• Preventive Nutrition and Food Science
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• v.8 no.4
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• pp.406-411
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• 2003

The objective of this study was to investigate the effects of iron supplementation and nutrition education on the iron status and anemia of middle school girls in Ulsan city in Korea. The subjects were already diagnosed as having anemia (hemoglobin < 12 g/dL) or iron deficiency (ferritin < 12 ng/mL and/or transferrin sataturation < 14 %). Over a period of three months, one iron tablet (80 mg Fe as ferrous sulfate/day) was administered to the iron deficient subjects and two tablets (160 mg Fe as ferrous sulfate/day) were administered to the anemia subjects. Total calorie intake of subjects was 82.1 % of RDA. The iron intake of subjects was 91.3 % of RDA and the Ca intake was 78.8 % of RDA. The basal hemoglobin concentration of subjects averaged 12.8 1.2 g/dL, and this increased significantly (p < 0.001) to 13.2 0.9 g/dL after iron supplementation. The basal ferritin concentrations were 14.9 14.2 ng/mL and these significantly increased to 26.6 19.8 ng/mL (p < 0.001). The level of total iron binding protein (TIBC) significantly decreased from the initial 523.1 108.7 $\mu\textrm{g}$/dL to 462.2 90.2 $\mu\textrm{g}$/dL (p < 0.001) after iron supplementation. Anemia symptoms such as‘Being bruised easily’, ‘Inflamed inner mouth’, and ‘Pale face’ improved significantly after iron supplementation in the subjects. There was a negative correlation between their class & year ranking and serum iron level, transferrin saturation after nutritional education and iron supplementation. It was shown, therefore, that the higher the improvement of their anemia level after iron supplementation, the higher their academic performance. It was shown that there was some improvement of their dietary attitudes after nutritional education, and that their serum level related to anemia symptoms and iron nutrition was improved after iron supplementation.

• Journal of Oral Medicine and Pain
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• v.44 no.1
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• pp.40-44
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• 2019

Third molar extraction, one of the important surgical treatments commonly practiced in dentistry, presents various symptoms after surgery ranging from temporary or mild symptoms to permanent or severe complications. However, oral burning pain, dysesthesia, parageusia, dry mouth, headache and pain in multiple teeth are not the common symptoms that patients often complain after dental extraction. Here, the authors report two cases who presented acute neuropathic symptoms mentioned above in the orofacial regions following third molar extraction. At the initial examination, the healing of the tooth sockets of two patients was normal. One patient was diagnosed as megaloblastic anemia associated with Vitamin $B_{12}$ deficiency and was referred to the Department of Hematology for assessing the underlying etiology of anemia. The laboratory test for the other patient revealed microcytic anemia related to iron deficiency. The patient with iron deficiency anemia was successfully treated with iron supplement. These two cases suggest that anemia, as an underlying systemic disease, may be a rare etiology explaining acute onset of peripheral neuropathy in the orofacial regions after third molar extraction and should be considered in the assessment of patients who report neuropathic symptoms after dental extraction.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.121-125
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• 2005

Anemia can be defined as a reduction in blood hemoglobin concentration or red cell mass relative to age matched normal values. Clinical presentation may range from obviously pale and lethargy to an incidental finding during screening of an otherwise well appearing child. The differential diagnosis of anemia in each instance is broad with numerous possible etiologies. A careful history and physical examination as well as complete blood count, peripheral blood smear and additional laboratory tests are necessary in defining underlying cause of the anemia and guide in further treatment plans. In addition, Iron deficiency anemia and anemia of inflammation are common causes of mild to moderate anemia in children, but most pediatricians have some confusions to differentiate these two entities.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.28-33
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• 2001

Purpose: H. pylori infection is thought to contribute to iron-deficiency anemia, especially during puberty. The ferritin protein Pfr of H. pylori is homologous to eukaryotic and prokaryotic ferritins. The purpose of this study was to analyze the H. pylori pfr status in gastric biopsy specimens according to clinical data, including antral gastritis with or without iron-deficiency anemia. Methods: A total of 26 H. pylori-positive patients aged from ten to 18 years were categorized into subgroups based on the presence or absence of iron-deficiency anemia. All of them had antral gastritis. Sixteen patients were proved to have iron-deficiency anemia by hematological study, two of which had a duodenal ulcer. The other ten patients showed normal hematological findings. DNA isolation was performed from each of the gastric biopsy specimens. PCR amplification of the pfr gene coding was done using two sets of primers. The pfr region, 501 bp, was generated by linking the sequences of the two PCR products. The nucleotide and protein sequences were compared between the pfr regions from Korean H. pylori strains and the NCTC 11638, 26695, and J99 strain, which were obtained from the Genbank. Sequence comparisons were also performed for the pfr regions between the iron-deficiency anemia (+) and (-) groups. Results: Analysis of the complete coding region of pfr gene revealed three sites of mutation. The Ser39Ala mutation was found in 100% (26/26), Gly111Asn in 26.9% (7/26), and Gly82Ser in 11.5% (3/26). There were no significant differences in the mutations of the pfr regions between the iron deficiency anemia (+) and (-) groups. Conclusion: The mutation in the pfr gene did not relate with the clinical phenotype, iron deficiency anemia. Further studies are needed on the aspects of host side or other complex factors to elucidate anemia. Further studies are needed on the aspects of host side or other complex factors to elucidate the mechanisms by which the H. pylori infection might lead to iron deficiency anemia.

• Journal of Nutrition and Health
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• v.32 no.7
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• pp.787-792
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• 1999

The purpose of this study was to estimate the iron availability and to analyze dietary factors which influence hematological indices of 130 female adolescents with iron deficiency anemia. Intakes of iron and other nutrients were estimated using a self-administrated questionnaire combined with the 24-hour recall mehtod and iron availability was calculated by Monsen's method. Mean daily intakes of calorie, protein and vitamin C were 1631.0kcal(77.7% of RDA), 54.7g(84.2% of RDA) and 45.7mg(83.0% of RDA), respectively. In terms of iron, mean daily intake was 8.7mg(48.3% of RDA) and heme iron intake was 3.0mg which correspond to 34% of total iron intake. The amount of total absorbable iron was 1.5mg and the estimated bioavailability of dietary iron was 17.2%. In summary, intake of several nutrients for most of the subjects were under RDA. Dietary factors affecting hematological indices were analyzed by stepwise multiple regression. Intake of vitamin C was a major determinant of Hb level, while both intake of enhancing factor and iron availability were major determinants of serum ferritin level. In conclusion proper nutritional education and guidance for iron deficiency anemic female adoalescent needs to be developed and to improve their iron storage should be increased intakes of enhancing factors, female adoalescents.

• Clinical and Experimental Pediatrics
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• v.58 no.8
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• pp.283-287
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• 2015

Purpose: We assessed the relationships between iron and vitamin D statuses in breastfed infants and their mothers and evaluated the determinants of iron and vitamin D deficiencies in breastfed infants. Methods: Seventy breastfed infants aged 4-24 months and their mothers participated in this study from February 2012 to May 2013. Complete blood counts, total iron binding capacity, and levels of C-reactive protein, iron, ferritin, calcium, phosphate, alkaline phosphatase, and 25-hydroxyvitamin D (25(OH)D) in infants and their mothers were measured. Results: A history of maternal prepregnancy anemia was associated with lower ferritin and 25(OH)D levels in both infants and their mothers. The 25(OH)D level of infants correlated with maternal 25(OH) D levels. The independent risk factors for iron deficiency in breastfed infants were the duration of breastfeeding (odds ratio [OR], 6.54; 95% confidence interval [CI], 1.09-39.2; P=0.04) and infant body weight (OR, 2.65; 95% CI, 1.07-6.56; P=0.04). The determinants for vitamin D deficiency were the infant's age (OR, 0.15; 95% CI, 0.02-0.97; P=0.046) and maternal 25(OH)D level (OR, 0.74; 95% CI, 0.59-0.92; P=0.01). Conclusion: A maternal history of prepregnancy anemia requiring iron therapy was associated with lower current ferritin and 25(OH)D levels in both infants and their mothers. Therefore, physicians should monitor not only iron but also vitamin D levels in infants who are breastfed by mothers who had prepregnancy anemia.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.374-378
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• 1987

Plummer-Vinson syndrome is also termed Paterson-Brown-Kelly syndrome and sideropenic dysphagia, because it was described originally by Paterson and Kelly in 19`19 and it was often combined with iron-deficiency anemia. The syndrome is encountered most often in middle-aged anemic female. It is characterized by dysphagia referred to the upper esophagus, atrophy of the oral or pharyngeal mucous membranes, koilonychia, and stenosis or webs of the upper esophageal mucosa. And it is also related to the late occurrence of the carcinoma of the upper esophagus. Here is presented a case of upper esophageal web with dysphagia and iron-deficiency anemia with review of literature, which was treated by the surgical esophagoplasty to relieve the symptom of dysphagia and to widen the upper esophageal narrowing.

• Journal of Nutrition and Health
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• v.35 no.9
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• pp.943-951
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• 2002

This study was designed to investigate the effects of iron supplementation and nutrition education on the iron status and anemia of high school girls. The subjects resided in Ulsan city in Korea and were already diagnosed as having anemia or iron deficiency. Over a period of three months, one iron tablet (80 mg Fe as ferrous sulfate/day) was administered to the iron deficient subjects and two tablets (160 mg Fe as ferrous sulfate/day) were administered to the anemia subjects. The average height and weight of anemia subjects were 161.24 $\pm$ 4.50 cm and 50.87 $\pm$ 5.86 kg, respectively. The average BMI (kg/$m^2$ )was 19.58 $\pm$ 2.03 and the PIBW(percent ideal body weight) were 92.52 $\pm$ 9.84%. Except for vitamin A and vitamin C intakes, the intake levels of all other nutrients were below the RDA. Total calorie intakes of anemia subjects were 73.5% of RDA. The iron intakes of subjects from food were 69. 1% of RDA and the Ca intakes were 59.1% of RDA. The basal hemoglobin(Hb) concentration of anemia subjects averaged 10.77 $\pm$ 1.33 g/dl, and this increased significantly (p < 0.001) to 12.12 $\pm$ 1.08 g/dl, after iron supplementation. The basal ferritin, and transferrin saturations ｛TS (%)｝of anemia subjects were 12.51 $\pm$ 15.19 ng/$m\ell$ and 8.43 $\pm$ 7.56%, respectively, and these significantly increased to 20.59 $\pm$ 22.39 ng/$m\ell$ and 15.56 $\pm$ 12.87%, respectively. The level of total iron binding protein (TIBC) significantly decreased from the initial 486.80 $\pm$ 70.16 $\mu\textrm{g}$/dl to 417.86 $\pm$ 67.73 $\mu\textrm{g}$/dl (p < 0.001) after iron supplementation. For the iron deficiency subjects, the ferritin, iron and TS(%) levels were increased significantly (p < 0.001) and the TIBC levels were significantly (p <0.001) decreased after iron supplementation. Anemia symptoms such as 'Feeling blue (p<0.05)', 'Decreased ability to concentrate (p<0.001)' and 'Poor memory (p<0.05)' improved significantly after iron supplementation in the anemia subjects. The number of tablets administered was positively correlated with changes in serum hemoglobin (t=0.194, p< 0.01), serum ferritin (t=0.181, p<0.01), TS(%) (t=0.141, p<0.05), and hematocrit (t=0.254, p<0.01), and was negatively correlated with changes in TIBC (t=-0.143. p<0.05) and red cell distribution width (RDW, t=-0.140, p<0.05). In conclusion, daily iron supplementation was effective in improving the iron status and reducing symptoms of anemia in high school girls. (Korean J Nutrition 35 (9) : 943~951,2002)

• Journal of Community Nutrition
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• v.6 no.2
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• pp.86-90
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• 2004

This study was designed to assess the iron nutritional status and anemia of middle school girls in Ulsan City, who were evaluated with a questionnaire, measurement of hematological indices. The average height and weight of respondents were 154.81$\pm$6.28cm and 48.51$\pm$8.80kg, respectively. Mean daily energy intake was 1815.72$\pm$328.04kcal and iron intake was 15.13$\pm$4.50mg. The average hemoglobin concentration of subjects was 11.98$\pm$0.78g/dl, and the average hematocrit level was 36.62$\pm$2.21%. Transferrin saturationTS (%) was 25.58$\pm$9.82%, and the ferritin level was 40.45$\pm$23.03ng/ml. Iron deficiency anemia among the subjects was estimated as 54.2% by using hemoglobin(<12g/이), 33.9% by hematocrit (<36%). The clinical symptoms relating anemia were measured with 4 Likert scale (1 : never, 4 : often), 'tired out easily (2.34$\pm$0.92)' was the highest, followed by 'feel dizzy always (2.26$\pm$0.85)', 'decreasing ability to concentrate (2.23$\pm$0.77)', 'get a cold easily (2.19$\pm$0.82)', 'have a headache (2.10$\pm$0.79)', 'poor memory (2.09$\pm$0.83)', 'no appetite (1.99$\pm$0.85)', As for the correlation between iron parameter and clinical symptoms related to anemia, the hematocrit rate was negatively correlated with 'get a cold easily', 'pale face', 'feeling blue', 'difficult digestion' (p<0.05). The level of iron was negatively correlated with 'tired out easily', 'get a cold easily' (p<0.05) and TS (%) were negatively correlated with 'tired out easily (p<0.05)', 'get a cold easily (p<0.01). Our study resulted that the prevalence of a iron deficiency of a middle school girl is very high, therefore the guidelines for iron supplementation and nutritional education to improve their iron status should be provided.

• Clinical and Experimental Pediatrics
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• v.45 no.3
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• pp.362-369
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• 2002

Background : Anemia is still the most common nutrient deficiency worldwide, especially in adolescence because of an insufficient supply of iron, an increased iron requirement due to accelerated physical growth and blood loss due to menstruation in girls. This study was designed to assess the anemia and serum iron status of middle school girls. Methods : Hematologic examinations, physical examinations and questionnaires were performed for middle school girls in 1990, 1997, 1999 and 2000. Anemia was defined as a serum hemoglobin level of less than 11.5 g/dL. Iron deficiency was defined as a serum ferritin level of less than 10 ng/mL. Iron deficiency anemia was defined as anemia plus one of the following; MCV less than 78 fL, Ferritin level less than 10 ng/mL or Transferrin saturation rate less than 10%. Results : There was no significant difference in mean Hb between urban and rural areas and decreases in mean Hb as with age. The prevalence of anemia decreased by year; 13.5% in 1990, 6.9 % in 1997, 6.0% in 1999, and 5.7% in 2000. It was high in high school girls(10.1% in 1997 and 12.6% in 2000). The prevalence of iron deficiency decreased by year; 36.1% in 1990, 13.9% in 1997, 13.3% in 1999, and 23.2% in 2000. It was 21.3% in 1997 high school girls and 37.8% in 2000. The prevalence of iron deficiency anemia(IDA) decreased by year; 10.0% in 1990, 4.6% in 1997, 8.3% in 1999, and 6.1% in 2000. It was 11.6% in 1997 high school girls and 18.6% in 2000. Conclusion : Although the prevalence of iron deficiency decreased during this period, the prevalence of anemia in the elder adolescence girls was high. Two things are recommended; first, it is necessary to screen for anemia in middle school girls and high risk groups, second, it is important to evaluate the knowledge of nutrition and to enforce effective nutritional education, leading to subjects receiving adequate nutrition.