• Journal of Chest Surgery
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• v.43 no.5
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• pp.525-528
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• 2010

Congenital interruption of the inferior vena cava (IVC) can lead to secondary hepatic congestion, portal hypertension, and liver cirrhosis. A 49-year-old woman was admitted to the gynecology department with symptoms of menorrhalgia, known uterine myoma, and anemia. Abdominal computed tomography (CT) and venography performed at our hospital revealed congenital interruption of the IVC. The patient underwent retrohepatic cavoatrial bypass surgery with a polytetrafluoroethylene (PTFE) 16-mm ringed graft via posterolateral thoracotomy, and recovered without major complications. A retroperitoneal approach via posterolateral thoracotomy provides appropriate visualization during dorsal cavoatrial bypass in treating patients with congenital interruption of IVC.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.812-819
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• 2008

Purpose : Vitamin D plays a key role in bone mineralization of the skeleton and vitamin D deficiency can lead to rickets. It is well known that vitamin D deficiency is common in breast fed infants. Of these patients, clinically, some have no signs of rickets, but laboratory and radiographic findings are diagnostic for vitamin D deficiency rickets (subclinical vitamin D deficiency rickets). The purpose of this study is to clarify current causes and ways to prevent this disease. Methods : We reviewed the clinical and laboratory characteristics of children who were incidentally diagnosed as subclinical rickets during treatment of other disease such as pneumonia, gastroenteritis, urinary tract infection at Eulji Hospital, Seoul, Korea from March, 2003 to July 2007. Results : Eight patients (six boys and two girls) were diagnosed with subclinical vitamin D deficiency rickets. The mean age of the patients was $12.6{\pm}5.8months$, and they were diagnosed from January to July. The associated diseases were pneumonia, urinary tract infection, acute gastroenteritis, and iron deficiency anemia. All patients were breast-fed. Two showed growth failure. The mean serum alkaline phosphatase was $1995.8{\pm}739.5IU/L$, the mean calcium count was $9.5{\pm}0.6mg/dL$, and the mean phosphorus content was $3.6{\pm}1.5mg/dL$. The mean intact parathyroid hormone was $214.8{\pm}155.9pg/mL$ (reference range, 9-65), the mean 1,25-dihydroxyvitamin D was $82.4{\pm}49.3pg/mL$ (reference range, 2070), and the mean 25-hydroxyvitamin D was $29.6{\pm}10.6ng/mL$ (reference range, 1030). A radiographic examination showed cupping, fraying, and flaring of metaphyses in all patients. Six patients were administered calcitriol (400 IU/day) for three months. A consequent radiographic and laboratory examination showed improvement. The first two patients were initially diagnosed with metaphyseal dysplasia, without the detection of vitamin D deficiency and they spontaneously improved without vitamin D supplements. However, two years later, they showed mild scoliosis and metaphyseal dysplasia, respectively. Conclusion : Breast-feeding without supplementation involves high risk of vitamin D deficiency. Some infants may also develop rickets; therefore, such groups should be considered for vitamin D supplementation.

• Journal of the Korean Society of Food Science and Nutrition
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• v.37 no.12
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• pp.1599-1608
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• 2008

This study aimed to assess the health status based on the anthropometric and biochemical measurements of middle-aged and elderly people living in Andong area. The subjects were 1,384 people (532 males, 852 females) aged 50 years and over (average 62.7 years). The mean anthropometric values for males and females were heights of 163.7 and 151.5 cm; weights 63.6 and 57.3 kg; body mass index (BMI) 23.6 and $24.9kg/m^2$; body fat 21.8 and 31.8%, respectively. Height and weight were lower, however, waist circumference (in female) and BMI were higher than those of the 2001 National Health and Nutrition Survey (NHNS). Obesity incidences of male and female subjects were 28.7% and 47.3% by BMI; 25.8% and 50.8% by % body fat; and 15.6% and 80.9% by waist circumference, respectively. Also, abdominal adiposity was very severe in female subjects of 50s. The mean biochemical measurements of male and female were as follows: systolic and diastolic blood pressure 136.9, 83.8 mmHg and 133.6, 82.5 mmHg; hemoglobin (Hb) 14.3 and 13.0 g/dL; hematocrit (Ht) 44.7 and 39.8%; blood albumin 4.15 and 4.04 g/dL; total-cholesterol 170.0 and 183.1 mg/dL; HDL-cholesterol 43.6 and 42.7 mg/dL; fasting blood glucose 96.7 and 93.0 mg/dL, respectively. Also, the prevalence of biochemically abnormal subjects according to each cut-off point of biochemical measurements were analyzed. The results for male and female were; hypertension 58.0% and 47.2%; iron deficient anemia 19.3% and 20.6% by Hb, 7.2% and 11.9% by Ht; hypoalbuminemia 9.8% and 11.7%; diabetes 12.0% and 10.2%; hypercholesterolemia 19.5% and 30.5%, respectively. From those results we found that hypoalbuminemia, hypertension and hypercholesterolemia were prevalent, and obesity in females of 50s, iron-deficient anemia and diabetes in males of 70 years and over were significant health problems in this area. Therefore, it seems to be necessary to examine their health status periodically and provide the appropriate health and nutrition education program, which includes low sodium intake, balanced diet, exercise and weight control, to prevent the occurrence of chronic diseases.

• Korean Journal of Food Science and Technology
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• v.39 no.1
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• pp.14-19
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• 2007

The nutritional compositions of different parts (roots, leaves, and seeds) of two lotus species (Nelumbo nucifera Gaertner), Muan's white-flowered and Naju's pink-flowered, are as follows; crude protein content in the seed was four times higher and the carbohydrate content was three times higher than those in the root and leaf. Comparing between the species, the crude protein content of the white lotus was the higher than that of the pink lotus, but the carbohydrate content was comparatively lower. The potassium content of the minerals in all samples was much higher than those in others. Additionally, the iron content of the root was much higher than those in the leaf and seed. In both species, the major free sugar in the root was sucrose; the main sugars in the leaf were fructose and alucose, and those in the seed were stachyose, raffinose, and sucrose. Among amino acids, glutamic acid showed the highest level in the leaf and seed, while aspartic acid was the highest in the root.

• Journal of Yeungnam Medical Science
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• v.14 no.2
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• pp.399-414
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• 1997

There are several factors concerning to anemia in chronic renal failure patients. But when rHuEPO is used, most of these factors can be overcome, and the levels of hemoglobin are increased. However, about 10% of the renal failure patients represent rHuEPO-resistant anemia eventhough high dosage of rHuEPO. For these cases, desferrioxamine can be applied to correct rHuEPO resistnacy, and many mechanism of DFO are arguing. So we are going to know whether DFO can be applied to correct anemia of the such patients, how long its effect can be continued. The seven pateients as experimental group(DFO+EPO) who represent refractoriness to rHuEPO and the other seven patients as control group(EPO) were included. Experimental group had lower than 9 g/dL of hemoglobin levels despite high rHuEPO dosage (more than 4000U/Wk) and showed normocytic normochromic anemia. There were no definitve causes of anemia such as hemorrhage or iron deficiency. Control group patients had similar characteristics in age, mean dialysis duration but showed adequate response to rHuEPO. DFO was administered to experimental group for 8 weeks along with rHuEPO(the rHuEPO individual mean dosage had been determined by mean dosage of the previous 6 months. Total mean dosage; 123.5 U/Kg/Wk). After 8 weeks of DFO administration, the hemoglobin and rHuEPO dosage levels were checked for 15 consecutive months. It should be noted that the patients determined their own rHuEPO dosage levels according to hemoglobin levels and economic status. In conrol group, rHuEPO was administered by the same method used in experimental group without DFO through the same period. Fifteen months of observation period after DFO trial were divided as Time I(7 months after DFO trial) and Time II(8 months after Time I). The results are as follows: Before DFO trial, mean hemoglobin level of experimental group was 7.8 g/dL, which is similar level(p>0.05) to control group(mean Hb; 8.2 g/dL). But in experimental group, significantly(p<0.05) higher dosages of rHuEPO(mean; 123.5 U/Kg/Wk) than control group (mean; 41.6 U/Kg/Wk) had been used. It means resistancy to rHuEPO of experimental group. But after DFO trial, the hemoglobin levels of the experimental group were increased significantly(p<0.05), and these effect were continued to Time II.(Time I; mean 8.6g/dL, Time II; mean 8.6g/dL) The effects of DFO to hemoglobin were continued for 15 months after DFO trial with similar degree through Time I, Time II. Also, rHuEPO dosages used in the experimental group were decreased to similar levels of the control group after DFO trial and these effect were also continued for 15 months(Time I; mean 48.1 U/Kg/Wk. Time II; mean 51.8 U/Kg/Wk). In the same period, hemoglobin levels and rHuEPO dosages used in the control group were not changed significantly. Notibly, hemoglobin increment and rHuEPO usage decrement in experimental group were showed maxilly in the 1st month after DFO trial. That is, after the use of DFO, erythopoiesis was enhanced with a reduced rHuEPO dosage. So we think rHuEPO reisistancy can be overcome by DFO therapy. In conclusion, the DFO can improve the anemia caused by chronic renal failure at least over 1 year, and hence, can reduce the dosage of rHuEPO for anemia correction. Additional studies in order to determine the mechanism of DFO on erythropoiesis and careful attention to potential side effects of DFO will be needed.

• The Korean Journal of Nuclear Medicine
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• v.10 no.1
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• pp.21-34
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• 1976

The diagnosis of iron deficiency rests upon the correct evaluation of body iron stores. Morphological interpretation of blood film and the red cell indices are not reliable and often absent in mild iron deficiency. Serum iron levels and iron-binding capacity are more sensitive indices of iron deficiency, but they are often normal in iron depletion and mild iron deficiency anemia. They are also subject to many variables which may introduce substantial errors and influenced by many pathologic and physiologic states. Examination of the bone marrow aspirate for stainable iron has been regarded as one of the most sensitive and reliable diagnostic method for detecting iron deficiency, but this also has limitations. Thus, there is still need for a more practical, but sensitive and reliable substitute as a screening test of iron deficiency. Pollack et al. (1965) observed that the intestinal absorption of cobalt was raised in iron-deficient rats and Valberg et al. (1969) found that cobalt absorption was elevated in patients with iron deficiency. A direct correlation was demonstrated between the amounts of radioiron and radiocobalt absorbed. Unlike iron, excess cobalt was excreted by the kidney, the percentage of radioactivity in the urine being directly related to the percentage absorbed from the gastrointestinal tract. Recently a test based on the urinary excretion of an oral dose of $^{57}Co$ has been proposed as a method for detecting iron deficiency. To assess the diagnostic value of urinary cobalt excretion test cobaltous chloride labelled with $1{\mu}Ci\;of\;^{58}Co$ was given by mouth and the percentage of the test dose excreted in the urine was measured by a gamma counter. The mean 24 hour urinary cobalt excretion in control subjects with normal iron stores was 6.1% ($1.9{\sim}15.2%$). Cobalt excretion was markedly increased in patients with iron deficiency and excreted more than 29% of the dose. In contrast, patients with anemia due to causes other than iron deficiency excreted less than 27%. Hence, 24 hour urinary cobalt excretion of 27% or less in a patient with anemia suggets that the primary cause of the anemia is not iron deficiency. A value greater than 27% in an anemic subject suggests that the anemia is caused by iron deficiency. The cobalt excretion test is a simple, sensitive and accurate method for the assessment of body iron stores. It may be particularly valuable in the epidemiological studies of iron deficiency and repeated evaluations of the body iron stores.

• Journal of Nutrition and Health
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• v.3 no.3
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• pp.149-159
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• 1970

This study is to investigate the status of anemia, especially iron deficiency anemia among pre-school children in rural area in Korea. The survey was conducted in Sang-dae Ri, Yusong Myon, Daedok Gun, Chung Chong Nam-Do from July 30 th to August 12th, 1968. The measurements were done of height, weight, hematologist and biochemical levels on ninety-two pre-school children, 47 male, and 45 female, one to six years of age. Hemoglobin was determined by the method of cyanmethemoglobin and hematocrit by micro hematocrit centrifuge. The determination of serum iron, iron-binding capacity was done by the method of Ramsay using bathophenanthroline and the serum albumin was determined by Biuret Reaction. The results of this study are as follows: 1) 54.4 percent of the pre-school children weighed less than 90 percent of the Korean General Standard Weight level. 2) The average hemoglobin level was $11.0{\pm}1.57gm/100ml$, 38.0 percent of the children were anemic with less than 1.0gm/100ml. Of the anemic children 60 percent were below the Korean General Standard Weight level. 3) 27.5 percent of the pre-school children were found to have below 32 percent of a hematocrit values and 28.0 percent showed less than 33 percent in M.C.H.C. These results showed that the incidence of hypochromic anemia in these pre-school children was high. 4) 37.9 percent of these children had a serum iron level less than $50{\mu}g/100ml\;and\;31.0\;percent\;had\;a\;TIBC\;above\;400{\mu}g$ while 48.3 percent showed a transferrin saturation lower than 15 percent. On the basis of these findings, it is concluded than the cause of this anemia was iron deficiency. 5) In this group there was a little evidence of low total serum protein levels. However, 10.4 percent of the children had a deficient serum albumin level, below 2.80 gm/100ml while 51.7 percent had a low level, less than 3.50gm/100ml, and 34.5 percent of the children had a low level of TIBC, less than $350{\mu}g/100ml$, and considering these facts, it is suggested that some of the anemias have a multiple causes through protein deficiency and repeated chronic infection apart from iron deficiency.

• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.11-16
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• 2003

Purpose : Iron deficiency is still the most common nutrient deficient disorder despite the improvement in general health and nutrition. This study is designed to evaluate the dietary history of infants and young children with iron deficiency anemia(IDA) and the effects of nutritional counseling. Methods : This study was conducted on 120 children from 6 to 36 months of age with IDA. Their parents completed a questionnaire and took counsel for nutrition. IDA was defined as Hb <11.0 g/dL, ferritin <10 ng.mL or transferrin saturation <15%, or Hb increase >1 g/dL after iron preparation. The questionnaire consisted of their feeding patterns, weaning time and kinds of food. Results : In the 120 infants and young children aged from 6 to 36 months, the parents of 82 cases was counseled about nutrition. Fifty six infants among 82 cases have started weaning and the main foods of weaning were rice and/or rice gruel. Nutritional problems in weaning were that some children over one year of age were using a bottle, and parents restricted weaning food at will because of allergic disease or chronic disease. Most parents were satisfied with the nutritional counseling given from a clinical dietitian and showed good compliance. Conclusion : Many infants and young children with IDA were provided with non iron-fortified foods and made an inadequate wean. Most parents were satisfied with the nutritional counseling and showed good compliance. The need of dietary counseling was required for prevention and treatment of iron deficiency anemia because of inadequate weaning.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.6
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• pp.1579-1584
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• 2008

Anemia are often detected among many patients who are treated in oriental traditional medicine hospitals in Korea through blood tests which are taken to diagnose the patients' general state, and most of them are diagnosed to have iron deficiency anemia. This study amis the effect of herbal medicine on the RBC count, hemoglobin, hematocrits and indices of red blood cells such as mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC), serum iron, and total iron binding capacity(TIBC) among patients who were treated in oriental medical hospital and diagnosed to have anemia through blood tests other than main symptoms. The subjects of this study were 29 patients(male 7, female 22, mean age: 56.24${\pm}$19.11years) who were chosen ones, they has below hemoglobin 12 gm/dL, serum iron 70 IU/L, MCV 80 fL on laboratory screening test when they first visits our hospital. As a result, the volume of red blood cell(RBC), hematocrit(HCT), and hemoglobin(Hb) in peripheral blood increased from $348.27{\pm}8.95{\times}10^5$ /UL, 28.82${\pm}$0.56%, 9.24${\pm}$0.22 g/dL to $375.62{\pm}9.11{\times}10^5$ /UL, 31.36${\pm}$0.68%, 10.31${\pm}$0.25 g/dL comparing before and after oriental medicine treatment. After the treatment, MCH, MCHC, and MCV also increased from 26.98${\pm}$0.84 Pg, 32.62${\pm}$0.45 g/dl, 79.26${\pm}$0.17 fL to 27.74${\pm}$0.74 Pg, 32.84${\pm}$0.33 g/dl, 84.15${\pm}$1.67 fL. There was statistically significant increase in MCH, MCV(P<0.05); however, there was no significant change in MCHC(P>0.05). The amount of iron in blood increased from 32.96${\pm}$4.20 ug/dL to 67.22${\pm}$7.18 ug/dL, which showed a statistically significant increase(P<0.05). On the other hand, TIBC decreased from 325.08${\pm}$13.97 ug/dL to 315.61${\pm}$18.79 ug/dL, which was not a statistically significant change(P>0.05). Like this, all the patients showed favorable results in anemia based on the measurements of indices of red blood cells except MCHC. According to the classification of herbal medicines, in strengthening energy group(補氣), replenishing blood group(補血), and replenishing both energy and blood group(補氣血), the volume of RBC, HCT, and hemoglobin showed significant increases. Furthermore, in herbal medicines strengthening blood(補血) and replenishing both energy and blood group(補氣血), serum iron also relatively increased compare to strengthening energy group(補氣).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.1
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• pp.42-55
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• 2008

Purpose: A new health policy, referred to as the National Health Screening Program for Infants and Children, was launched in November 2007 by the Ministry of Health and Welfare and National Health Insurance Corporation in Korea. We have developed a nutrition-counseling program that was incorporated into this project. Methods: We reviewed the nutritional guidelines published by The Korean Pediatric Society and internationally well-known screening programs such as Bright Future in the United States. We also reviewed the recent Korean national surveys on nutritional issues, including the Korea National Health and Nutrition Examination Survey (KNHANES) and the 2005 National Survey of Physical Body and Blood Pressure in Children and Adolescents. The development of questions, pamphlets, computer programs, and manuals for doctors was carried out after several meetings of researchers and governmental officers. Results: We summarized the key nutritional issues according to age, including breastfeeding in infants, healthier complementary feeding, and prevention of iron deficiency anemia, establishment of healthier diets, as well as dietary prevention of overweight children with an emphasis on physical exercise. We have constructed a new Korean nutrition questionnaire and an anticipatory guidance program based on the primary care schedule of visits at 4, 9, 18, 30, and 60 months of age. Five to eight questions were asked at each visit and age-matched pamphlets for parents and guidelines for doctors were provided. Conclusion: We developed a nutrition-counseling program based on recent scientific evidence for Korean infants and children. Further research on this national program for screening the nutritional problems in detail and setting the therapeutic approaches may help identify areas of success as well as those that need further attention.