• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.199-206
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• 2009

Purpose: To analyze the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after liver transplantation in children. Methods: From January 1988 to June 2009, we retrospectively reviewed the medical records of 8 PTLD cases among 148 pediatric patients underwent liver transplantation. The age at transplantation, time of presentation after transplantation, clinical manifestations, histologic diagnosis, results of EBV (Epstein-Barr virus) assessments, managements and outcomes of PTLD were investigated. Results: The prevalence of PTLD in liver transplant pediatric recipients was 5.4% (8 of 148). The mean age of patients was 25.4${\pm}$21.3 months (range 10 to 67 months). Seven of 8 patients (87.5%) underwent liver transplantation before 1 year of age. The common clinical presentations were persistent fever (8 of 8, 100%) and bloody diarrhea (6 of 8, 75%). PTLD was diagnosed with gastrointestinal endoscopic biopsies in five patients and surgical biopsies in three. Histologic findings showed early lesion in three patients, polymorphic in two, and monomorphic in three. Burkitt lymphoma and lymphoblastic lymphoma were found in two of 3 monomorphic patients. Seven of 8 patients were found with EBV-positive. Eight patients were treated with dose reduction of immunosuppressants and infusion of ganciclovir. Rituximab was added to four patients. PTLD were successfully managed in all patients except one who died of sepsis during chemotherapy. Conclusion: Major risk factor of PTLD was to undergo liver transplantation before 1 year of age. Continuous monitoring for EBV viral load and gastrointestinal endoscopic biopsy may be useful to early detection of PTLD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.63-67
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• 2000

Purpose: Biliary atresia, one of the major causes of neonatal cholestais, is an idiopathic, serious disorder, affecting the newborn that results in complete obstruction of biliary tract. Successful reestablishment of bile flow is dependent on early surgical intervention, early diagnosis is imperative. The authors evaluate the utility of Tc-99m-labeled diisoprpyliminodiacetic acid (DISIDA) hepatobiliary scintigraphy in the diagnosis of biliary atresia. Methods: From January, 1995 to August, 1999, total 60 patients with neonatal cholestasis underwent Tc-99m DISIDA hepatobiliary scintigraphy at Asan Medical Center. Results: The undelying causes of neonatal cholestasis were biliary atresia in 14, neonatal hepatitis in 33, intrahepatic bile duct paucity in 9, and total parenteral nutrition induced cholestasis in 4. All patient with biliary atresia were interpreted correctely in DISIDA hepatobiliary scintigraphy, showing 100% sensitivity. Of the 46 patients with neonatal hepatitis and other causes, 37 patients had intestinal radioactivity showing 80% specificity. Conclusion: Visualization of DISIDA in the intestinal tract indicates patency of the biliary ducts and excludes the diagnosis of biliary atresia. But the absence of intestinal excretion on the DISIDA hepatobiliary scintigraphy dose not necessarily indicate biliary atresia.

• Journal of Haehwa Medicine
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• v.7 no.2
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• pp.609-620
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• 1999

Over the period between January 1997 and December 1998, herbal medicine was more than three times administered to the patients coming to Na dong gyu's Oriental Medical Clinic on account of the symptom of growth deficiency. According to radiological opinions about the patients providing cooperation for measuring their height and weight as well as their bone age every three months, it was found that the growth plates were not closed. A research was conducted for 200 children randomly selected of patients in prepuberty (they grew by less than 5cm a year before treatment at a age of 12years for female children and 14years for male children). As a result, the following conclusion was drawn: 1. The randomly selected subjects were made up of 116 male and 84 female children in terms of gender. The age direstribution was most 10 to 12 years in 86 children(34.00%), followed by 8-10 years(27.50%) and 12 to 14 years(19.50%). 2. Considering the distribution of sick children's parental height, the fathers of 141 children(70.50%) measured less than 170cm high, the subaverage height, while the mothers of 172 children(86%) measured less than 160cm high, the subaverage height. It was shown that sick childen's height was genetically influenced by their parents. 3. Children patients's weight at a time of birth was most 3.1-3.5kg for 85 children(44%) and less than 2.5kg which came under the range of growth dificiency for 19 children(9.5%). 4. The highest proportian of the children patients with growth dificiency(56.33%) had the symptom of digestive disorders, of which 77 children patients(18.78%) had anorexia, 16.59% of children patients had the high level of respiratory disorders. Both the digestive disorder and the respiratory disorder put together, they had the high rate of 72.92%. Therefore, this indicates that both the digestive disorder and the respiratory disorder have a great effect on children's growth dificiency. 10.74% of chilren patients were shown to have allergic disorders, which indicates that they also exert an effect on growth deficiency. Specifically, 7.07% of the children patients had the high level of obesity, which shows that an excessive uptake of nutrition may rather induce children to have growth dificiency though an appropriate amount of nutritional uptake is necessary. 5. Comparing their bone age and their chronological age, 58 children patients(29.00%) showed that they were the same at the highest percent. 79 children patients(39.50%) showed that thier bone age was lower than their chronological age. And 63 children patients(31.50%) showed that their bone age was higher than their chronological age. 6. As regards the prescription administered to children patients for treating their growth dificiency, Growth tang A related to the kidney, the congenital factor, of the causes for growth dificiency in traditional Oriental Medicine was administered to 108 children patients(54%), whereas the Growth tang B related to the spleen, the acquired factor, was administered to 92 children patients(46%). 7. 116 male children patients with growth dificiency had the average value of growth for one year before treatment, 4.39cm, while 84 female children patients had the average value of growth for one year before treatment, 4.24cm. A total of 200 children had the average value of growth for one year before treatment, 4.33cm. The annual average value of growth in growth curve surveyed by the Korea Pediatrics Society was 5.79cm. Compared to this value, the one year average value of growth for 108 male and female children patients taking Growth tang A was shown be 8.44cm, which indicates a greater growth by 4.12cm(95.37%) in comparison with the average value of growth before treatment, 4.32cm, and a greater growth by 2.65cm(45.77%) compared to 5.79cm, the average value of growth in growth curve surveyed by the Korea Pediatrics Society. Also, the average value of growth before treatment for 92 male and female children patients taking Growth tang B was shown to be 8.47cm, which indicates a greater increase by 4.15cm(96.06%) compared to 4.32cm, the average value of growth before treatment and a greater increase by 2.67cm(46.29%) in comparison with 5.79cm, the average value of growth in growth curve surveyed by the Korea Pediatrics Society. Considering the average value of growth for male and female children patients taking Growth tang A and B, it was shown to be 8.46cm, which indicates a greater increase by 4.14cm(95.81%) compared to 4.32cm, the average value of growth before treatment, and a greater increase by 2.67cm(46.11%) compared to 5.79cm, the average value of growth in growth curve surveyed by the Korea Pediatrics Society.

• KIPS Transactions on Software and Data Engineering
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• v.9 no.4
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• pp.137-144
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• 2020

Delirium is among the most common mental disorders encountered in patients with a temporary cognitive impairment such as consciousness disorder, attention disorder, and poor speech, particularly among those who are older. Delirium is distressing for patients and families, can interfere with the management of symptoms such as pain, and is associated with increased elderly mortality. The purpose of this paper is to generate useful clinical knowledge that can be used to distinguish the outcomes of patients with delirium in long-term care facilities. For this purpose, we extracted the clinical classification knowledge associated with delirium using a local covering rule acquisition approach with the rough lower approximation region. The clinical applicability of the proposed method was verified using data collected from a prospective cohort study. From the results of this study, we found six useful clinical pieces of evidence that the duration of delirium could more than 12 days. Also, we confirmed eight factors such as BMI, Charlson Comorbidity Index, hospitalization path, nutrition deficiency, infection, sleep disturbance, bed scores, and diaper use are important in distinguishing the outcomes of delirium patients. The classification performance of the proposed method was verified by comparison with three benchmarking models, ANN, SVM with RBF kernel, and Random Forest, using a statistical five-fold cross-validation method. The proposed method showed an improved average performance of 0.6% and 2.7% in both accuracy and AUC criteria when compared with the SVM model with the highest classification performance of the three models respectively.

• Journal of the Korean Society of School Health
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• v.19 no.1
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• pp.1-15
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• 2006

Purpose : This study was to identify the incidence, trend, and situation of the unexpected sudden death of elementary, middle, and high school students in school for 17 years from 1988 to 2004 in seoul. Methods : We used the data of The Seoul Safety Mutual aid Association in seoul. Subjects were 53 unexpected sudden death in school from elementary, middle, and high school students, and we explored the gender, month, a day of the week, year, contents of situation, and medical certificate of death. Statistic analysis were chi-square test, Cochran-Armitage trend test, and the tool was SAS 9.1.Results : There were 53 unexpected sudden death students(male 42 and female 11). The incidence of male students was higher than that of female during 16 years except in 1995. The incidence occurred in middle school students were 31 (58.5%) of 53 and were also most frequent in middle school students in both of male and female students. In 1990, the incidence was 8(15.1%) students, 6(11.3%) in 1992 , and 5(9,4%) in 2000 respectively. The frequency of unsuspected sudden death in March was 11(20.8%) of 53 students, 11 (20.8%) in September, 7(13.2%) in October. In Thursday, it was 12(22.6%) of 53 students. Only 14(26.4%) students of 53 died during general life, but 39(73.6%) were related to excercise. The diagnosis of 14 students died during general life were cardiac arrest 7(50.5%), brain disorder 3(21.4%) which were based on medical certificate. But the diagnosis of 39 students died during or after excercise were brain disorder including cerebral hemorrhage 9(23.1%), heart disease 9(23.1%), cardiac arrest 8(20.5%), and unknown 6(15.4%), respectively. Conclusion : The incidence of unexpected sudden death were more frequent in male students, in middle school, and in excercise-related situation and the trend was similar for 17 years. Therefore, to prevent the unexpected sudden death, it needs to further study substantially the risk factors of unexpected sudden death including past history, life-style, nutrition and development, family history, and learning environment.

• Horticultural Science & Technology
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• v.28 no.3
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• pp.434-441
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• 2010

'Wonhwang' pear ($Pyrus$ $pyrifolia$ Nakai) often showed physiological disorder and quality deterioration during long-term storage and shelf life although this cultivar has the advantage of a good appearance and better taste for overseas exportation. This study was conducted to investigate the effect of temperature during transportation and continuing market temperature on fruit quality, and the occurrence of physiological disorder to set up the appropriate transportation and distribution temperatures in the fruits harvested at different times. Unripe fruits harvested 120 days after full bloom maintained higher firmness until 21days of shelf life at both 18 and $25^{\circ}C$ than late harvested ones. Otherwise, ripe fruits harvested 130 days after full bloom showed high incidence of mealiness breakdown of flesh tissues in 21 days of shelf-life at $25^{\circ}C$ of market temperature, but not in the fruits stored at $18^{\circ}C$. Late harvested fruits showed much severe physiological disorders when compared with early harvested ones that showed relatively lower respiration rates. Fruit quality parameters were more highly affected by market temperature than transportation temperature. Results showed that unripe fruits harvested at 120 days after full bloom maintains high marketability until 21 days of shelf-life, while the maximum shelf-life of ripe fruits harvested 130 days after full bloom will be considered at within 7 days.

• Korean Public Health Research
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• v.44 no.4
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• pp.35-49
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• 2018

Objective : The purpose of this study was to investigate the risk factors of dehydration from the subjects who underwent anthropometric and blood parameters testing during a comprehensive health screening. Methods : For the study analysis, 5,391 samples with valid data of the levels of Sodium($Na^+$), BUN (Blood Urea Nitrogen) and FBS(Fasting Blood Sugar) were selected to calculate a dehydration indicator of plasma osmolality. The study data was collected from the health screening examinees who visited Sahmyook Medical Center Seoul Adventist Hospital Comprehensive Health Check-up Center from 2014.01.01 to 2015.12.31. The relationship between dehydration and age group, BMI, disease exposures(hypertension, diabetes mellitus, dyslipidemia, kidney disorder) were analyzed by gender. Results : The odds ratio of dehydration showed statistical significance from age ${\geq}50$ in both male and female, respectively. The female obese group was vulnerable to dehydration while the male study group showed no statistical significance in the BMI difference. The disease exposed groups(hypertension, diabetes mellitus, dyslipidemia, kidney disorder) were vulnerable to dehydration. Also, the more types of disease carried by the exposed patients, the higher odds ratio and susceptibility to dehydration. Conclusions : Aging, increasing BMI, and exposed to diseases were found to be the risk factors for vulnerability to dehydration. To prevent dehydration, special caution to be taken for those in the ${\geq}50s$ group, along with controlling BMI and chronic diseases. Further studies are suggested to investigate the risk factors of dehydration that may affect increasing plasma osmolality as a potential stimulus mechanism in disease outbreaks.

• Journal of the East Asian Society of Dietary Life
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• v.21 no.5
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• pp.649-660
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• 2011

The purpose of this study was to compare the dietary life and nutrient intakes among elderly persons residing at nursing homes and their homes in order to provide fundamental data for improved foodservice and dietary management. We recruited 150 subjects at a nursing home stay and 150 home stay elderly persons for a survey. The results were as follows. There was no significant difference in frequency of napping between the two groups. The frequency of going out was higher in the home stay subjects, but regular exercise was higher in nursing home stay subjects. Subjects possessed the following diseases: dementia and digestive disorders for nursing home stay elderly men, blood vessel disorder and diabetes for home stay elderly men, digestive and blood vessel disorders for nursing home stay elderly women, and blood vessel and heart disease for home stay elderly women. In a health-related assessment, smoking, drinking, and teeth condition of nursing home stay subjects were not higher than those of home stay subjects. The ratio of subjects who ate meals everyday was higher in nursing home stay elderly women than in home stay women. While most nursing home subjects ate adequate amount of meals, home stay subjects ate until they were full. The daily energy intakes of men and women were 2,229.9 kcal and 2,302.1 kcal for nursing home subjects and 1,894.0 kcal and 1,885.9 kcal for home subjects, respectively. Nutrient intake was also higher in nursing home than home stay subjects. In summary, the dietary life of elderly persons residing in a nursing home was higher than that of elderly persons residing at their home from the view point of meal frequency, meal intake, and nutrient intakes. Therefore, systematic assessment and management of nutrition for elderly staying at a nursing home or at home alone should be conducted continually.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.9 no.1
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• pp.30-35
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• 2013

The four principles of treatment of odontogenic infection are as follows : (1) removal of the cause, (2) establishment of drainage, (3) institution of antibiotic therapy, and (4) provision of supportive care, including proper rest and nutrition. A separate incision is required to establish drainage, especially in the case of extensive fascial space infections. There are four principle causes for active bleeding in the immediate incision & drainage phase; (1) vascular wall alteration (infection, scurvy, chemicals), (2) disorder of platelet function, (3) thrombocytopenic purpuras, (4) disorders of coagulation (liver disease, anticoagulation drug). If the hemorrhage from incision & drainage site is aggressive, the site must be packed with proper wet gauze and wound closure & drainage dressing are applied. The specific causes of bleeding may be associated with hypoxia, changes in the pH of blood & chemical changes affecting vascular contractility and blood clotting. This is a case report of bleeding control by the circumferential suture & drainage on active bleeding incision & drainage site of temporal space abscess due to advanced odontogenic infection in a multiple medically compromised disabled patient.

• Korean Journal of Pharmacognosy
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• v.38 no.3 s.150
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• pp.245-253
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• 2007

Artemisia princeps PAMPANINI has been used in traditional medicine of the treatment of inflammatory, liver dysfunction and order disorder in the far east countries including Korea. The present study was carried out to investigate the hepatoprotective effects of ethanol extract of Artemisia princeps (AP) and its fermented agents (AP-F) by lactic acid bacteria derived from human intestinal bacteria on liver injured rat induced by $CCl_4$ and d-galactosamine. Hepatoprotective activity was monitored by estimating serum ALT, AST, ALP, LDH, superoxide dismutase (SOD), glutathione redeuctase (GR) and glutathione peroxidase (Gpx) activities in the liver injured by hepatotoxin. Pretreating rats with AP or AP-F at the same dosage regimen significantly suppressed the acute elevation of serum transaminase, ALP, LDH and GR activities, and significantly increased the lowering of blood SOD and GR activites induced by hepatoxin. Based on these findings, it is presumed that AP and APF may have the hepatoprotective effect on $CCl_4$ and d-galactosamine-induced hepatotoxicity rat.