• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.6
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• pp.518-527
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• 2021

Purpose: The incidence of hepatic steatosis among children has been increasing; however, data distinguishing simple steatosis from a more complex disorder are lacking. Methods: This study identified the etiologies resulting in hepatic steatosis through a retrospective review of pediatric liver biopsies performed in the last 10 years. A total of 158 patients with hepatic steatosis proven by histopathological evaluation were enrolled in the study, and baseline demographic features, anthropometric measurements, physical examination findings, laboratory data, ultrasonographic findings, and liver histopathologies were noted. Results: The two most common diagnoses were inborn errors of metabolism (IEM) (52.5%) and nonalcoholic fatty liver disease/steatohepatitis (NAFLD/NASH) (29.7%). The three most common diseases in the IEM group were glycogen storage disorders, Wilson's disease, and mitochondrial disease. The rates of consanguineous marriage (75.6%; odds ratio [OR], 26.040) and positive family history (26.5%; OR, 8.115) were significantly higher (p=0.002, p<0.001, respectively) in the IEM group than those in the NAFLD/NASH group. Younger age (p=0.001), normal anthropometric measurements (p=0.03), increased aspartate aminotransferase levels (p<0.001), triglyceride levels (p=0.001), and cholestatic biochemical parameters with disrupted liver function tests, as well as severe liver destruction of hepatic architecture, cholestasis, fibrosis, and nodule formation, were also common in the IEM group. Conclusion: Parents with consanguinity and positive family history, together with clinical and biochemical findings, may provide a high index of suspicion for IEM to distinguish primary steatosis from the consequence of a more complex disorder.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.4
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• pp.298-307
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• 2022

Portal cavernoma cholangiopathy is defined as an obstruction of the biliary system due to distended veins surrounding bile ducts that mainly occur in patients with extrahepatic portal venous obstruction. The periductal venous plexuses encircling the ducts can cause morphological changes which may or may not become symptomatic. Currently, non-invasive techniques such as ultrasonography, computed tomography, magnetic resonance cholangiopancreatography, and dynamic contrast enhanced magnetic resonance images are being used to diagnose this disorder. Only a few patients who have symptoms of biliary obstruction require drainage which might be accomplished using endoscopic stenting, decompression of the portal venous system usually via a lienorenal shunt, a difficult direct hepaticojejunostomy, and rarely a liver transplant.

• The Journal of the Korea Contents Association
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• v.8 no.10
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• pp.217-223
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• 2008

Adult polycystic liver disease (PLD) is a rare, benign condition association with autosomal dominant polycystic kidney disease (ADPKD). It is an autosomal dominantly inherited disorder characterized by multiple diffuse cystic lesions of the liver parenchyma. Significant symptoms or complications from liver involvement can occur cases. Surgical therapy is the mainstay of therapy including laparoscopic or open fenestration with or without hepatic resection and orthotopic liver transplantation. We report the literature addressing the presence of abdominal discomport, a case of a patient with PLD. This case showed the typical ultrasonogaphic and computer tomogaphic findings of this disease.

• Clinical and Experimental Pediatrics
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• v.59 no.4
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• pp.196-201
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• 2016

Chronic granulomatous disease (CGD) is a rare inherited disorder caused by defective nicotinamide adenine dinucleotide phosphate oxidase enzyme and characterized by recurrent bacterial and fungal infections. Although liver abscess is a common manifestation of CGD, its management in CGD patients is not well-defined. In addition, the generalized guidelines for treating liver abscesses do not necessarily apply to CGD patients. Corticosteroids are commonly used to control granulomatous complications, such as inflammatory gastrointestinal and genitourinary lesions, in patients with CGD, Corticosteroids have also been used in combination with antimicrobials to treat refractory infections in patients with CGD. Because corticosteroids are capable of suppressing symptomatic inflammation, all potential infections must be adequately controlled prior to corticosteroid initiation. We report 3 typical CGD cases with liver abscesses refractory to conventional treatments that were successfully treated with the concomitant use of corticosteroid and antimicrobials. It remains unclear whether corticosteroid therapy is required for liver abscesses in CGD refractory to conventional treatments. However, based on our observations, use of corticosteroids in combination with optimal antimicrobials should be considered for refractory liver abscesses in CGD.

• Journal of Oriental Neuropsychiatry
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• v.14 no.1
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• pp.161-174
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• 2003

Attention deficit hyperactivity disorder(ADHD) is one of the most common childhood-onset psychiatric disorders. It is distinguished by symptoms of hyperactivity, inattention, and impulsivity. The etiology of ADHD is unknown, and the disorder may several different causes. The pharmacotherapy most widely used for ADHD occasionally gives rise to ill effects. The studys of ADHD were approached from the viewpoint of medicine and pedagogics, but it is rare from the viewpoint of the Korean Medicine. So, we searched for the studies on ADHD of Chinese Traditional Medicine(TCM) in last eight years(1995-2002). In TCM, ADHD was placed under the category of 'wind(風)-one of the five pathogenic factors', 'insomnia(失眠)', 'forgetfulness(健忘)' and 'restlessness(躁動)', etc. Jang and Bu(the internal organs; 臟腑) related with the differentiations of syndrome about ADHD were liver(肝), heart(心), spleen(脾), kidney(腎) and gallbladder(膽). Among them, liver(肝), kidney(腎) and spleen(脾) were important. The herbal medicines used in ADHD had the effects of spirit-calming(安神), orifices-opening(開竅), Eumyang-balance(陰陽平衡). And acupuncture therapy, ear-acupuncture therapy and dietary treatment, etc. were used in the treatment of ADHD. We expect that this review about ADHD in TCM help the clinical study of ADHD in Korean Medicine.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.2
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• pp.141-165
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• 2001

Attention-deficit/hyperactivity disorder(ADHD) is one of the most common childhood-onset psychlatric disorders. It is distinguished by symptoms of inattention, hyperactivity, and impulsivity. ADHD may be accompanied by learning disabilities, depression, anxiety, conduct disorder, and oppositional defiant disorder. The etiology of ADHD is unknown, and the disorder may have several different causes. Individual with ADHD present in childhood and may continue to show symptoms as they enter adolescence and adult life. Public interest in ADHD has increased along with debate in the media concerning the diagnostic process and treatment strategies. The purpose of this study is oriental medical approach to ADHD. This study was progressed for oriental diagnosis and treatment for ADHD. In oriental medicine, the reason of ADHD was deficiency of the kidney, hyperactivity of the liver(腎虛肝亢), deficiency of the heart and the spleen(心脾不足), heart disturbed by phlegm and heat(痰熱擾心). The method of medical treatment was nourishing the kidney and checking exuberance of yang(滋腎潛陽), relieving mental stress and promoting wisdom(寧神益智), nourishing the heart and strengthening the spleen(養心健脾), tranquilzation(安神定志). removing heat-phlegm(淸熱化痰), inducing resuscitation and tranquilzation(開窮安神). The prescription was commonly used as Liuwei Dihuang Wan jiajian(六味地黃丸加減), Guipi Tang he Ganmai Dazao Tang jiajian(歸脾湯合甘麥大棗湯加減), Huanglian Wendan Tang jiawei(溫黃連溫膽湯加味). It should help primary care providers in their assessment of a common child health problem.

• The Journal of Pediatrics of Korean Medicine
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• v.28 no.3
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• pp.85-101
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• 2014

Objectives The purpose of this study is to report test results in eight tic disorder children using Sensitiv $Imago^{TM}$. Methods Eight tic disorder children were tested using Sensitiv $Imago^{TM}$. Also, they were diagnosed with tic disorders by DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, $4^{th}$ edition) and we evaluated tic disorder cases by Yale Global Tic Severity Scale (YGTSS). Results In 8 cases, 1 case was transient tic disorder, 3 cases were Tourette's disorder and 4 cases were unspecified tic disorder. In the result of Sensitiv $Imago^{TM}$, 4 cases showed the lowest score at filter ${\sharp}5^*$ and 4 cases showed the lowest score at filter ${\sharp}6^*$ in [Express Monitoring] of [Review of System Disorders of Homeostasis]. Filter #5 includes urogenital organs, liver, gallbladder, kidneys, urinary bladder and ureter and Filter #6 stands for organs of immune and respiratory systems. Conclusion We report test results in eight tic disorder children using Sensitiv $Imago^{TM}$. Further studies about the principle, repeatability, reproducibility of Sensitiv $Imago^{TM}$ are needed.

• Journal of Acupuncture Research
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• v.27 no.2
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• pp.43-49
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• 2010

Objectives : Among young generation, the prevalence of spinal disorders is known to be increasing. This study aimed to analyze the clinical data of spinal disorder in young ages in Korea. Methods : Number of patient, kinds of disorder, and medical cost were analyzed for patients(7~18 years) underwent spinal disorders using computerized database of Health Insurance Review and Assessment Service(HIRAS) from 2004 to 2008. We included dorsopathies as spinal disorder according to Korean Classification of Diseases(KCD) and excluded spinal disorder caused by trauma. We compared the data of traditional Korean medicine treatment with that of western medical care. Results : 4.8% of the children and adolescents had medical treatment with spinal disorder in 2008. The claim number and medical cost for both traditional Korean medicine and western medicine treatment are increasing 1.8 and 1.3 times respectively over 5 years. Total medical spent of western clinic was 2.1 times than those of traditional Korean clinic. The most common spinal disorder was dorsalgia(31.8%) and scoliosis(13.5%) in western clinics while back pain(29.0%) and neck pain(10.8%) in oriental clinic. Conclusions : We first reported the clinical tendency of spinal disorder in Korean children adolescents from 2004 to 2008. This study will support the development of a strategy for traditional Korean medicine-based prevention or treatment of spinal disorders in young generation.

• Journal of the Korean Society of School Health
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• v.22 no.2
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• pp.169-181
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• 2009

Purpose: Mood disorders such as depression and bipolar disorder are a major mental health problem in college students. We investigate the prevalence of depression and bipolar disorder and the relevance of risk factors for these mood disorders among one college freshmen. Methods: The subjects were 2,865 college students who entered one university located in Seoul and Ansung in 2009. We used BDI (Beck Depression Inventory) for depression assessment and K-MDQ (Mood Disorder Questionnaire) for bipolar disorder assessment. Demographic and socioeconomic factors were measured by questionnaire. Height, weight, blood pressure, total cholesterol, complete blood cell count, and liver function test data were obtained by physical examination for freshmen. Chi-square test and multiple logistic regression were performed to analyze the possible risk factors for depression and bipolar disorder. Results: With different BDI cutoff value, 16 and 21, the prevalence of depression was 8.7% (male: 7.6%, female: 10.1%) and 2.4% (male: 2.5%, female: 2.3%), separately. 'Low economic status', 'urban birth place', and 'low grade at entrance' were significantly associated with depression. Using the original cutoff criterion, defined as clustering of 7 or more symptoms that caused moderate or severe problems, the prevalence of bipolar disorder was 1.3% (male: 1.4%, female: 1.1%). The risk factor of bipolar disorder was academic fields (art fields). Conclusion: Depression and bipolar disorder are common disease in college freshmen. Therefore, Campus-based mental health service program is needed to help with prevention of and early intervention of these mood disorders.

• Nutrition Research and Practice
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• v.10 no.1
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• pp.19-25
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• 2016

BACKGROUND/OBJECTIVES: Cadmium is a toxic metal that is an occupational and environmental concern especially because of its human carcinogenicity; it induces serious adverse effects in various organs and tissues. Even low levels of exposure to cadmium could be harmful owing to its extremely long half-life in the body. Cadmium intoxication may be prevented by the consumption of dietary components that potentially reduce its accumulation in the body. Dietary chitosan is a polysaccharide derived from animal sources; it has been known for its ability to bind to divalent cations including cadmium, in addition to other beneficial effects including hypocholesterolemic and anticancer effects. Therefore, we aimed to investigate the role of dietary chitosan in reducing cadmium accumulation using an in vivo system. MATERIALS/METHODS: Cadmium was administered orally at 2 mg (three times per week) to three groups of Sprague-Dawley rats: control, low-dose, and high-dose (0, 3, and 5%, respectively) chitosan diet groups for eight weeks. Cadmium accumulation, as well as tissue functional and histological changes, was determined. RESULTS: Compared to the control group, rats fed the chitosan diet showed significantly lower levels of cadmium in blood and tissues including the kidneys, liver, and femur. Biochemical analysis of liver function including the determination of aspartate aminotransferase and total bilirubin levels showed that dietary chitosan reduced hepatic tissue damage caused by cadmium intoxication and prevented the associated bone disorder. CONCLUSIONS: These results suggest that dietary chitosan has the potential to reduce cadmium accumulation in the body as well as protect liver function and bone health against cadmium intoxication.