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Korean Children and Adolescents with Crohn's Disease Are More Likely to Present with Perianal Fistulizing Disease at Diagnosis Compared to Their European Counterparts

  • Kang, Ben;Kim, Jung Eun;Jung, Jae Hun;Choe, Jae Young;Kim, Mi Jin;Choe, Yon Ho;Kim, Seung;Koh, Hong;Lee, Yoo Min;Lee, Jee Hyun;Lee, Yoon;Lee, Ji-Hyuk;Lee, Hae Jeong;Jang, Hyo-Jeong;Choi, Youjin;Choi, So Yoon;Kim, Ju Young;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.1
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    • pp.49-62
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    • 2020
  • Purpose: We aimed to investigate the disease phenotype of Korean pediatric Crohn's disease (CD) patients at diagnosis according to the Paris classification by comparison with patients from the European multicenter 5-years recruitment of children with newly developed IBD (EUROKIDS registry). Methods: Korean children and adolescents who had been newly diagnosed with CD at the age of <18 years during 2013-2016 were included in this multicenter retrospective study. Disease phenotype at diagnosis was classified according to the Paris classification, and compared with the published data from the EUROKIDS study. Results: A total of 255 patients were included. The median diagnosis age was 14.7 years (range, 0.8-17.9 years). No significant difference was observed in male-to-female ratio with EUROKIDS (1.9:1 vs. 1.45:1, p=0.062). The proportion of children aged <10 years was significantly lower in Koreans (7.1% vs. 19.6%, p<0.001). Colonic disease was less prominent (10.0% vs. 27.3%, p<0.001), while upper GI involvement was more prominent in Korean children (59.3% vs. 46.2%, p<0.001). The proportion with perianal fistulizing disease at diagnosis was significantly higher in Korean patients (44.8% vs. 8.2%, p<0.001). A separate analysis of Korean patients revealed that perianal fistulizing disease at diagnosis was positively associated with male sex and body mass index z-score (odds ratio [OR]=2.12, 95% confidence interval [CI]=1.20-3.76, p=0.010; and OR=1.29, 95% CI=1.05-1.58, p=0.015, respectively). Conclusion: Approximately half of pediatric CD patients in Korea present with perianal fistulas and/or abscesses at diagnosis, which is a distinct feature of CD in Korean children and adolescents compared to their European counterparts. An underlying genetic difference between ethnicities may play a role in this expression of different phenotypes in pediatric CD.

Minimal Invasive Surgery: A National Survey of Its Members by the Korean Association of Pediatric Surgeons (최소 침습 수술: 대한소아외과학회 회원을 대상으로 한 전국조사)

  • Kim, Dae Yeon;Kim, I.S.;Kim, H.Y.;Nam, S.H.;Park, K.W.;Park, W.H.;Park, Y.J.;Park, J.H.;Park, J.Y.;Park, J.S.;Park, J.Y.;Boo, Y.J.;Seo, J.M.;Seol, J.Y.;Oh, J.T.;Lee, N.H.;Lee, M.D.;Jang, J.H.;Jung, K.H.;Jung, S.Y.;Jung, S.E.;Jung, S.M.;Jung, E.Y.;Jung, J.H.;Cho, M.J.;Choi, K.J.;Choi, S.J.N.;Choi, S.O.;Choi, S.H.;Choi, Y.M.;Hong, J.
    • Advances in pediatric surgery
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    • v.20 no.1
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    • pp.1-6
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    • 2014
  • Minimal invasive surgery (MIS) has rapidly gained acceptance for the management of a wide variety of pediatric diseases. A questionnaire was sent to all members of the Korean Association of Pediatric Surgeons. Thirty one members (25.4%) took part in the survey that included data for the year 2012: demographic details, opinion regarding minimal invasive surgery and robotic surgery, spectrum of minimally invasive operations, and quantity of procedures. 48.4% of the respondents had more than 10 years experience, 35.5% less than 10 years experience, and 16.1 % had no experience. The respondents of the recommend MIS and perform MIS for surgical procedures are as follow; inguinal hernia (61.3%), simple appendicitis (87.1%), complicated appendicitis (80.6%), reduction of intussusceptions (83.9%), pyloromyotomy (90.3%), fundoplication (96.8%), biopsy and corrective surgery of Hirschsprung's disease (93.5%/90.3%), imperforate anus (77.4%), congenital diaphragmatic hernia (80.6%), and esophageal atresia (74.2%). The MIS procedures with more than 70% were lung resection (100%), cholecystectomy (100%), appendectomy (96.2%), ovarian torsion (86.7%), fundoplication (86.8%), hiatal hernia repair (82.6%), and splenectomy (71.4%). The MIS procedures with less than 30% were congenial diaphragmatic hernia reapir (29.6%), esophageal atresia (26.2%), correction of malroatation (24.4%), inguinal hernia repair (11.4%), anorectal malformation (6.8%), Kasai operation (3.6%).

THE TASTE COMPOUNDS FERMENTED ACETES CHINENSIS (새우젓의 정미성분에 관한 연구)

  • CHUNG Seung-Yong;LEE Eung-Ho
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.9 no.2
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    • pp.79-110
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    • 1976
  • In Korea fermented fish and shellfish have traditionally been favored and consumed as seasonings or further processed for fish sauce. Three major items in production quantity among more than thirty kinds which are presently available in the market are fermented anchovy, oyster and small shrimp. They are usually used as a seasoning mixture of Kimchi in order to provide a distinctive flavor. Fermented small shrimp, Acetes chinensis is most widely and largely used ana occupies an important position in food industry of this country. But no study on its taste compounds has been reported. This study was attempted to establish the basic data for evaluating taste compounds of fermented small shrimp. The changes of such compounds during fermentation as free amino acids, nucleotides and their related compounds, TMAO, TMA, and betaine were analysed. In addition, change in microflora during the fermentation under the halophilic circumstance was also investigated. The samples were prepared with three different salt contents of 20, 30 and $40\%$ to obtain the proper degree of fermentation at a controlled tempeature of $20{\pm}2^{\circ}C$. The results are summarized as follows: Volatile basic nitrogen increased rapidly until 108 days of fermentation and afterwards it tended to increase slowly. Amino nitrogen also increased rapidly until 43 days of fermentation and then increased slowly. Extract nitrogen increased and marked the maximum value at 72 day fermentation and then decreased slowly. ADP, AMP and IMP tended to degrade rapidly while hypoxanthine increased remarkably at 27 day fermentation but slightly decreased at 72 day fermentation. It is presumed that the characteristic flavor of fermented small shrimp might be attributed to the relatively higher content of hypoxanthine. In the free amino acid composition of fresh small shrimp abundant amino acids were proline, arginine, alanine, glycine, lysine, glutamic acid, leucine, valine and threonine in order. Such amino acids like serine, methionine, isoleucine, phenylalanine, aspartic acid, tyrosine and histidine were poor. In small shrimp extract, proline, arginine, alanine, glycine, lysine and glutamic acid were dominant holding $18.5\%,\;14.6\%,\;10.8\%,\;8.7\%,\;8.1\%\;and\;7.7\%$ of total free amino acids respectively. The total free amino acid nitrogen in fresh small shrimp was $63.9\%$ of its extract nitrogen. The change of free amino acid composition in the extract of small shrimp during fermentation was not observed. Lysine, alanine glutamic acid, proline, glycine and leucine were abundant in both fresh sample and fermented products. The increase of total free amino acids during 72 day fermentation reached approximately more than 2 times as compared with that of fresh sample and then decreased slowly. Fermented small shrimp with $40\%$ of salt was too salty to be commercial quality as the results of organoleptic test showed. It is found that 72 day fermentation with $20\%\;and\;30\%$ of salt gave the most favorable flavor. It is convinced that the characteristic flavor of fermented small shrimp was also attributed to such amino acids as lysine, proline, alanine, glycine and serine known as sweet compounds, as glutamic acid with meaty taste, and as leucine known as bitter taste. The amount of betaine increased during fermentation and reached the maximum at 72 day fermentation and then decreased slowly TMA increased while TMAO decreased during fermentation. The amount of TMAO nitrogen in fermented small shrimp was $200mg\%$ on moisture and salt free base. Betaine and TMAO known as sweet compounds were abundant in fermented small shrimp. It is supposed that these compounds could also play a role as important taste compounds of fermented small shrimp. At the initial stage of fermentation, Achromobacter, Pseudomonas, Micrococcus denitrificans which belong to marine bacteria were isolated. After 40 day fermentation, they disappeared rapidly while Halabacterium, Pediococcus, Sarcian, Micrococcus morrhuae and the yeasts such as Saccharomyces sp. and Torulopsis sp. dominated. It is concluded that the most important taste compounds of fermented small shrimp were amino acids such as lysine, proline, alanine, glycine, serine, glutamic acid, and leucine, betaine, TMAO and hypoxanthine.

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Relationships among Violence Experience, Resilience and Job Stress of Nurses Working in Emergency Department (응급실 간호사의 폭력경험, 자아탄력성, 직무스트레스와의 관계연구)

  • Song, Young-Jin;Lee, Hye-Kyung
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.5
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    • pp.1390-1401
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    • 2020
  • This study is a descriptive research to identify the relationship among violence experience, resilience and job stress of nurses working in emergency department. The subjects of this study were 143 nurses with over one year working in emergency departments of 6 hospitals located in D city and C city and collected data through structured questionnaire. It was from November 6th to November 15th. The degree of violent experience of the subjects was 1.26 ± 1.31 out of 4. The average score of resillience was 2.50 ± 0.55 out of 4. The average score of job stress was 3.62 ± 0.49 out of 5. The result of correlation between violence experience, resilience and job stress, among the sub factors, in the correlation among violence experience and job stress sub factors, verbal violence experience was significantly positively correlated with nursing work(r=.194, p=.010), role conflict stress(r=.158, p=.030), and physical threat experience was positively correlated with nursing work(r=.200, p=.008), role conflict(r=.162, p=.027), and conflict with doctor(r=.145, p=.042). In the correlation between resilience and job stress sub factors, nursing work stress is hardness(r=-.189, p=.012), persistence(r=-.165, p=.025), and optimism (r=-.186, p=.013) and there was a negative correlation with the region. Expertise stress is hardness(r=-.230, p=.003), persistence(r=-.195, p=.010), optimistic(r=-.194, p=.010) and there was a negative correlation. Nurse-treated stress was positively correlated with spirituality(r=.154, p=.033). In the subcategory correlations of resilience and violent experience, the hardness had a negative correlation with the physical threat(r=-.150, p=.037) experience. The persistence was negatively correlated with the experience of physical threats(r=-.138, p=.050). The optimism was negatively correlated with the experience of physical violence(r=-.151, p=.036). As a result, it is necessary to create a safe working environment free from violence and to reinforce training on how to deal with violence in order to reduce the job stress of emergency department nurses. In addition, measures to cope with stress according to age and work experience and programs to increase resilience should be developed and mediated to reduce the job stress of emergency department nurses.

Fabrication of Backscatter Electron Cones for Radiation Therapy (산란전자선을 이용한 강내측방조사기구의 제작과 특성)

  • Chu, Sung-Sil;Suh, Chang-Ok;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.74-80
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    • 2001
  • Purpose : Irradiation cones by using backscatter electrons are made for the treatment of superficial small lesions of skin, oral cavity, and rectum where a significant dose gradient and maximum surface dose is desired. Methods and Materials : Backscatter electrons are produced from the primary electron beams from the linear accelerators. The design consists of a cylindrical cone that has a thick circular plate of high atomic number medium (Pb or Cu) attached to the distal end, and the plate can be adjusted the reflected angle. Primary electrons strike the metal plate perpendicularly and produce backscatter electrons that reflect through the lateral hole for treatment. Using film and a parallel plate ion chamber, backscatter electron dose characteristics are measured. Results : The depth dose characteristic of the backscatter electron is very similar to that of the hard x-ray beam that is commonly used for the intracavitary and superficial lesions. The basckscatter electron energy is nearly constant and effectively about 1.5 MeV from the clinical megavoltage beams. The backscatter electron dose rate of $35\~85\;cGy/min$ could be achieved from modern accelerators without any modification. and the depth in water of $50\%$ depth dose from backscatter electron located at 6mm for $45^{\circ}$ angled lead scatter. The beam flatness is dependent on the slit size and the depth of treatment, but is satisfactory to treat small lesions. Conclusions : The measured data for backscatter electron energy, depth dose flatness dose rate and absolute dose indicates that the backscatter electrons are suitable for clinical use.

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Prioritizing Noxious Liquid Substances (NLS) for Preparedness Against Potential Spill Incidents in Korean Coastal Waters (해상 유해액체물질(NLS) 유출사고대비 물질군 선정에 관한 연구)

  • Kim, Young-Ryun;Choi, Jeong-Yun;Son, Min-Ho;Oh, Sangwoo;Lee, Moonjin;Lee, Sangjin
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.22 no.7
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    • pp.846-853
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    • 2016
  • This study prioritizes Noxious Liquid Substances (NLS) transported by sea via a risk-based database containing 596 chemicals to prepare against NLS incidents. There were 158 chemicals transported in Korean waters during 2014 and 2015, which were prioritized, and then chemicals were grouped into four categories (with rankings of 0-3) based on measures for preparedness against incident. In order to establish an effective preparedness system against NLS spill incidents on a national scale, a compiling process for NLS chemicals ranked 2~3 should be carried out and managed together with an initiative for NLS chemicals ranked 0-1. Also, it is advisable to manage NLS chemicals ranked 0-1 after considering the characteristics of NLS specifically transported through a given port since the types and characteristics of NLS chemicals relevant differ depending on the port. In addition, three designated regions are suggested: 1) the southern sector of the East Sea (Ulsan and Busan); 2) the central sector of the South Sea (Gwangyang and Yeosu); and 3) the northern sector of the West Sea (Pyeongtaek, Daesan and Incheon). These regions should be considered special management sectors, with strengthened surveillance and the equipment, materials and chemicals used for pollution response management schemes prepared in advance at NLS spill incident response facilities. In the near future, the risk database should be supplemented with specific information on chronic toxicity and updated on a regular basis. Furthermore, scientific ecotoxicological data for marine organisms should be collated and expanded in a systematic way. A system allowing for the identification Hazardous and Noxious Substances (HNS) should also be established, noting the relevant volumes transported in Korean waters as soon as possible to allow for better management of HNS spill incidents at sea.

Development of KD- Propeller Series using a New Blade Section (새로운 날개단면을 이용한 KD-프로펠러 씨리즈 개발)

  • J.T. Lee;M.C. Kim;J.W. Ahn;H.C. Kim
    • Journal of the Society of Naval Architects of Korea
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    • v.28 no.2
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    • pp.52-68
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    • 1991
  • A new propeller series is developed using the newly developed blade section(KH18 section) which behaves better cavitation characteristics and higher lift-drag ratio at wide range of angle-of-attack. The pitch and camber distributions are disigned in order to have the same radial and chordwise loading distribution with the selected circumferentially averaged wake input. Since the geometries of the series propeller, such as chord length, thickness, skew and rate distribations, are selected by regression of the recent full scale propeller geometric data, the performance prediction of a propeller at preliminary design stage can be mure realistic. Number of blades of the series propellers is 4 and the expanded blade area ratios are 0.3, 0.45, 0.6 and 0.75. Mean pitch ratios are selected as 0.5, 0.65, 0.8, 0.75 and 1.1 for each expanded area ratio. The new propeller series is composed of 20 propellers and is named as KD(KRISO-DAEWOO) propeller series. Propeller open water tests are performed at the experimental towing tank, and the cavitation observation tests and fluctuating pressure measurements are carried out at the cavitation tunnel of KRISO. $B_{P}-\delta$ curves, which can be used to select the optimum propeller diameter at the preliminary design stage, are derived from a regression analysis of the propeller often water test results. The KD-cavitation chart is derived from the cavitation observation test results by choosing the local maximum lift coefficient and the local cavitation number as parameters. The caviy extent of a propeller can be predicted more accurately by using the KD-cavitation chart at a preliminary design stage, since it is derived from the results of the cavitation observation tests in the selected ship's wake, whereas the existing cavitation charts, such as the Burrill's cavitation chart, are derived from the test results in uniform flow.

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Application of Environmental Friendly Bio-adsorbent based on a Plant Root for Copper Recovery Compared to the Synthetic Resin (구리 회수를 위한 식물뿌리 기반 친환경 바이오 흡착제의 적용 - 합성수지와의 비교)

  • Bawkar, Shilpa K.;Jha, Manis K.;Choubey, Pankaj K.;Parween, Rukshana;Panda, Rekha;Singh, Pramod K.;Lee, Jae-chun
    • Resources Recycling
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    • v.31 no.4
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    • pp.56-65
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    • 2022
  • Copper is one of the non-ferrous metals used in the electrical/electronic manufacturing industries due to its superior properties particularly the high conductivity and less resistivity. The effluent generated from the surface finishing process of these industries contains higher copper content which gets discharged in to water bodies directly or indirectly. This causes severe environmental pollution and also results in loss of an important valuable metal. To overcome this issue, continuous R & D activities are going on across the globe in adsorption area with the purpose of finding an efficient, low cost and ecofriendly adsorbent. In view of the above, present investigation was made to compare the performance of a plant root (Datura root powder) as a bio-adsorbent to that of the synthetic one (Tulsion T-42) for copper adsorption from such effluent. Experiments were carried out in batch studies to optimize parameters such as adsorbent dose, contact time, pH, feed concentration, etc. Results of the batch experiments indicate that 0.2 g of Datura root powder and 0.1 g of Tulsion T-42 showed 95% copper adsorption from an initial feed/solution of 100 ppm Cu at pH 4 in contact time of 15 and 30 min, respectively. Adsorption data for both the adsorbents were fitted well to the Freundlich isotherm. Experimental results were also validated with the kinetic model, which showed that the adsorption of copper followed pseudo-second order rate expression for the both adsorbents. Overall result demonstrates that the bio-adsorbent tested has a potential applicability for metal recovery from the waste solutions/effluents of metal finishing units. In view of the requirements of commercial viability and minimal environmental damage there from, Datura root powder being an effective material for metal uptake, may prove to be a feasible adsorbent for copper recovery after the necessary scale-up studies.

Assessment of Bone Metastasis using Nuclear Medicine Imaging in Breast Cancer : Comparison between PET/CT and Bone Scan (유방암 환자에서 골전이에 대한 핵의학적 평가)

  • Cho, Dae-Hyoun;Ahn, Byeong-Cheol;Kang, Sung-Min;Seo, Ji-Hyoung;Bae, Jin-Ho;Lee, Sang-Woo;Jeong, Jin-Hyang;Yoo, Jeong-Soo;Park, Ho-Young;Lee, Jae-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.30-41
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    • 2007
  • Purpose: Bone metastasis in breast cancer patients are usually assessed by conventional Tc-99m methylene diphosphonate whole-body bone scan, which has a high sensitivity but a poor specificity. However, positron emission tomography with $^{18}F-2-deoxyglucose$ (FDG-PET) can offer superior spatial resolution and improved specificity. FDG-PET/CT can offer more information to assess bone metastasis than PET alone, by giving a anatomical information of non-enhanced CT image. We attempted to evaluate the usefulness of FDG-PET/CT for detecting bone metastasis in breast cancer and to compare FDG-PET/CT results with bone scan findings. Materials and Methods: The study group comprised 157 women patients (range: $28{\sim}78$ years old, $mean{\pm}SD=49.5{\pm}8.5$) with biopsy-proven breast cancer who underwent bone scan and FDG-PET/CT within 1 week interval. The final diagnosis of bone metastasis was established by histopathological findings, radiological correlation, or clinical follow-up. Bone scan was acquired over 4 hours after administration of 740 MBq Tc-99m MDP. Bone scan image was interpreted as normal, low, intermediate or high probability for osseous metastasis. FDG PET/CT was performed after 6 hours fasting. 370 MBq F-18 FDG was administered intravenously 1 hour before imaging. PET data was obtained by 3D mode and CT data, used as transmission correction database, was acquired during shallow respiration. PET images were evaluated by visual interpretation, and quantification of FDG accumulation in bone lesion was performed by maximal SUV(SUVmax) and relative SUV(SUVrel). Results: Six patients(4.4%) showed metastatic bone lesions. Four(66.6%) of 6 patients with osseous metastasis was detected by bone scan and all 6 patients(100%) were detected by PET/CT. A total of 135 bone lesions found on either FDG-PET or bone scan were consist of 108 osseous metastatic lesion and 27 benign bone lesions. Osseous metastatic lesion had higher SUVmax and SUVrel compared to benign bone lesion($4.79{\pm}3.32$ vs $1.45{\pm}0.44$, p=0.000, $3.08{\pm}2.85$ vs $0.30{\pm}0.43$, p=0.000). Among 108 osseous metastatic lesions, 76 lesions showed as abnormal uptake on bone scan, and 76 lesions also showed as increased FDG uptake on PET/CT scan. There was good agreement between FDG uptake and abnormal bone scan finding (Kendall tau-b : 0.689, p=0.000). Lesion showed increased bone tracer uptake had higher SUVmax and SUVrel compared to lesion showed no abnormal bone scan finding ($6.03{\pm}3.12$ vs $1.09{\pm}1.49$, p=0.000, $4.76{\pm}3.31$ vs $1.29{\pm}0.92$, p=0.000). The order of frequency of osseous metastatic site was vertebra, pelvis, rib, skull, sternum, scapula, femur, clavicle, and humerus. Metastatic lesion on skull had highest SUVmax and metastatic lesion on rib had highest SUVrel. Osteosclerotic metastatic lesion had lowest SUVmax and SUVrel. Conclusion: These results suggest that FDG-PET/CT is more sensitive to detect breast cancer patients with osseous metastasis. CT scan must be reviewed cautiously skeleton with bone window, because osteosclerotic metastatic lesion did not showed abnormal FDG accumulation frequently.

Factors influencing the axes of anterior teeth during SWA on masse sliding retraction with orthodontic mini-implant anchorage: a finite element study (교정용 미니 임플랜트 고정원과 SWA on masse sliding retraction 시 전치부 치축 조절 요인에 관한 유한요소해석)

  • Jeong, Hye-Sim;Moon, Yoon-Shik;Cho, Young-Soo;Lim, Seung-Min;Sung, Sang-Jin
    • The korean journal of orthodontics
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    • v.36 no.5
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    • pp.339-348
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    • 2006
  • Objective: With development of the skeletal anchorage system, orthodontic mini-implant (OMI) assisted on masse sliding retraction has become part of general orthodontic treatment. But compared to the emphasis on successful anchorage preparation, the control of anterior teeth axis has not been emphasized enough. Methods: A 3-D finite element Base model of maxillary dental arch and a Lingual tipping model with lingually inclined anterior teeth were constructed. To evaluate factors influencing the axis of anterior teeth when OMI was used as anchorage, models were simulated with 2 mm or 5 mm retraction hooks and/or by the addition of 4 mm of compensating curve (CC) on the main archwire. The stress distribution on the roots and a 25000 times enlarged axis graph were evaluated. Results: Intrusive component of retraction force directed postero-superiorly from the 2 mm height hook did not reduce the lingual tipping of anterior teeth. When hook height was increased to 5 mm, lateral incisor showed crown-labial and root-lingual torque and uncontrolled tipping of the canine was increased.4 mm of CC added to the main archwire also induced crown-labial and root-lingual torque of the lateral incisor but uncontrolled tipping of the canine was decreased. Lingual tipping model showed very similar results compared with the Base model. Conclusion: The results of this study showed that height of the hook and compensating curve on the main archwire can influence the axis of anterior teeth. These data can be used as guidelines for clinical application.