0.14 g were randomly allotted to 4 treatments with 12 replicate pens per treatment and 16 broilers per pen for 32 days. Dietary treatments were: 1) SBO, basal diet + 5% soybean oil, 2) PF, basal diet + 5% poultry fat, 3) TAL, basal diet + 5% tallow, and 4) LARD, basal diet + 5% lard. During d 1 to 14, broilers fed TAL diet had a higher (P<0.05) body weight gain (BWG) than broilers fed with PF and LARD diets, moreover, broilers fed TAL diet had a higher (P<0.05) feed intake than broilers fed SBO, PF and LARD diets. Overall (d 0-32), BWG in SBO and TAL treatments was greater (P<0.05) than that in LARD treatment. The meat color a^* (redness) of broilers fed with LARD diet was increased (P<0.05) compared with broilers fed with PF and TAL diets. No difference was observed in visceral organ weight of liver, spleen, bursa of Fabricius, breast muscle, abdominal fat, gizzard and excreta concentrations of Lactobacillus and Escherichia coli. The blood LDL cholesterol concentration in TAL treatment was higher (P<0.05) than that in LARD treatment. In conclusion, broilers supplementation with tallow could improve not only the body weight gain and feed intake but also blood LDL cholesterol concentration. Moreover, broiler fed lard could increase a^* (radness) of meat color, while the soybean oil supplementation improve body weight gain in broilers.

• Journal of Korea Entertainment Industry Association
• /
• v.13 no.7
• /
• pp.375-384
• /
• 2019

The purpose of this study was to investigate the effects of long-term aerobic dancing exercise on body composition, physical fitness and mental function in older women over 70 years old. All subjects were limited to older women aged 70 to under 85. The experimental group performed aerobic exercise of 2-3 times a week for 9.2 ± 4.6 yrs, and the control group did not perform any regular exercise and spent 3-4 times a week mainly in the relaxing facility for older. As a results in this study, the weight, muscle mass and body fat percentage of the aerobic group were not significantly different from those of the control group, but there were significantly positive effects of aerobic group in visceral fat mass, abdominal obesity rate(%), body water content and systolic blood pressure(p < .05). In terms of physical fitness, Sit & reach, one-legged stand (right) and TUG of the aerobic group were significantly higher than those of the control group(p < .05), but there were no significant differences between two groups in the shoulder flexibilities and grip strength. MMSE as a cognitive function was not significantly different between the two groups, but GDS was significantly lower in the aerobic group than in the control group(p < .05). According to the correlation analysis between all variables and MMSE and GDS, MMSE was significantly inversely correlated with height (r = -0.425)(p < .05), and no correlation was detected with other variables. However, GDS have signitively negative correlations with resting heart rate(r = -0.464), sit & reach(r = -0.525) left(r = -0.491) and right grip strengths(r = -0.635) as well as positive correlation systolic blood pressure(r = 0.482) and TUG (r = 0.479), respectively(p < .05). In conclusion, long-term aerobic exercise of elderly women over 70 older had positive effects on variables related to metabolic disease (visceral fat and resting heart rate), silver fitness variables related to falls, and depression level in the elderly.

• Journal of the Korean Society of Radiology
• /
• v.17 no.7
• /
• pp.1149-1155
• /
• 2023

This study aims to investigate the effect of changes in the Sub ROI on exposure index(EI) and to present indicators of changes in EI values that may occur when changing Sub ROI in clinical practice. This study was conducted on a subject of 20 cm of acrylic for a setting similar to abdominal radiography, and the specifications of one acrylic sheet is 20 × 20 × 5 cm. The survey conditions were the same as 80 kVp , 320 mA, 25 ms, SID 110 cm and the Sub ROI obtained 30 images for each type using five types provided by the equipment company. The EI value provided by the equipment and entrance skin exposure(ESE) were compared and analyzed. The mean value of EI according to the change in Sub ROI was 101.18±0.27 for LS, 106.57±0.31 for AEC, 107.74±0.39 for VR, 107.90±0.38 for HR, and 109.72±0.32 for SS (p<0.01). The average value of ESE by sub ROI type (LS, AEC, VR, HR, SS) was measured to be 476.45±1.71 μGy, 476.92±1.48 μGy, 476.14±2.30 μGy, 475.61±1.96 μGy, and 477.14±1.46 μGy, with statistically significant differences (p<0.01). As a result of this study, the EI according to the sub ROI type is based on LS(109.72), which represents the minimum value. AEC increased 5.3%, VR increased 6.4%, HR increased 6.6%, SS increased 8.4%, and overall, increased by about 5.3%. As for the average value of ESE, HR(475.61 μGy)type showed the minimum value, and based on this, AEC increased 0.27%, VR increased 0.11%, LS increased 0.17%, SS increased 0.32%, and overall, increased by about 0.17%.

• Journal of the Korean Society of Radiology
• /
• v.83 no.6
• /
• pp.1342-1353
• /
• 2022

Purpose We compared the radiation dose and image quality between the 2nd generation and the 3rd generation dual-source single-energy (DSSE) and dual-source dual-energy (DSDE) CT of the abdomen. Materials and Methods We included patients undergoing follow-up abdominal CT after partial or radical nephrectomy in the first 10 months of 2019 (2nd generation DS CT) and the first 10 months of 2020 (3rd generation DS CT). We divided the 320 patients into 4 groups (A, 2nd generation DSSE CT; B, 2nd generation DSDE CT; C, 3rd generation DSSE CT; and D, 3rd generation DSDE CT) (n = 80 each) matched by sex and body mass index. Radiation dose and image quality (objective and subjective qualities) were compared between the groups. Results The mean size-specific dose estimation of 3rd generation DSDE CT group was significantly lower than that of the 2nd generation DSSE CT (42.5%, p = 0.013) and 2nd generation DSDE CT (46.9%, p = 0.015) groups. Interobserver agreement was excellent for the overall image quality (intraclass correlation coefficient [ICC]: 0.8867) and image artifacts (ICC: 0.9423). Conclusion Our results showed a considerable reduction in the radiation dose while maintaining high image quality with 3rd generation DSDE CT as compared to the 2nd generation DSDE CT and 2nd generation DSSE CT.