• Pediatric Infection and Vaccine
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• v.29 no.2
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• pp.70-76
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• 2022

Coronavirus disease 2019 (COVID-19) in patients with underlying diseases, is associated with high infection and mortality rates, which may result in acute respiratory distress syndrome and death. Mucopolysaccharidosis (MPS) type II is a progressive metabolic disorder that stems from cellular accumulation of the glycosaminoglycans, heparan, and dermatan sulfate. Upper and lower airway obstruction and restrictive pulmonary diseases are common complaints of patients with MPS, and respiratory infections of bacterial or viral origin could result in fatal outcomes. We report a case of COVID-19 in a 16-year-old adolescent with MPS type II, who had been treated with idursulfase since 5 years of age. Prior to infection, the patient's clinical history included developmental delays, abdominal distension, snoring, and facial dysmorphism. His primary complaints at the time of admission included rhinorrhea, cough, and sputum without fever or increased oxygen demand. His heart rate, respiratory rate, and oxygen saturation were within the normal biological reference intervals, and chest radiography revealed no signs of pneumonia. Consequently, supportive therapy and quarantine were recommended. The patient experienced an uneventful course of COVID-19 despite underlying MPS type II, which may be the result of an unfavorable host cell environment and changes in expression patterns of proteins involved in interactions with viral proteins. Moreover, elevated serum heparan sulfate in patients with MPS may compete with cell surface heparan sulfate, which is essential for successful interaction between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein and the host cell surface, thereby protecting against intracellular penetration by SARS-CoV-2.

• Korean Journal of Radiology
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• v.22 no.11
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• pp.1909-1917
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• 2021

Objective: Muscle quantity and quality can be measured with an automated system on CT. However, the effects of contrast phases on the muscle measurements have not been established, which we aimed to investigate in this study. Materials and Methods: Muscle quantity was measured according to the skeletal muscle area (SMA) measured by a convolutional neural network-based automated system at the L3 level in 89 subjects undergoing multiphasic abdominal CT comprising unenhanced phase, arterial phase, portal venous phase (PVP), or delayed phase imaging. Muscle quality was analyzed using the mean muscle density and the muscle quality map, which comprises normal and low-attenuation muscle areas (NAMA and LAMA, respectively) based on the muscle attenuation threshold. The SMA, mean muscle density, NAMA, and LAMA were compared between PVP and other phases using paired t tests. Bland-Altman analysis was used to evaluate the inter-phase variability between PVP and other phases. Based on the cutoffs for low muscle quantity and quality, the counts of individuals who scored lower than the cutoff values were compared between PVP and other phases. Results: All indices showed significant differences between PVP and other phases (p < 0.001 for all). The SMA, mean muscle density, and NAMA increased during the later phases, whereas LAMA decreased during the later phases. Bland-Altman analysis showed that the mean differences between PVP and other phases ranged -2.1 to 0.3 cm² for SMA, -12.0 to 2.6 cm² for NAMA, and -2.2 to 9.9 cm² for LAMA.The number of patients who were categorized as low muscle quantity did not significant differ between PVP and other phases (p ≥ 0.5), whereas the number of patients with low muscle quality significantly differed (p ≤ 0.002). Conclusion: SMA was less affected by the contrast phases. However, the muscle quality measurements changed with the contrast phases to greater extents and would require a standardization of the contrast phase for reliable measurement.

• Journal of the Korean Society of Radiology
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• v.85 no.3
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• pp.654-660
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• 2024

Primary malignant fibrous histiocytoma (MFH) is a malignant tumor of mesenchymal origin that rarely occurs in the urinary tract, particularly in the urinary bladder. Unlike urothelial carcinoma, which accounts for most bladder cancers, it occurs in the submucosal portion of the bladder wall and consists of the lamina propria, muscularis propria, and adventitia. It is presumed to originate from poorly differentiated pluripotent mesenchymal cells in which fibroblasts and histiocytes are partially differentiated. Radiologically, it is known as the "non-papillary tumor" and is commonly diagnosed as a large mass without necrosis, which shows invasion beyond the muscularis propia. Although the prognosis of this rare malignancy depends on pathological parameters, it generally has a poor prognosis with high local tumor recurrence. Here, we present a case of primary MFH in the urinary bladder with clinical symptoms of lower abdominal pain without gross hematuria that recurred rapidly and showed an aggressive disease course.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.1
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• pp.91-97
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• 2022

Backgrounds/Aims: Metastatic lesions of the pancreas (PMET) account for 1%-5% of all malignant solid pancreatic lesions (SPL). In this study we evaluated the utility of endoscopic ultrasonography with fine needle aspiration (EUS-FNA) in diagnosing PMET. Methods: Patients who underwent EUS-FNA at a community referral center between 2011-2017 for SPL were identified. Clinical, radiologic, and EUS-FNA features of those with PMET were compared to those with primary solid tumors of the pancreas: pancreatic adenocarcinoma (PDAC) and neuroendocrine tumors (PNET). Results: A total of 191 patients were diagnosed with solid pancreatic malignancy using EUS-FNA: 156 PDAC, 27 PNET, and eight (4.2%) had PMET. Patients with PMET were less likely to have abdominal pain (25.0% vs. 76.3% vs. 48.2%; p < 0.01) or obstructive jaundice (37.5% vs. 58.3% vs. 0%; p < 0.01) compared to PDAC and PNET. Those with PMET were more likely to have mass lesions with/without biliary or pancreatic ductal dilatations (100% vs. 86.5% vs. 85.2%; p < 0.01) and lower CA19-9 (82.5 ± 43.21 U/mL vs. 4,639.30 ± 11,489.68 U/mL vs. 10.50 ± 10.89 U/mL; p < 0.01) compared to PDAC and PNET. Endosonographic features were similar among all groups. Seven (87.5%) patients with PMET had a personal history of malignancy prior to PMET diagnosis. The primary malignancy was renal cell carcinoma in five PMET. Conclusions: PMET are exceedingly rare, comprising less than 5% of SLP. Patients with PMET are less likely to present with symptoms and mostly identified by surveillance imaging for the primary malignancy.

• Clinical and Experimental Pediatrics
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• v.46 no.5
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• pp.454-458
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• 2003

Purpose : Rotavirus is the main cause of infantile diarrheal disease worldwide. The purpose of this study is to assess the difference between clinical manifestations and feeding or delivery methods in healthy full-term neonates and those with nosocomially-acquired rotaviral infection. Methods : The study was conducted on 348 babies who were delivered in Dongguk University Kyongju Hospital from Jan 1 to June 30 in 2001. Stool specimens were collected from clinically symptomatic neonates. We studied the rate of positive stool rotazyme ELISA tests and positive symptoms. We compared the frequency of clinical manifestations according to the feeding methods [breast feeding(BF) or formula feeding(FF)] and the delivery methods[normal vaginal delivery(NVD) or Cesarean section(C/sec)]. Results : Rotavirus was detected in 152 of 348 babies. The rate of positive rotazyme ELISA test was 43.7% in healthy full-term symptomatic neonates. The most common symptom of rotaviral enteritis was mild fever; the others were watery diarrhea, abdominal distension, vomiting, delayed weight gain, irritability, poor oral intake and dehydration. Compared with FF neonates, BF neonates have lower frequency of symptoms, especially watery diarrhea, delayed weight gain and poor oral intake. The symptomatic frequency was higher in FF and NVD neonates than BF and C/sec. Conclusion : The symptoms of rotaviral enteritis were less frequent in BF or C/sec delivered neonates. BF appeared to alleviate the rotaviral enteritis but further studies are needed. The cause of the lower frequency of symptoms in C/sec delivered neonates was unknown.

• Korean Journal of Community Nutrition
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• v.15 no.3
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• pp.308-328
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• 2010

As the older adult period $({\geq}65y)$ is increasing, it is needed to investigate the trend of aging-dependent anthropomeric index and nutrient intake, and establish the more specific dietary guide for the different stages of aging period. To find the difference in nutrient intake among the Koreans aged 50-64, 65-74 and 75 years and older, and also any characteristics of dwellers in longevity area, we recruited 1,083 subjects (385 male and 698 female) aged 50-95 years (mean age, 71.3 yrs) living in Kugoksoondam area (Kurye, Goksung, Soonchang and Damyang counties), known as a longevity-belt region in Jeonlaprovince, Korea. We measured some anthropometric index and collected 2 day-dietary record. Nutrient intakes were analyzed by using DW24 program. The mean height and weight of subjects aged 75 years and older were lower than Korean national reference. BMI and obesity $({\geq}25kg/m^2)$ prevalence were significantly decreasing with aging. Underweight $(BMI<18.5kg/m^2)$ prevalence was also increasing with aging, especially in males, and it was slightly higher than national average, but similar to that in some other rural area. Obesity prevalence of male subjects was lower compared to national prevalence, but abdominal obesity prevalence $(waist{\geq}80cm)$ was very high in females (about 89%). In both genders, the average proportional contribution of carbohydrate, protein and fat to energy intake was not different between 65-74 years and 75 years and older. On overall, nutrient intake and quality of diet of females were inferior to those of males so that many of females aged 75 years and older assumed to be at risk of malnourished status. Fiber, folate and vitamin E intakes were substantially higher compared to those in 2007 KNHNES and other some studies in rural area. While almost nutrient %EAR was significantly decreased with aging in females, there was no significant difference in %EAR for protein, vitamin A, $B_1$, $B_6$, $B_{12}$, niacin, Ca and Zn between 65-74 years and 75 years and older in males. Vitamin $B_2$ for male aged 50-64 years, vitamin $B_2$ and Ca for male aged 65 years and over and female aged 50-74 years, and vitamin $B_2$, vitamin C, Ca and folate intake for female aged 75 years and older were assessed to be at risk to undernutrition based on the prevalence of intake below EAR. MAR of 13 nutrients and the number of nutrients consuming below EAR were significantly decreasing with aging in both genders, however, the number of nutrients of INQ < 1 and the average mini-nutritional assessment score were not significantly different between 65-74 years and 75 years and older. Taken together, decreasing tendency of nutrients intake and the quality of diet with aging was more evident in females than in males, and it is unique that our subjects consumed substantially higher fiber, folate and vitamin E compared to not only urban but also some other rural areas.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.85-93
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• 2012

Purpose: It is essential to minimize the respiratory-induced motion of involved organs in the Tomotherapy for tumor located in the chest and abdominal region. However, the application of breathing control system to Tomotherapy is limited. This study was aimed to investigate the possible application of the ABCHES system and its efficacy as a means of breathing control in the tomotherapy treatment. Materials and Methods: Five subjects who were treated with a Hi-Art Tomotherapy system for lung, liver, gallbladder and pancreatic tumors. All patients undertook trained on two breathing methodes using an ABCHES, free breathing methode and shallow breathing methode. When the patients could carry out the breathing control, 4D-CT scan was a total of 10 4D tomographic images were acquired. A radiologist resident manually drew the tumor region, including surrounding nomal organs, on each of CT images at the inhalation phase, the exhalation phase and the 40% phase (mid-inhalation) and average CT image. Those CT images were then exported to the Tomotherapy planning station. Data exported from the Tomotherapy planning station was analyzed to quantify characteristics of dose-volume histograms and motion of tumors. Organ motions under free breathing and shallow breathing were examined six directions, respectively. Radiation exposure to the surrounding organs were also measured and compared. Results: Organ motion is in the six directions with more than a 5 mm displacement. A total of 12 Organ motions occurred during free breathing while organ motions decreased to 2 times during shallow breathing under the use of Abches. Based on the quantitative analysis of the dose-volume histograms shallow breathing showed lower resulting values, compared to free breathing, in every measure. That is, treatment volume, the dose of radiation to the tumor and two surrounding normal organs (mean doses), the volume of healthy tissue exposed to radiation were lower at the shallow breathing state. Conclusion: This study proposes that the use of ABCHES is effective for the Tomotherapy treatment as it makes shortness of breathing easy for patients. Respiratory-induced tumor motion is minimized, and radiation exposure to surrounding normal tissues is also reduced as a result.

• Korean Journal of Organic Agriculture
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• v.17 no.4
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• pp.539-555
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• 2009

The potential of encapsulated inuloprebiotics from domestic Jerusalem artichokes (Helianthustuberosus) as natural antibacterial growth promotor for an antibiotic replacement in broiler chickens was presently assessed through assays of growth performance, serum immunoglobulin production and influence on caecal microflora. Two hundred-forty, 1-day-old, male broilers (Ross 308) were randomly allotted to four treatments (T1-T4), with three replicate pens per treatment and 20 chicks per pen. Broiler chicks were fed a basal diet (T1: control) or basal diet plus antibiotics (T2: Chlorotetracycline, 0.10%), 300 ppm of the inuloprebiotics (T3), or 450 ppm of the inuloprebiotics (T4) for 35 days. Body weight, dressing percentage or weight of breast and thigh muscles relative to carcass weight of T3 and T4 broiler chickens was significantly (P<0.05) higher than T1 and T2 broiler chickens. The weight of abdominal fat from T3 and T4 broiler chickens were significantly (P<0.05) lower than that of T1 and T2 chickens. Serum immunoglobulins in the T3 and T4 groups were significantly (P<0.05) elevated compared to the T1 and T2 groups. The weight of immune organs, thymus and Bursa of Fabricius relative to live body weight in the T3 and T4 groups were significantly (P<0.05) higher than the T1 and T2 groups. Bifidobacteria and Lactobacillus, which are beneficial bacteria, were present in greater numbers in the caecum of T3 and T4 birds than T1 and T2 groups, whereas potentially harmful Escherichiacoli and Salmonella were present in lower numbers, with differences being significant (P<0.05). These results suggest that a diet supplemented with 300 ppm of inuloprebiotics has potential as an antibiotic replacement for organic livestock feed supplement intended to improve production of broiler chicken.

• Korean Journal of Organic Agriculture
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• v.17 no.1
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• pp.111-125
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• 2009

Pitamin is a component of pine bark extract that exhibits antimicrobial activity and a variety of physiological effects. This study was earned out to investigate the effects of dietary pitamin as an organic livestock feed additive in broiler chickens. A 35 day trial was conducted to determine the influence of dietary premix containing 5% pitamin; investigated parameters included blood lipids, growth performance, quality characteristics of carcasses, and changes of caecal microbials in broiler chickens. Chickens were randomly divided into groups that were untreated (control), treated conventionally with antibiotics in the absence of premix, received 0.1 % or 0.2% premix containing 5% pitamin. Plasma lipids were lower in groups fed diets with pitamin premix (p<0.05). The body weight gain from broiler chickens fed with the diet containing 0.1% pitamin premix and antibiotics was similar, and was significantly higher than that of the other groups (p<0.05). The weight of breast muscle and thigh meat of carcasses was similar, and was higher than that of the control group (p<0.05). Abdominal fat and thymus index from chickens receiving either pitamin-supplemented premix was significantly lower and increased, respectively, that of the antibiotic and control groups (both p<0.05). The chickens on the pitamin premix-supplemented diets evidenced significantly higher caecal levels of Bifidobacterium species as compared with the chickens on the control diet (p<0.05). These results suggest that feeding a diet supplemented with a 0.1% premix containing 5.0% pitamin for 35 days maintains the production of broiler chickens at a level comparable to that obtained from the use of antibiotics.

• Journal of dental hygiene science
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• v.15 no.2
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• pp.119-128
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• 2015

The purpose of this study is to understand the effects of obesity and stress on oral disease in Korean adults by using the data of the Fifth Korea National Health and Nutrition Examination Survey. The subjects of this study are 4,627 adults at the age of 19 to 64, and the data were analyzed by using SPSS Windows ver.18.0. The results are as follows: Obesity was higher in men and the age of 40 to 64 than the other. And the group with lower education or lower income level tended to show significantly higher obesity (p<0.05). As for stress, women, the age of 19 to 39 and the subjects with higher academic career tended to indicate significantly higher stress (p<0.05). As for the effects of obesity on oral disease, there were no significant difference between body mass index (BMI) or waist-hip ratio (WHR) and oral disease but there was statistically significant difference between stress and temporomandibular joint disorder (TMD) (p<0.05). Even when the subjects with stress were obese or abdominally obese, there was no significant difference in oral disease (p>0.05). As to correlation among variables, there were correlations between BMI and WHR, stress and TMD, masticatory problems and periodontal disease or TMD (p<0.05). About the effects of general characteristics, obesity, and stress on oral disease, age was the variable influencing TMD, and age and abdominal obesity were the variables influencing masticatory problems (p<0.05). In this society, the environment surrounding individuals is fairly complex, and the concept of health including quality of life has more complex meaning than in the past. Various factors are influencing obesity and stress, and they are also influencing oral health and behaviors. Accordingly, it will be needed not only to make efforts to reduce obesity and stress but also to employ approaches from different perspectives to improve oral health.