• Journal of Haehwa Medicine
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• v.9 no.2
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• pp.251-268
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• 2001

We arrived at the following conclusion after we have studied crohn's disease through the literatures of western and oriental medicine. 1. Crohn's disease has a characteristic of granulomatous necrosis and cicatricial inflammation which is called by segmental enteritis, granulomatous enteritis. This falls under the category of "Diarrhea", "Dysentery" and is similar to "small intestinal diarrhea", "acute temesmus", "splenic diarrhea" in oriental medicine. 2. In western medicine, the cause of crohn's disease indefinites, but it is presumed immunological unbalance of alimentary canal. In oriental medicine, it is summarized as the abnormal ascending and descending circulation of stomach and splenic energies, the hepatic stagnation, being the lower part of cleaning qi by exogenous disease, dyspeptic convulsion. 3. The presenting symptoms of crohn's disease are intermittent chronic diarrhea, fever, weight loss, abdominal spastic pain or abdominal discomfort. When anyone has a abdominal mass, a rectal abcess, and a rectal constriction by physical examination, we can doubt crohn's disease. 4. The methods of western medical treatment are a suppression of intestinal toxic contents and inflammatory mediator, a supply of nutritive substanceus to intestinal epithelial cell. Oriental medical treatments of these are "inducing diuresis", "warming kidney to reinforce yang", "nourishing qi to invigorate spleen", "eliminatin dampness by cooling" according to syndrome differentiations. As mentioned above, we can confirm possibility of oriental medical treatment that induces recovery of immunologic control function and we need advanced experiment, study, and clinical approach.

• Journal of Korean Medical Science
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• v.33 no.51
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• pp.324.1-324.6
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• 2018

Oxysterol $7{\alpha}$-hydroxylase deficiency is a very rare liver disease categorized as inborn errors of bile acid synthesis, caused by CYP7B1 mutations. As it may cause rapid progression to end-stage liver disease even in early infancy, a high index of suspicion is required to prevent fatal outcomes. We describe the case of a 3-month-old boy with progressive cholestatic hepatitis and severe hepatic fibrosis. After excluding other etiologies for his early liver failure, we found that he had profuse urinary excretion of $3{\beta}$-monohydroxy-${\Delta}^5$-bile acid derivatives by gas chromatography/mass spectrometry analysis with dried urine spots on filter paper. He was confirmed to have a compound heterozygous mutation (p.Arg388Ter and p.Tyr469IlefsX5) of the CYP7B1 gene. After undergoing liver transplantation (LT) from his mother at 4 months of age, his deteriorated liver function completely normalized, and he had normal growth and development until the current follow-up at 33 months of age. We report the first Korean case of oxysterol $7{\alpha}$-hydroxylase deficiency in the youngest infant reported to undergo successful living donor LT to date.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.5
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• pp.470-482
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• 2021

Purpose: We investigated the relationship between sonographic measurements of fatty liver and body mass index standard deviation score (BMI-Z score), abdominal wall fat thickness (AWFT), and serum biochemical parameters in childhood obesity. Methods: Anthropometric, laboratory, and ultrasonography data were obtained from 174 children with BMI-Z score >1. After the qualitative grading of hepatosteatosis (grades 0-3), the quantitative liver-kidney echogenicity ratio (LKER) was calculated using a software tool. Groups according to sex, age (AG-I to AG-III), BMI-Z score (BMG-I to BMG-III), and hepatosteatosis degree (HS-I and HS-II) were formed. The differences and distributions of the variables were statistically analyzed and compared among the groups. Results: Serum transaminase and glucose levels showed a positive correlation with LKER, whereas the HDL level showed a negative correlation. BMI-Z score and AWFT showed a positive correlation with fasting insulin level and HOMA-IR value. LKER was significantly higher in girls than in boys (p=0.008). In the AG-I group (age 3-8.9 years), the BMI-Z score was significantly higher, whereas AWFT was significantly lower than in the other age groups (p<0.001). The cutoff point of LKER for predicting grade 2 or higher steatosis (HS-II group) was determined to be 1.83. Cardiovascular disease risk was significantly higher in the HS-II group (p=0.035). Conclusion: As a valuable quantitative measurement tool, LKER can be used for the sonographic screening of fatty liver. AWFT, on the basis of its correlation with fasting insulin level and HOMA-IR value, may be a useful sonographic parameter in the management of childhood obesity.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.6
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• pp.555-563
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• 2021

Purpose: The aim of this study was to evaluate the pancreatic fat fraction (PFF) using magnetic resonance imaging (MRI) in children with and without obesity and to correlate PFF with body mass index (BMI) z-score, hepatic fat fraction (HFF), and ultrasonography-derived pancreato-perihepatic fat index (PPHFI). Methods: This prospective study included 45 children with obesity and 19 without obesity (control group). PFF and HFF were quantitatively assessed using the abdominal multi-echo Dixon method for MRI. The PPHFI was assessed using transabdominal ultrasonography. Anthropometric, MRI, and ultrasonographic characteristics were compared between the two groups. Correlations between PFF, HFF, PPHFI, and BMI z-scores in each group were also analyzed. Results: The PFF, HFF, PPHFI, and BMI z-score were higher in the group with obesity than in the control group (PFF: 6.65±3.42 vs. 1.78±0.55, HFF: 19.5±13.0 vs. 2.31±1, PPHFI: 3.65 ±1.63 vs. 0.94±0.31, BMI z-score: 2.27±0.56 vs. 0.42±0.54, p<0.01, respectively). PFF was correlated with BMI z-scores, PPHFI, and HFF in the obesity group, and multivariate analysis showed that PFF was strongly correlated with BMI z-score and PPHFI (p<0.05). The BMI z-score was strongly correlated with PFF in the control group (p<0.01). Conclusion: These results suggest that MRI-derived PFF measures are associated with childhood obesity. PFF and PPHFI were also highly correlated in the obesity group. Therefore, PFF may be an objective index of pancreatic fat content and has the potential for clinical utility as a non-invasive biomarker for the assessment of childhood obesity.

• The Korean Journal of Gastroenterology
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• v.72 no.6
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• pp.318-321
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• 2018

Primary neuroendocrine tumors originating from the extrahepatic bile duct are rare. Among these tumors, large cell neuroendocrine carcinomas (NECs) are extremely rare. A 59-year-old man was admitted to Sanggye Paik Hospital with jaundice that started 10 days previously. He had a history of laparoscopic cholecystectomy, which he had undergone 12 years previously due to chronic calculous cholecystitis. Laboratory data showed abnormally elevated levels of total bilirubin 15.3 mg/dL (normal 0.2-1.2 mg/dL), AST 200 IU (normal 0-40 IU), ALT 390 IU (normal 0-40 IU), and gamma-glutamyl transferase 1,288 U/L (normal 0-60 U/L). Serum CEA was normal, but CA 19-9 was elevated 5,863 U/mL (normal 0-37 U/mL). Abdominal CT revealed a 4.5 cm sized mass involving the common bile duct and liver hilum and dilatation of both intrahepatic ducts. Percutaneous transhepatic drainage in the left hepatic duct was performed for preoperative biliary drainage. The patient underwent radical common bile duct and Roux-en-Y hepaticojejunostomy for histopathological diagnosis and surgical excision. On histopathological examination, the tumor exhibited large cell NEC (mitotic index >20/10 high-power field, Ki-67 index >20%, CD56 [+], synaptophysin [+], chromogranin [+]). Adjuvant concurrent chemotherapy and radiotherapy were started because the tumor had invaded the proximal resection margin. No recurrence was detected at 10 months by follow-up CT.

• The Journal of Internal Korean Medicine
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• v.43 no.2
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• pp.184-190
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• 2022

Objectives: This study aims to report the clinical efficacy of Korean medical treatment of a patient with nonalcoholic fatty liver disease accompanied by obesity and dyslipidemia. Methods: A 52-year-old man with nonalcoholic fatty liver disease, obesity, and dyslipidemia was treated with Saenggangunbi-tang extract from November 3, 2021 to January 8, 2022. During the treatment period, the patient also undertook exercise and maintained a hypocaloric diet to reduce body weight. Changes were observed in the patient's symptoms, laboratory findings, such as liver enzymes and lipid profiles, and bioelectrical impedance analyzer results. Results: After taking Saenggangunbi-tang extract for approximately two months, with concomitant adjustments to exercise and diet, the serum levels of liver enzymes and triglyceride were decreased and the patient's body weight, body mass index, hepatic steatosis index, and visceral fat area were also reduced. In addition, symptoms including fatigue and dyspepsia improved. Conclusion: This study suggests that Saenggangunbi-tang extract with exercise and a regulated diet could be a helpful treatment strategy for managing nonalcoholic fatty liver disease with metabolic disorders.

• Journal of the Korean Society of Food Culture
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• v.38 no.4
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• pp.270-282
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• 2023

We performed a study to examine the association between diet quality and nonalcoholic fatty liver disease (NAFLD). Our study included 3,586 women aged 40-64 years who participated in the sixth Korea National Health and Nutrition Examination Survey. The study subjects were classified into the NAFLD group (n=816) and the normal group (n=2,770) using the hepatic steatosis index. The anthropometric indices, blood profiles, and dietary intake data of the subjects were obtained. The waist circumference, body mass index, and the serum levels of triglycerides, fasting blood sugar, HbA1c, and systolic and diastolic blood pressures were higher in the NAFLD compared to the normal groups (p<0.001, respectively). The intakes of protein (g/kg body weight, p<0.001), potassium (p<0.001), and vitamin A (p=0.006) were significantly lower in the NAFLD group. It was observed that the higher the total Korean Healthy Eating Index score, the lower the risk of NAFLD. A reverse relationship was shown between the NAFLD risk and the intakes of total fruits, total vegetables, vegetables excluding Kimchi and pickled vegetables, meat, fish, eggs and beans. Therefore, it is recommended that middle-aged women in Korea increase their intakes of fruits, vegetables, and foods high in protein for the proper management of NAFLD.

• Korean Journal of Poultry Science
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• v.32 no.3
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• pp.157-163
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• 2005

An experiment was conducted to investigate the effects of dietary betaine and protein levels on performance, internal e99 Qualify, blood composition, abdominal fat and liver amino acid concentration in laying hens. A total of 432 ISA-Brown laying hens were randomly allotted to four treatments with six replications for twenty few weeks. Treatments were factorially designed with two levels of crude protein(14.5 and $16.5\%$) and two levels of betaine(0 and 600ppm). The egg production was increased by feeding $16.5\%$ protein-fed group compared to that of $14.5\%$ protein-fed groups(P<0.05), but was different from betaine supplementation. Increasing protein and betaine supplementation to diets improved egg weight, egg mass and fred conversion(P<0.05). Eggshell breaking strength, thickness and Haugh unit were not influenced by either dietary betaine or protein levels. Dietary betaine did not affect serum total protein, albumin and uric acid concentration, whereas uric acid concentration was increased in $16.5\%$ protein-fed groups(P<0.05). The deposition of abdominal fat was lower in 600ppm betaine groups compared to those fed on 0ppm betaine groups(P<0.05). Concentration of the most hepatic amino acids were affected by dietary protein levels and betaine supplementation. There were synergistic effect between dietary protein and betaine. These results suggested that dietary betaine can improve the egg weight, mass, feed conversion and decrease the abdominal fat, but increase the hepatic amino acid contents.

• Tuberculosis and Respiratory Diseases
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• v.56 no.5
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• pp.550-554
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• 2004

A paragonimiasis infestation is caused by the paragonimus species. It is commonly found in the lung but has also been found to exist extrapulmonary infestations including cerebral, spinal, subcutaneous, hepatic, splenic, abdominal, urinary, and gynecologic infestation. On the other hand, a cutaneous infestation is extremely rare. Human infestation is caused by ingesting raw or undercooked intermediate hosts. Because paragonimus westermani larva mature to an adult worm in the lung, the possibility of identifying the adult worm of paragonimus westermani at extrapulmonary region is very rare. Case : After ingesting a fresh-water crab 1 month prior to the hospital visit, a 45-year old female patient was suffering from right pleuritic chest pain during that 1 month. The patient also complained of a palpable mass that was movable and migrating, and it was localized at the right upper quadrant of the abdomen. The eosinophil fraction of the white blood cell of peripheral blood and pleural fluid was elevated to 55.1% and 90%, respectively. Parasite eggs were not found in her sputum and stool examination. By using the enzyme-linked immunosorbent assay (ELISA), the paragonimus-specific IgG antibody titer was elevated to 0.28. During incisional biopsy, we were able to find the young adult worm of paragonimus westermani. We experienced the rare case of ectopic paragonimiasis with pleural effusion that was confirmed by identifying the adult worm of paragonimus westermani within the abdominal subcutaneous tissue. We report a case with brief literature reviews.

• Clinical and Experimental Pediatrics
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• v.48 no.11
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• pp.1239-1243
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• 2005

Purpose : Iron accumulation interferes with hepatic insulin extraction and affects insulin synthesis and secretion. The purpose of this study is to investigate the correlation between serum ferritin and type 2 diabetes mellitus. Methods : We compared the serum ferritin level among 18 patients in an impaired glucose tolerance (IGT) group, 36 in a type 1 diabetes group, eight in a type 2 diabetes group and 29 in a healthy control group. The correlation between serum ferritin levels and sex, body mass indices(BMI), blood pressure(BP), serum fasting sugar level and serum fasting insulin level were also analyzed. Results : The mean log ferritin were $1.33{\pm}0.32$(healthy control group), $1.63{\pm}0.19$(IGT group) and $1.90{\pm}0.30$(type 2 diabetes group). In the IGT group, log ferritin was higher than in the healthy control group(P=0.001). The log ferritin of the type 2 diabetes group was higher than that of the healthy control group(P=0.001). Comparing log ferritin to other factors, log ferritin had a significant positive correlation with body mass indices(P<0.001), systolic blood pressure(P=0.001), and fasting glucose(P=0.001), fasting insulin(P=0.002). Conclusion : Compared to the normal healthy group, serum ferritin concentrations were significantly higher in the IGT group and the type 2 diabetes group. The elevation of serum ferritin concentration may be a risk factor of type 2 diabetes mellitus.