• Neonatal Medicine
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• v.17 no.2
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• pp.239-244
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• 2010

Purpose: To evaluate two different heel lancet device in terms of pain response and success of the procedure in the preterm infants undergoing heel puncture. Methods: 100 preterm infants undergoing capillary blood gas analysis or capillary bilirubin monitoring underwent heel puncture, were randomly allocated to blood sampling from the heel with either a conventional manual lancet or an automatic incision device. Primary outcome measures included the Premature Infants Pain Profile (PIPP) score, total duration of procedure, number of heel puncture and number of bruise. The pain response was evaluated using PIPP score and the effectiveness was evaluated using three criteria: total duration of blood sampling, number of puncture, bruising of the heel or ankle. Statistical analysis was performed using the SPSS ver. 13.0 program. Difference between the groups were analysed with t test (continuous variables) and the Chi square test or Fisher test (categorical variables). Results: The mean PIPP score was 4.91 for the automatic lancet group compared with 5.84 for the conventional manual lancet group (P=0.0255).The number of pain scores above 7 during blood collection did not differ between two groups (P=0.2167). The procedure took less time to perform in the automatic lancet group (mean, 30.69 seconds) than in the conventional lancet group (mean, 48.92 seconds) (P<0.0001). Conclusion: This study demonstrated that the automatic lancet device causes less pain and a shorter procedure time than the conventional manual lancet in preterm infants undergoing heel puncture. On the basis of these results the automatic lancet device is very useful method for blood collection in preterm infants by heel puncture.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7825-7829
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• 2015

Background: Egypt has the highest prevalence of HCV infection in the world (~14.7%). Around 10-15% of HCV-infected persons will advance to cirrhosis within the first 20 years. The incidence of HCC is expected to grow in the next two decades, largely due to HCV related cirrhosis, and detection of HCC at an early stage is critical for a favorable clinical outcome. No simple reliable non-invasive marker has been available till now. B2M, a non-glycosylated polypeptide composed of 99 amino acids, is one of the components of HLA class I molecules on the surfaces of all nucleated cells. It has been reported that the level of serum B2M is elevated in patients with chronic hepatitis C and HCV-related HCC when compared to HCV-negative patients or healthy donors. Determining the clinical utility of serum B2M as a marker for disease progression in Egyptian patients with HCV related chronic hepatitis, cirrhosis and hepatocellular carcinoma was the aim of the present study. Materials and Methods: In this analytical cross sectional study 92 participants were included in 4 equal groups: Group (1) non cirrhotic chronic HCV; Group (2) HCV related liver cirrhosis; Group (3) HCC on top of HCV,; and Group (4) healthy controls. History taking, clinical examination, routine labs and abdominal ultrasound were conducted for all patients, PCR and Metavir scores for group (1) patients, and triphasic CT abdomen and AFP for Group (3) patients. B2M levels were measured in serum with a fully-automated IMX system. Results: The mean serum B2M level of Group (1) was $4.25{\pm}1.48{\mu}g/ml$., Group (2) was $7.48{\pm}3.04$, Group (3) was $6.62{\pm}2.49$ and Group (4) was $1.62{\pm}0.63$. Serum B2M levels were significantly higher in diseased than control group (p<0.01) being significantly higher in cirrhosis ($7.48{\pm}3.04$) and HCC groups ($6.62{\pm}2.49$) than the HCV group ($4.25{\pm}1.48$) (p<0.01). There was a significant correlation between B2M Level and ALK, total and direct bilirubin and INR (p<0.05), and a significant inverse correlation between B2M level and albumin, total proteins, HB andWBCS values (p<0.05). There was no significant correlation between B2M level and viral load or Metavir score, largest tumour size or AFP (p>0.05). The best B2M cut-off for HCV diagnosis was 2.6 with a sensitivity of 100%, a specificity of 92%, a positive predictive value (PPV) of 97% and a negative predictive value (NPV) of 100%. The best B2M cut-off for HCC diagnosis was 4.55 which yielded sensitivity, specificity, positive predictive value, negative predictive values of 74%, 62%, 39.5, 87.8% respectively (p-value <0.01) while best cut-off for cirrhosis was 4.9, with sensitivity 74 % and specificity 74%.The sensitivity for HCC diagnosis increased upon B2M and AFP combined estimation to 91%, specificity to 79%, NPV to 95% and accuracy to 83%. Conclusions: Serum B2M level is elevated in HCV related chronic liver diseases and may be used as a marker for HCV disease progression towards cirrhosis and carcinoma.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.161-166
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• 2003

Purpose: The purpose of this study was to evaluate the efficiency of treatment of living-related liver transplantation (LRLT) with the parental heterozygote carrier graft in children with Wilson disease. Methods: We retrospectively evaluated 7 children with Wilson disease who had received liver transplantation from 1994 to 2002 at Asan Medical Center. All the donors were parental. Liver functions, Kayser-Fleischer ring, and other factors regarding to copper metabolism were analyzed. Results: Of the 7 children, 5 had fulminant hepatitis and 2 had decompensated liver cirrhosis irresponsive to medical therapy. All donors being parental, all grafts came to be heterozygote carrier grafts. Survival rate was 100% in those 7 children, 87% in all children with liver transplantation in the same period, and 84% in children with non-metabolic liver disease. After liver transplantation, all 7 children could stop low copper diet and penicillamine therapy and their AST, total bilirubin and prothrombin time were recovered to normal. After liver transplantation, ceruloplasmin and serum copper levels were also recovered to normal. A marked reduction in 24 hr-urinary copper excretion was observed in all recipients after transplantation. During follow-up, Kayser-Fleischer rings resolved completely after LRLT in 5 children and partially in 1 child. Conclusion: We concluded that living-related liver tranplantation in children with Wilson disease with parental heterozygote carrier graft is an effective treatment modality.

• Journal of Preventive Medicine and Public Health
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• v.24 no.2 s.34
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• pp.195-210
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• 1991

Fatty liver is caused by derangement of fat metabolism and can be reversed by removal of contributing factors. The contributing factors of fatty liver is known to be overweight, chronic alcoholism, diabetes mellitus, malnutrition, and drug abuse such as tetracycline. This study was carried out on 1335 persons who visited 'Soon Chun Hyang Human Dock Center' from March to June 1990. In analysis of the data, prevalence of fatty liver diagnosed by ultrasonogram by age and sex, laboratory finding between fatty liver group and normal group, and odds ratio of known contributing factors, were compared. The results obtained are as following ; 1) The prevalence rate of fatty liver diagnosed by ultrasonogram is 29.6% in male and 11.5% in female. 2) Age groups with high prevalences are $40{\sim}50's$ in male (32.0%) and 50's in female (24.5%). 3) The fatty liver shows significant association with style (p<0.05), whereas not with hepatitis B-virus surface antigen (p>0.05). 4) All laboratory values except alkaline phosphatase and bilirubin are elevated significantly in accordance with the degree of fatty liver (p<0.01). 5) Fatty liver diagnosed by ultrasonogram showed so strong associations with body index, triglycerides and gamma-glutamyl transferase for males, and body index and fasting blood sugar for females that these factors may be used as supplementary data in establishing diagnosis of fatty liver. 6) Odds ratio of contributing factors are as follows ; If the odds ratio of below 29 year of age is 1.0 then that of $30{\sim}39$ is 1.74 (p=0.33), $40{\sim}49$ is 2.47 (p=0.10), $50{\sim}59$ is 2.86 (p=0.0570), over 60 is 1.81 (p=0.34). If the odds ratio of female is 1.0 then that of male is 5.67 (p<0.01). If the odds ratio of body index below zero is 1.0 then that of $0{\sim}9$ is 5.08 (p<0.01), $10{\sim}19$ is 12.37 (p<0.01), $20{\sim}29$ is 29.19 (p<0.01), 30 above is 154.02 (p<0.01). If the odds ratio of below 99 mg/dl FBS is 1.0 then that of $100{\sim}120$ is 106 (p=0.76), over 120 is 1.91 (p=0.02). If the odds ratio of below $29{\mu}/1{\gamma}-GT$ is 1.0 then that of $30{\sim}s59$ is 2.11 (p<0.01), $60{\sim}90$ is 1.87 (p<0.05), 90 above is 1.69 (p=0.15). If the odds ratio of below 149 mg/dl TG is 1.0 then $150{\sim}199$ is 1.49 (p=0.05), $200{\sim}250$ is 1.09 (P=0.77), 250 above is 2.53 (p<0.01). In summary, early diagnosis of fatty liver could be made by ultrasonogram supplemented with body index and nm triglyceride. The fatty liver could be preventive by avoiding contributing factors such as obesity, alcohol intake, high blood sugar appropriately.

• The Korean Journal of Food And Nutrition
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• v.15 no.2
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• pp.165-172
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• 2002

Studies were carried out to observe the influence of the Aralia continentalis Kitagawa root on blood pressure and blood constituents of the 24 hypertensive elderly(10 men and 14 women aged over 60). Total subjects were divided into three groups according to taking antihypertensive medications(A), antihypertensive medications and mixing beverages with the Aralia continentalis Kitagawa root(B) or mixing beverages with Aralia continentalis Kitagawa root(C). The systolic blood pressure of C group was significantly lower than that of A and B groups. The diastolic blood pressure of C group was lower than A and B groups. The blood glucose level of C group was a little lower than that of A and B groups. The level of TG increased more in A group than C group and decreased in B group. The levels of T-cholesterol and LDL-cholesterol lowered in B and C groups and HDL-cholesterol level was higher in C group. The GOT, GPT and T-bilirubin levels of C group were significantly higher than others. Mixing beverages with Aralia continentalis Kitagawa root did not affect on blood protein and non-protein nitrogens. In conclusion, mixing beverages with Aralia continentalis Kitagawa root had an effect on lowering blood pressure, blood glucose, T-cholesterol and LDL-cholesterol concentrations.

• Neonatal Medicine
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• v.18 no.1
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• pp.117-123
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• 2011

Purpose: Congenital intrahepatic portosystemic shunts are rare disease and clinically asymptomatic shunts may be detected by chance on ultrasonogram before and after birth. We studied clinical course, treatment and prognosis of congenital intrahepatic portosystemic shunt at prenatal or neonatal period. Methods: Medical records of 8 patients which were diagnosed in intrahepatic portosystemic shunt in Cheil General Hospital from 2006 through 2010 were reviewed retrospectively. Results: Eight patients with congenital intrahepatic portosystemic shunts were identified. Six patients were diagnosed at prenatal radiological screening, including three cases of intrauterine growth restriction and two cases of preterm baby. One case with increased serum ammonia underwent coil embolization. In four cases including one case that presented elevated direct bilirubin, shunts were closed spontaneously within 11th month after birth. Two patients were diagnosed on abdominal sonogram after birth because of elevated direct hyperbilirubinemia, all of whom presented intrauterine growth restriction. Closure of shunts was confirmed during 4th month to 6th month. Conclusion: Congenital intrahepatic portosystemic shunts are clinically asymptomatic mostly and spontaneous closure is expected within 2 years age. But occasionally they have severe complication, so clinical and radiological observation is needed. Specially in cases of intrauterine growth retardation without evident cause, the possible diagnosis of congenital intrahepatic portosystemic shunts should be considered and prenatal and postnatal examination should be performed. When prenatal diagnosis is made, fetal wellbeing should be monitored periodically until spontaneous closure of shunts.

• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.17-23
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• 2003

Purpose : Cholestasis is a major complication in prolonged use of TPN, especially in the neonatal period, but there are few long-term reviews examining the clinical course in premature infants. Thus, in this study, we reviewed premature infants with TPN-associated cholestasis(TPNAC) to determine the incidence, clinical courses and possible risk factors. Methods : Retrospective review of 66 premature infants less than 2,000 gm of birth weight and on TPN for more than two weeks was performed. Cholestasis was defined as a serum direct bilirubin level greater than 2.0 mg/dL. The clinical course of cholestasis was described, and perinatal risk factors were evaluated. Results : TPNAC developed in 21 out of 66 infants(31.8%). The onset was $41.7{\pm}17.4days$ after receiving TPN, and the mean duration was $33.6{\pm}23.4days$. The incidence of TPNAC was significantly correlated with birth weight, and gestational age, and duration of TPN. But, possible etiologic factors, such as incidence of perinatal asphyxia or infection, showed no remarkable differences between infants with TPNAC and those without TPNAC(control). The enteral intake in the third postnatal week was significantly smaller in infants with TPNAC than in the control infants(P=0.033). Conclusion : The enteral intake in the third postnatal week was smaller in the infants with TPNAC than in the control infants. Thus, the incidence of TPNAC may be reduced by increasing the amount of oral intake during TPN in high risk infants.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.2
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• pp.242-248
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• 2006

Purpose: Neonatal hepatitis is the major cause of neonatal cholestasis and may be divided into infectious, metabolic, genetic, and idiopathic neonatal hepatitis. Non-familial, non-metabolic, and non-A, B, C viral neonatal hepatitis is known to have made satisfactory progress, but little is known about its chronic clinical features. Methods: Clinical and histological assessments were carried out in 34 cases with chronic neonatal hepatitis [elevated serum alanine aminotrasferase (ALT) level for more than 6 months] except for A, B, C viral hepatitis, metabolic, or genetic neonatal hepatitis, who were admitted to the Department of Pediatrics, Pusan National University Hospital, from January 1998 to January 2004. Results: Males were more common (70%). Jaundice (100%) and hepatomegaly (44%) were frequent manifestations. Peak serum ALT levels were most commonly below 300 IU/L in 41.2% of patients and peak serum direct bilirubin levels were most commonly between 1.0~5.0 mg/dL in 50% of patients. Ten cases (34%) of 29 patients had positive serum cytomegalovirus (CMV) IgM or urine CMV polymerase chain reaction. Serum ALT level was normalized within 1 year in 11 (37.9%) of 29 cases, and within 2 years in 9 (69.2%) of 13 cases. Serum ALT level was elevated persistently over 2 years in four (30.7%) of 13 cases. Histologic findings such as portal or periportal activity, lobular necrosis, portal or periportal fibrosis were more severe in patients with persistent ALT elevation over 2 years than in those showing normalization of ALT within 2 years (p>0.05). Conclusion: When the elevation of ALT level sustains over 1 year in non-familiar, non-metabolic, non-A, B, C viral neonatal hepatitis, an assessment of the severity of liver injury and a careful monitoring about chronic liver disease may be required.

• Herbal Formula Science
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• v.9 no.1
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• pp.231-250
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• 2001

In order to determine the effects of annexing bile extracts of bears on the anti-fibrotic effect of Injinhotang. Mix compound of Injinhotang and bile extracts of bears were administered to the carbon tetrachloride ($CCl_4$)-induced cirrhotic rats during 20 days and the changes of serum levels of GOT (glutamic-oxalacetic transaminase), GPT (glutamic pyruvic transaminase), LDH (lactate dehydrogenase), ALP (alanine phosphatase), GGT (gamma glutamyl transpeptidase) and T-BIL (total bilirubin) were monitored with comparison to the results of Injinhotang administered group. The results were summarized as follows. 1. A significant (p<0.01) increase of serum GOT levels were observed in control group compared to those of normal group but these increased levels were dramatically decreased in Injinhotang and Injinhotang with Fel Ursi-administered group. In addition, a significant (p<0.05) increase were also detected In Injinhotang with Fel Ursi-administered group compared to that of Injinhotang-administered group. 2. A significant (p<0.01) increase of serum GPT levels were observed in control group compared to those of normal group but these increased levels were dramatically decreased in Injinhotang and Injinhotang with Fel Ursi-administered group. Although significances were not recorded, increase of serum GPT levels were also detected in Injinhotang with Fel Ursi-administered group compared to that of Injinhotang-administered group. 3. A significant (p<0.01) increase of serum LDH levels were observed in control group compared to those of normal group but these increased levels were dramatically decreased in Injinhotang and Injinhotang with Fel Ursi-administered group. Although significances were not recorded, increase of serum LDH levels were also detected in Injinhotang with Fel Ursi-administered group compared to that of Injinhotang-administered group. 4. A significant (p<0.01 or p<0.05) increase of serum ALP levels were observed in control group compared to those of normal group but these increased levels were dramatically decreased in Injinhotang and Injinhotang with Fel Ursi-administered group. In addition, a significant (p<0.05) increase were also detected in Injinhotang with Fel Ursi-administered group compared to that of Injinhotang-administered group. 5. A significant (p<0.01) increase of serum GGT levels were observed in control and Injinhotang-administered group compared to those of normal group but these increased levels were dramatically decreased in Injinhotang with Fel Ursi-administered group. 6. A significant (p<0.01) increase of serum T-BIL levels were observed in control group compared to those of normal group but these increased levels were dramatically decreased in Injinhotang and Injinhotang with Fel Ursi-administered group. Although significances were not recorded, increase of serum T-BIL levels were also detected in Injinhotang with Fel Ursi-administered group compared to that of Injinhotang-administered group. In conclusion, it is considered that bile extract of bears has some additional effect to the anti-fibrotic effect of Injinhotang but to know the exact mechanism of suitable dose and duration of administration, further studies such as pharmacokinetics and dose-dependent pharmacological studies were needed

• Korean Journal of Veterinary Research
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• v.30 no.2
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• pp.163-170
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• 1990

The blood chemical values and blood enzyme activities were examined from 74 healthy mixed breed dogs in the area of Seoul. The results obtained are summarized as follows; 1. Mean${\pm}$SD values and ranges of glucose were $61.97{\pm}8.41mg/100ml$ and 47.28~81.67mg/100ml, of blood urea nitrogen(BUN) $15.99{\pm}2.31mg/100ml$ and 8.21~21.31mg/100ml, of total protein(TP) $8.17{\pm}0.93g/100ml$ and 6.06~9.91g/100ml, of albumin $4.16{\pm}0.47g/100ml$ and 2.81~5.15g/100ml, of globulin, $4.01{\pm}0.64g/100ml$ and 2.72~5.54g/100ml, of albumin/globulin(A/G) ratio $1.06{\pm}0.17$ and 0.71~1.42, of cholesterol(Chol) $187.33{\pm}19.78mg/100ml$ and 128.70~222.90mg/100ml, of total bilirubin(TB) $0.73{\pm}0.14mg/100ml$ and 0.43~1.16mg/100ml, of phosphorus(Pi) $5.25{\pm}1.00mg/100ml$ and 2.61~7.72mg/100ml, of calcium(Ca) $10.76{\pm}1.08mg/100ml$ and 8.24~12.60mg/100ml, of triglyceride(TG) $89.48{\pm}21.16mg/100ml$ and 47.80~133.00mg/100ml, respectively. 2. The glucose value in the age group of 7~12 months was higher (p<0.01) but in the age group of 3~4 years was lower (p<0.05) than the total glucose value. The TP value in the age group of 7~12 months was lower (p<0.01) but in the age group of 1~2 years was higher (p<0.05) than the total TP value. The globulin value in the age group of 7~12 months was lower (p<0.01) but in the group of 1~2 years was higher (p<0.01) than the total globulin value. The A/G ratio value in the age group of 7~12 months was higher (p<0.05) but in the age group of 1~2 years was lower (p<0.05) than the total A/G ratio value. The phosphorus values in the age group of 1~2 years and the age group of 3~4 years were lower (p<0.01, p<0.001) than the total phosphorus value. The calcium value in the age group of less than 6 months was higher (p<0.05) but in the age group of 7~12 months was lower (p<0.001) than the total calcium value. 3. Mean${\pm}$S.D. values and ranges of alkaline phosphatase(AP) were $72.47{\pm}19.73IU/l$, and 28.13~105.00IU/l, of lactic dehydrogense(LDH) $159.46{\pm}45.11IU/l$ and 60.63~265.30IU/l, of serum aspartate aminotransferase(AST) $38.64{\pm}8.62IU/l$ and 21.47~70.58IU/l, of serum alanine aminotransferase(ALT) $34.88{\pm}11.30IU/l$ and 14.51~73.17IU/l, respectively. 4. The AP value in the age group of 7~12 months was higher (p<0.05) but in the age group of 1~2 years was lower (p<0.01, p<0.001) than the total AP value. The LDH value in the age group of less than 6 months was higher (p<0.001) but in the age group of 1~2 years and the age group of 3~4 years were lower (p<0.05) than the total LDH value. The serum AST value in the age group of 3~4 years was lower (p<0.01) than the total SGOT value. The serum ALT value in the age group of 7~12 months was higher(p<0.05) than the total SGPT value.