• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.1
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• pp.30-38
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• 2009

Purpose: To investigate the physical and biochemical parameters related with elevated serum alanine aminotransferase (ALT) levels in obese children. Methods: One hundred forty-two obese or overweight children who visited the out-patient clinics of Chungnam National University Hospital between January 2006 and August 2008 were enrolled. Physical measures and biochemical tests were performed in all patients. Liver sonography was performed in 43 patients. They were divided into the following 2 groups based on ALT levels: group I, normal ALT levels (n=65); and group II, elevated ALT levels (n=77). We compared the physical measures, biochemical results, and ultrasonographic findings of the livers in both groups. Other causes of elevated serum ALT levels were ruled out. Results: The male-to-female ratios were 1.6:1 in group I and 7.6:1 in group II. Among physical parameters, the waist circumference-to-height ratio and hip circumference-to-height ratio were significantly higher in group II (p=0.001 and 0.046, respectively). Among biochemical parameters, aspartate aminotransferase (AST), ${\gamma}$-glutamyltransferase (${\gamma}$-GT), and total cholesterol levels were significantly higher in group II (p<0.001, 0.001, and 0.001, respectively). The AST/ALT ratio was <1 (mean, 0.55) and statistically lower in group II. There was a positive correlation between the serum ALT level and ${\gamma}$-GT (p<0.001, r=0.750), and a positive correlation between the serum ALT level and the waist circumference-to-height ratio in group II (p<0.001, r=0.401). Conclusion: The results suggest that the waist circumference-to-height ratio and ${\gamma}$-GT may be associated with elevated alanine aminotransferase activity in obese children.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.209-213
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• 1986

To study the therapeutic effect of ribavirin, a broad spectrum antiviral agent, for chronic hepatitis B in pediatric patients, 24 patients who were diagnosed as chronic hepatitis B (elevated SGOT and SGPT and positive HBsAg and HBeAg for more than 6 months) at the pediatric department of Yeungnam University Hospital from Mar. 1, 1985 to Sep. 30, 1986 were randomly divided into two groups. Ribavirin was administered to 11 patients in dose of 15mg/kg/day and 13 patients were control group and both groups were followed for 12 months. Serum HBsAg and HBeAg were measured with RIA(Ausria-1I and Abbott-HBe, respectively) and compared in PIN ratio (counts per minute of patient's sample/counts per minute of normal serum). There were no statistically significant reductions in PIN ratios of HBsAg and HBeAg in both groups between prior to the therapy and 12 months follow-up period. It seems that ribavirin does not have the therapeutic effect on chronic hepatis B in children. Also, there were no noticeable side effects from ribavirin therapy.

• Journal of Yeungnam Medical Science
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• v.15 no.2
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• pp.237-245
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• 1998

만성 B형 간염 환자에서 Interferon (IFN) 치료 후 혈청 HBeAg 소실 및 anti-HBe의 양전율을 높이고 효율적인 치료의 근거를 알기 위하여 치료 전 간기능검사상 갑자기 상승한 혈청 ALT치를 나타낸 환자군과 그렇지 않은 대조군을 대상으로 하여 IFN을 투여한 군과 IFN 치료없이 정상 HBeAg의 자연 소실을 보인 환자군을 임상적으로 장기간 관찰하고 조사하였다. ALT치가 정상 상한치의 4배 이상 높이 증가되어 3개월 이상 왕복을 보인 40명의 환자(A군)와 ALT치가 정상 상한치의 3배 이하로 증가된 10명(B군)에게 ${\alpha}$-IFN 2b를 매일 300만 단위 피하주사로 3~12개월 주사하였다. 대조군으로는 ALT치가 A군처럼 장승한 45명 (C군)이었으며, IFN 치료없이 평균 2.9년을 관찰하였다. HBeAg/anti-HBe 혈청 양전율은 A군 68%, B군 20%, C군 13%이었으며 IFN 치료 중단 후 1년까지의 HBeAg 재양성율은 A군에서 29%였고 HBeAg이 소실된 A와 B군의 38명중에서 6명에서 HBV DNA가 양성이었다. 6명중 4명은 HBeAg/anti-HBe 양전을 보였으나 HBV DNA 양성이었고 나머지 2명은 HBeAg, anti-HBe 및 HBV DNA (hybridization) 모두 음성이었으나 중합효소연쇄반응검사상 HBV DNA 양성이었다. 이상의 결과를 보면 비록 IFN 치료 후에 HBeAg이 소실되었다가 다시 양성화되더라도 IFN은 단기간내에 혈중 HBeAg이나 DNA가 자연적으로 감소가 될 환자나 그렇지 않은 환자에게도 HBV의 비증식화를 유발하여 도움이 될 것으로 사료된다. 그러나 IFN 투여 후에도 혈중 HBeAg과 DNA 소실에 전혀 도움이 되지 않을 환자 및 HBV 증식 억제효과가 기대되는 HBV 간질환 환자의 조건, IFN 투여량, 기간 등에 대한 계획적이고 체계적인 연구로 더 나은 치료효과를 기대할 수 있으리라 생각된다.

• Journal of Preventive Medicine and Public Health
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• v.22 no.1 s.25
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• pp.65-70
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• 1989

To examine the association between serum HBeAg status and tuberculosis infection, we reviewed medical records of 579 inpatients who had serum HBeAg test with RIA method at the Department of Nuclear Medicine of Kyungpook University Hospital from January 1, 1985 to December 31, 1987. HBeAg positive patients had lower tuberculosis infection rate(5.0%) than that of HBeAg negative patients(9.8%) and the odds ratio of HBeAg associated with tuberculosis was 0.48(95% C.I.:0.22-1.08). Similar relationship was found in the patients of hepatobiliary diseases; tuberculosis infection rate was 4.4% in HBeAg positive patients, 8.1% in HBeAg negative patients, and the odds ratio was 0.52(95% C.I.:0.17-1.35). Although the association did not reach the statistical significance level of 0.05, the negative association was consistent with other study done on Southeast Asian population of Philadelphia. A cohort study in general population is warranted to confirm above findings because of the limitations on hopital-based data.

• KSBB Journal
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• v.15 no.2
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• pp.214-218
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• 2000

A hepatitis B Surface Antigen(HBsAg)-screening kit using immunochromatographic assay(ICA) method was developed by e employing two kinds of antibodies. One is mouse monoclonal anti-HBs for tracer antibody and the other is goat p이yclonal a anti-HBs for capture antibody. This capture antibody was immobilized on the surface of nitroceliulose(NC) membrane and the t tracer antibody was conjugated with g미d particles. When serum sample was added to the sample well, the $\infty$njugates d deposited in a dry state on the surface of glass fiber filter were reconstituted and then combined with HBsAg in serum. In 5 5 min after adding, the assay result was visible through the window, that is, the complexes composed of HBsAg and the c conjugates appeared as maroon line on the lower part of the NC membrane. The detection limit of the ICA kit was 2 ng/ml w when being tested with the reference HBsAg.

• The Korean Journal of Nuclear Medicine
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• v.19 no.2
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• pp.25-41
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• 1985

간흡충증은 한국 및 동남아세아에 널리 분포되어 있는 중요한 풍토병의 하나로서 진단은 전통적으로 분변검사에 의존하여 오고 있다. 최근 들어 담관내 간흡충 및 이의 합병증의 진단을 위해 ERCP 및 contrast cholangiogram등이 시도되었으나 실제에 이용하기에는 많은 제약이 있다 하겠다. 저자는 간흡충증에 있어서 최근 소개된 $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy의 진단적 의의를 규명하고자 1982년부터 1983년까지 고신의대 부속 복음병원에서 검진한 간흡충증 환자 90명을 대상으로 하여 $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy와 formalin-ether 원침법에 의한 분변검사를 시행하였다. $^{99m}Tc-DISIDA$ scintigram소견은 간내 담관 bile flow 및 총수담관 bile flow defect, 그리고 간세포기능의 정도에 따라 자료를 분석하였고 그외 합병증의 진단은 병록 기록, 수술 소견, ERCP 등에 의존하여 결론을 얻었다. $^{99m}Tc-DISIDA$ scintigraphy는 특이한 양상의 bile flow dynamics를 나타내었으며 간내 주담관의 intermittent irregular focal bile flow defect 및 tile flow stasis를 나타내고 말초담관의 bile flow defect는 경미하고 60분 내에 담관 bile flow activity의 완전한 배설을 나타내는 경우를 mild pattern, 간내 담관의 심한 irregular bile flow dynamics 및 간내담관의 심한 irregularity (담관내벽의 심한 불규칙성), 총수담관, 간내 주담관 및 말초 담관까지 심하게 irregular bile flow stasis를 나타내며 bile flow activity의 완전 베설이 $60\sim90$분사이 혹은 90분이상까지 인지된 경우를 moderate-severe pattern으로 분류하였다. 1) 분변검사상 간흡충증은 95검사중 70검사(환자 86명중 67명)에서 양성을 보여 분변 충난검사의 양성율은 73.7%였고 음성율은 26.3%였다. 2) $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy는 90명중 70명에서 특이한 Cs-bile flow양성을 보였으며 양성율은 77.8%였으며 음성율은 22.2%였다. 3) $^{99m}Tc-DISIDA$ hepatobiliary scintigram양성율을 나타낸 환자 70명중 11명은 mild pattern, 59명은 moderate-severe pattern을 나타냈으며 그중 21명은 여러가지 간세포 기능 및 담관에 영향을 미치는 질환과 합병했지만 특이한 Cs-bile flow pattern을 dominent하게 나타내었으며 합병된 여러 질환들도 bile flow pattern상 인지 할 수 있었다. 4) $^{99m}Tc-DISIDA$ hepatobiliary scintigram 음성율을 나타낸 환자 20명중 8명은 만성간염, 5명은 간경변증, 3명은 재발성 농양성담관염(recurrent pyogenic cholangitis)과 간내담도의 stricture 및 담관담석증이 합병되었으며 scintigram상 합병증의 pattern을 나타냈고 4명에서는 low CBD obstruction을 나타내었으며 후에 CBD stone, CBD carcinoma, gall bladder Ca.의 porta hepatis 전이 및 clonorchis worms의 cluster에 의한 obstruction이 operation 및 ERCP로서 진단 되었다. 5) $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy pattern은 현재의 자각증상과 관계된 dominent disease를 나타내었으며, 공간 점유병소도 multiple project images를 시행하므로서 쉽게 발견할 수 있었다. 이와 같이 간흡충증에 있어서 $^{99m}Tc-DISIDA$ hepatobiliary scintigram은 환자의 자각증상과 관계된 질환을 규명하는 데 필요한 정보를 얻었을 수 있었으며 간내담관의 damage정도를 규명하는데 필요한 procedure임이 판명되었다.

• Journal of the Korean Society of Radiology
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• v.17 no.7
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• pp.1057-1065
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• 2023

Non-invasive liver fibrosis diagnosis is crucial for patients with chronic liver diseases. Many patients cannot undergo liver tissue biopsy, so predicting the degree of liver fibrosis early through meaningful methods can reduce complications related to chronic liver diseases, such as liver cell carcinoma and cirrhosis. This study compared and analyzed the quantitative measurement of liver fibrosis using shear wave elastography in conjunction with liver ultrasound findings and their associations with serum biomarkers (p<0.05). The results showed that the shear wave elastography measurement in the normal group was 4.55 ± 0.69 kPa, while the abnormal contrast group with echogenic patterns had a measurement of 8.27 ± 1.83 kPa. The hepatitis B carrier group exhibited higher shear wave elastography measurements, and among serum biomarkers, AST, ALT, GGT, and PT showed statistically significant positive correlations with fibrosis severity according to SWE categories (p<0.05), while ALP and TB did not demonstrate statistically significant differences (p=0.163, p=0.567). Conversely, Albumin and PLT showed significant negative correlations (p<0.05). Clinically, utilizing shear wave elastography measurements through liver ultrasound in the tracking and repeat testing of liver fibrosis in chronic hepatitis B patients without cirrhosis can assist in achieving more objective diagnoses among healthcare providers.

• Korean Journal of Rural Living Science
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• v.7 no.2
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• pp.189-194
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• 1996

포괄적 의료서비스를 제공하는 가정의에게 농촌지역의 질병 양상 및 실태에 대한 파악은 중요하고 지역사회를 이해하는데 도움이 될 것이다. 하지만 노령화된 농촌지역의 만성질환의 유병율 및 실태에 대한최근의 연구는 많지 않을 것 같다. 본 연구를 위 한 진료활동은 농촌지 역의 2개면에서 가정의학과, 내과, 정형외과, 흉부외과 전문의에 의해 행해졌고 흉부 방사선 촬영 및 CBC, LFT, 요 검사, B형간염항원, 항체 등의 임상병리 검사를 병행하였다. 본 연구의 조사대상은 479명으로 성별로는 남자가 194명 (40.5%), 여자가 285명 (59.5%)였고 연령별로는 60세가 남녀에서 가장 높았다. 조사 대상자의 만성질환 유병율은 66.2%였고 남녀에서 비슷한 수준이였고 질병의 빈도는 근 골격계 질환이 40.9%로 가장 높았고 순환기 질환, 소화기 질환, 호흡기 질환, 내분비 질환의 순서로 많았다. 농촌사회는 과거에 비해 더욱 고령화되고 만성질환의 유병율은 더욱 증가하고 있다. 농촌에 대한 보건복지정책의 수립과 더불어 지속적, 총체적, 포괄적인 의료서비스를 지향하는 가정의는 더욱 많은 관심과 연구를 지속적으로 하여야 할 것이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.2
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• pp.207-212
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• 2001

Purpose: Mycoplasma pneumoniae infection is relatively common in childhood. Its extrapulmonary manifestations have been reported so much, but hepatitis associated with it has not been studied yet until now in Korea. Methods: We performed the prospective study of 19 cases that had AST and ALT>50 IU/L respectively without evidence of hepatitis A, B, C, cytomegalovirus, and Ebstein-Barr virus infections amongst 143 patients with M. pneumoniae pneumonia who were admitted to the Department of Pediatrics, Seoul Red Cross Hospital from Jan. 1999 to Dec. 2000. Results: 1) Hepatitis occurred in 13.3% of Mycoplasma pneumoniae infection, especially in fall and winter times. The average age was 4.86 years and male to female ratio was 2.2:1. 2) Vomiting was developed in 21.1%, diarrhea in 36.8%, and hepatomegaly in 21.1%, respectively. And leukocytosis was noted in 21.1%, eosinophilia in 15.4%, anemia in 10.5%, and thrombocytosis in 5.3%, respectively. The average level of C-reactive protein was $6.34{\pm}4.82$ mg/dl. 3) There was no hyperbilirubinemia, but hypoalbuminemia was detected in 42.1%. The average serum levels of AST and ALT were $214.05{\pm}183.22$ IU/L and $284.16{\pm}286.84$ IU/L, respectively. 4) Chest radiology showed lobar or lobular consolidation in 73.7%, bronchial infiltration in 26.3%, and pleural effusion in 31.6%. 5) The average length of hospitalization was 7.9 days, and the average length of normalization of serum transaminases was 8.8 days. All patients recovered within 2 weeks completely. Conclusion: The prognosis of M. pneumoniae hepatitis is good. However, its incidence is not so low that liver function should be considerately checked in case of M. pneumoniae infection.

• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.239-244
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• 1998

Purpose : The incidence of hepatitis A virus infection in Korea has decreased recently. However, the prevalence in children and young adults is on an increasing trend in Inchon-Kyunggi prefecture. Economic development that leads to better living conditions and improves hygiene facilities has reduced the rate of HAV infection. This study was designed to evaluate the recent seroprevalence rate of hepatitis A in children and adolescents. Methods : Study population consisted of 612 children and adolescents aged 1 to 17 years in Inchon-Kyunggi prefecture. Serum samples were collected between 1996 and 1997 and tested for anti HAV by Microparticle Enzyme Immunoassay(MEIA). Results : According to age, the seropositive rates were 10.5%(male 13%, female 6.7%) in 1 year-old group, 0% in 3, 5, 11 and 13 year-old group, 6%(male 8%, female 4%) in 15 year-old group, and 11%(male 14%, female 8%) in 17 year-old group. Conclusion : This study showed that seropositive rate of HAV infection increased with age. While it revealed extremely low incidence of HAV infection in children less than 13 years old, they are also likely 10 be exposed 10 the infection. Our findings suggest that the effective administration of vaccination is needed in selected and high risk groups.