• The Journal of Pediatrics of Korean Medicine
• /
• v.37 no.3
• /
• pp.1-16
• /
• 2023

Objectives We aimed to investigate the effectiveness of the Korean medical critical pathway (CP) in treating childhood anorexia. Methods In total, 21 patients who met the criteria and agreed to provide information were assigned to the CP group, while 24 patients who met the criteria, agreed to provide information, but disagreed with CP application were assigned to the non-CP group. Demographic, clinical, and economic indices were compared between the two groups. Clinical indices before and after treatment were also compared between the two groups. Results In the CP group, height, weight, body mass index (BMI), BMI percentile, and food approach (FAP) increased significantly after treatment, and numeric rating scale (NRS) and food avoidance (FAV) scores decreased significantly. In the non-CP group, height, weight, weight percentile, BMI, BMI percentile, and FAP increased significantly, whereas NRS and FAV decreased significantly after treatment. Compared to the non-CP group, CP application increased FAP and decreased FAV, medical expenses per consultation, and the total treatment period. Conclusions The application of the Korean medical critical pathway for childhood anorexia is an effective cure system that decreases overall medical expenses with good-quality treatment by means of the standardization of medical practices.

• Journal of Practical Agriculture & Fisheries Research
• /
• v.20 no.2
• /
• pp.117-123
• /
• 2018

The purpose of this report is to describe the diagnosed case of a large colonic impaction in an adult donkey. An adult female donkey (Equus africanus asinus; 6-years-old) was admitted to the Equine Hospital of Jeju Race Park with signs of anorexia, which had started 1 day previously. Clinical examination revealed: weak gut sounds, dehydration, and severe abdominal distension, but normal respiratory and heart rates and no signs of pain. Transrectal palpation identified an impaction in the colon. The patient was treated with nasogastric siphonage, fluid therapy, and nonsteroidal anti-inflammatory drugs. Over the course of a day, her condition worsened; she started trembling, could not stand, and 2 hours later she died. Upon necropsy, a vast amount of ingesta was found in the large colon, particularly in the left ventral colon. The cecum and small colon were normal. Eleven days prior to presentation, the stable management and diet of the donkey had changed. We suspect that the change of feed, reduced water consumption, and lack of exercise precipitated the illness. However, the exact cause of the sudden death of the donkey requires further investigation.

• Journal of Practical Agriculture & Fisheries Research
• /
• v.25 no.3
• /
• pp.30-34
• /
• 2023

White leg shrimps which were cultured in a private aquaculture farm showed abnormal swimming behavior and appetite reduction in July 2023. Then, gradual mortality was observed in the aquaculture farm. During the diagnosis, bacterial strain KNUAFVaSHP08147 was isolated from the hepatopancreas of the dead shrimps. Based on the sequence of 16S rRNA gene, KNUAFVa-SHP08147 was proved to be Vibrio alginolyticus, showing 99.71 % nucleotide identity with that of V. alginolyticus MG54 and GS MYPK1. According to the result of the growth of KNUAFVa-SHP08147, the treatment a commercial disinfectant, Virkon^TMS was not proved to be effective to prohibit the growth of Vibrio.

• Journal of Practical Agriculture & Fisheries Research
• /
• v.25 no.3
• /
• pp.14-18
• /
• 2023

White leg shrimps cultured in an inland private aquaculture farm with low salinity waters showed abnormal swimming behavior and appetite reduction in July 2022. Then, gradual mortality was observed in the aquaculture farm. During the diagnosis, bacterial strain KNUAF-SHP3 was isolated from the hepatopancreas of the dead shrimps. Based on the sequence of 16S rRNA gene, KNUAF-SHP3 was proved to be Shewanella sp., clustering into a group with S. algae MARS 14 and S. chilikensis JC5T. According to the result of experimental infection test, all shrimps challenged with high concentrations, 2.1×108 CFU/ml and 2.1×109 CFU/ml showed apparent disease symptoms and the cumulative mortality rates reached 100% in 7 days post challenge. These results emphasized that Shewanella isolate in this study can be a potential pathogen of white leg shrimp cultured in low salinity water.

• The Journal of Pediatrics of Korean Medicine
• /
• v.38 no.2
• /
• pp.1-10
• /
• 2024

Objectives This study aimed to assess the reliability and validity of the Five-Visceral Weak Children Questionnaire (FWCQ) in childhood anorexia and to propose optimal cutoff values. Methods We conducted two surveys, spaced one month apart, targeting the parents of 366 children aged 2-9 years who had been diagnosed with anorexia for at least one month. To evaluate the reliability of the FWCQ, we calculated Cronbach's alpha coefficient and employed the test-retest method. Additionally, correlation analysis was performed between the FWCQ and each visceral question, and discriminant validity was assessed by comparing responses from the anorexic and normal groups. Furthermore, we determined the cutoff value of the spleen weak score, which is closely associated with appetite, for the anorexic group. Results The first survey yielded responses from 336 participants, followed by 171 responses in the second survey conducted one month later. The FWCQ demonstrated high internal consistency (Cronbach's alpha = 0.776), and test-retest results were consistent. The correlation coefficients between the FWCQ and each visceral question were all statistically significant. Moreover, significant discriminant validity was observed between the anorexic and normal groups in the FWCQ score and the heart, spleen, and kidney weak scores. The optimal cutoff value for the spleen weak score in the anorexic group was found to be 5.5 points (with a sensitivity of 73.44% and specificity of 66.47%). Conclusions The FWCQ exhibited strong reliability and validity in children with anorexia.

• The Journal of Pediatrics of Korean Medicine
• /
• v.38 no.2
• /
• pp.21-31
• /
• 2024

Objectives This study aimed to develop consensus-based recommendations for establishing standard clinical practice guidelines for pediatric anorexia through the utilization of a Delphi study. Methods We analyzed existing randomized controlled trials for pediatric anorexia treatment using the Delphi method-a structured process for achieving consensus among a panel of experts. A questionnaire was distributed among a select panel of nine specialists in the field. Results The initial Delphi round led to consensus on 30 distinct recommendations; however, consensus was not reached for 19 other recommendations, prompting a second Delphi round. In the subsequent round, adjustments were made based on feedback from the initial round, and deliberations were held on recommendations that previously lacked consensus. Following these adjustments, consensus was achieved on all recommendations. Additionally, a third Delphi iteration was conducted to address three specific queries that required amendment due to a reevaluation of the evidence levels of certain recommendations. In total, three Delphi rounds were carried out to produce informed recommendations related to the diagnosis, treatment, and general management of anorexia. Conclusions This investigation successfully generated evidence-based recommendations for the diagnosis and treatment of pediatric anorexia. The recommendations encompassed various practices, including herbal medicine, acupuncture, moxibustion, cupping, and Chuna manual therapy, which can be integrated into clinical settings.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.6 no.1
• /
• pp.39-46
• /
• 2003

Purpose: In a retrospective study for the pediatric patients who underwent liver transplantation in the past 6 years at Samsung Medical Center, the clinical features of 5 patients with posttransplant lymphoproliferative disorder (PTLD) were analyzed. Methods: Between June 1996 and June 2002, 41 pediatric patients underwent liver transplantation. Seven of them died in the postoperative period. Thirty-five including one patient who died of PTLD were finally reviewed. Patients were divided into two groups: high risk group, EBV naive recipients of EBV-positive grafts; low risk group, the patients other than those in high risk group. The authors reviewed age at operation, immunosuppressive agent, postoperative duration until diagnosis, postoperative duration until EBV seroconversion, presence of treatment against rejection, and presenting symptoms of PTLD. Results: Five of 41 patients (12.2%) developed PTLD. All of them belonged to high risk group, and the incidence of PTLD in high risk group was 31.3% (5/16). The mean age at operation was 10.8 months old and the mean duration between operation and diagnosis for PTLD was 9.8 months. Primary EBV infection developed after a median of 6 months after transplantation. One patient was diagnosed as laryngeal and gastrointestinal PTLD and the other four, gastrointestinal PTLD. The following symptoms and signs were seen in the patients: anemia (100%), hypoalbuminemia (100%), fever (80%), diarrhea (80%), gastrointestinal bleeding (80%), and anorexia (60%). Conclusion: PTLD is one of the major complications after pediatric liver transplantation, especially in the group of high-risk recipients. Anemia, hypoalbuminemia, fever, diarrhea and gastrointestinal bleeding were features that are characteristic of PTLD. The common features of PTLD development were: (i) EBV-positive donors placed into EBV naive recipients, (ii) primary EBV infection about 6 months after transplantation, (iii) young age, about 1 year old at operation, and (iv) the requirement for intensive posttransplant immunosuppression.

• Pediatric Infection and Vaccine
• /
• v.7 no.1
• /
• pp.120-128
• /
• 2000

Purpose : Active immunization against hepatitis A with an inactivated vaccine reveals excellent immunogenicity, tolerability and protective efficacy. Inactivated hepatitis A vaccines have been selectively used since 1996 in Korea to prevent hepatitis A. This study was performed to assess the immunogenicity and reactogenicity after two doses of HM175 strain hepatitis A vaccine in healthy Korean children. Methods : 128 healthy children(M/F; 65/63) aged 1 to 15 years, who were seronegative for hepaitatis A, participated in this study. A alum-adsorbed vaccine containing 720 EL.U of antigen form HM175 hepatitis A strain per 0.5 mL dose was injected intramuscularly on the deltoid area. The second dose was given 6 months later, Anti-HAV antibodies were measured by ELISA before and 1 month after each vaccination to assess the immunogenicity. Any local and general adverse events were reported by patients parents with the prepared questionnaire after each vaccination. Results : 120 volunteers(M/F; 60/60) completed the whole series of the study. Seroconversion occurred in all cases after primary and booster vaccination. The mean anti-HAV antibody titer after primary vaccination was 389.2mIU/mL, and 3,609mIU/mL after booster vaccination. And levels of anti-HAV antibodies after booster immunization were significantly higher in female children. The most common local adverse event was soreness on the injection site, but it was mild and resolves within 3 days. Fever was not reported after booster vaccination. Conclusion : Based on these data, we conclude that the inactivated HM175 strain hepatitis A vaccine is highly immunogenic and tolerable in healthy Korean children.

• Pediatric Infection and Vaccine
• /
• v.17 no.2
• /
• pp.122-129
• /
• 2010

Purpose : Enteroviral infection is a common viral illness in children. We undertook this study in attempt to comprehend the epidemiologic and clinical features of enteroviral infections, particularly EV71 in children. Methods : We enrolled 63 children with enteroviral infection at Severance Children's Hospital in Seoul between May and August 2009. Reverse transcriptase-polymerase chain reaction (RT-PCR) was performed from stool or cerebrospinal fluid samples, which were then tested for enteroviral infection. Viral isolation and serotype identification also were performed by RT-PCR. Results : A total of 63 patients with clinical diagnosis of enteroviral infections were enrolled; of those, 38 (60%) were positive for enterovirus. The mean age of the patients was 2 years and 7 months and the sex ratio of male to female was 0.9 :1. Their clincal manifestations included aseptic meningitis (21 cases, 55%), HFMD (16 cases, 42%), herpangina (5 cases, 13%), neonatal fever (2 cases, 5%), encephalitis (1 case, 3%), and myocarditis (1 case, 3%). Serotypes of isolated enteroviruses were EV71 (8 cases, 21%), coxsackievirus B1 (8 cases, 21%), coxsackievirus A16 (2 cases, 6%), coxsakievirus A2 (1 case, 3%), coxsakievirus A5 (1 case, 3%), and echovirus 9 (1 case, 3%). Clinical symptoms of EV71 infection included HFMD (5 cases, 63%), aseptic meningitis (3 cases, 38%), encephalitis (1 case, 13%), and myocarditis (1 case, 13%). A positive rate of C-reactive protein in EV71 was higher than those in other enterviral infections. However, there was no statistically significant difference in other laboratory findings. Conclusion : We reported on identified enteroviruses, including EV71, during a period of 3 months in the summer of 2009. In this study, EV71 infection frequently occurred in male and clinical manifestation caused by EV71 was a more severe disease than that due to other enterviral infections. There is a need for continuous surveillance of enteroviral infection and its clinical manifestations for diagnosis and treatment of enteroviral infection.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.17 no.2
• /
• pp.69-76
• /
• 2017

Citrin deficiency is an autosomal recessive disorder caused by mutations in the SLC25A13 gene on chromosome 7q21.3, and a type of urea cycle disorder that causes hyperammonemia. Although neonatal intrahepatic cholestasis and adult-onset type II citrullinemia, a type of citrin deficiency, have been described well in many articles for several decades, failure to thrive and dyslipidemia caused by citrin deficiency (FTTDCD), the other type of citrin deficiency, has been only identified recently. There was previously no case report about FTTDCD in Korea. Patients with FTTDCD could present with loss of appetite, fatigue, failure to thrive, hypoglycemia, hypercitrullinemia, dyslipidemia, and an increased lactate/pyruvate ratio. Routine evaluation may not reveal the cause of hypoglycemia caused by citrin deficiency. We recently had a case that presented with recurrent hypoglycemia in a 30-month-old boy. Chemistry profiling, urine organic acid analysis, plasma acylcarnitine analysis, and hormone studies indicated values within the normal range or non-specific findings. Mutation analysis to identify the cause of hypoglycemia identified the subject as a compound heterozygote carrying each of the c.852_855del ($p.Met285Profs^*2$), and c.1177+1G>A mutant alleles. We report here on this unusual case of citrin deficiency presenting with FTTDCD for the first time in Korea.