• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권1호
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• pp.16-22
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• 2009

목 적: 경제 및 위생 상태의 개선, 의학 기술의 발달로 최근 질병양상은 변화를 보이고 있다. 이에 저자들은 의료의 질 관리가 이루어지고 있는 전국 수련 병원에서 영유아 및 소아 청소년 입원 환자를 대상으로 우리 나라 영유아 및 소아 청소년에서 간 담도 질환의 현황 연구를 수행하였다. 방 법: 연구는 전국 85개 수련 병원에서 2004년 1월 1일부터 2006년 12월 31일까지 입원했던 진료과에 관계없이 만 18세 이하를 대상으로 ICD-10 진단 체계를 사용한 대한소아과학회와 건강증진사업단에서 시행한 영유아 및 소아청소년 입원 질환의 중장기 변화 추세 조사 및 감시 체계 구축 방안을 위한 기초 연구에서 간담도 질환자를 분류해서 MS 액세스, MS 엑셀, STATA 10.0을 사용해 자료 분석을 하였다. 결 과: 간담도 질환을 앓았던 환자는 총 4,151명으로 전체 환자의 5.0%를 차지했다. 간담도 질환 중 간염 환자가 2,385명으로 전체 간담도 환자 중 57.4%를 차지 하면서 가장 많았으며, 그 다음으로 담도폐쇄증 및 총담관낭을 포함한 선천성 간담도 질환이 524명으로 12.6%를 차지하였다. 연령별로는 신생아기에는 선천질환이 많다가 학동기에는 A형 및 B형 간염의 비율이 증가하였다. 그리고 간 담도 수술은 청소년기, 영아기에 가장 많았다. 연도별 간담도 질환의 평균 재원일수는 통계적으로 유의한 차이는 없었으나 감소하는 추세를 보였고, 재원 환자수는 차이가 현저하지 않았다. 최근 유병률이 증가하고 있는 A형 간염의 경우 연중 6, 7, 8월에 가장 많았다. 결 론: 본 연구에서 저자들은 퇴원 기록을 바탕으로 영유아 및 소아청소년에서의 간담도 질환의 현황 및 입원 질병부담에 대해 기술하였다. 최근의 소아청소년 간담도 입원 질환 중에서 급성 A형 간염 비중의 급격한 증가는 보다 적극적인 예방 대책이 필요함을 시사한다. 소아청소년 간담도 질환의 경우 그 빈도가 많지 않아 단순 조사로는 역학 자료를 얻기 어려우므로 국가 주도의 체계적인 감시 시스템 구축이 필요하다.

• 대한한방내과학회지
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• 제43권6호
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• pp.1149-1161
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• 2022

Purpose: This systematic review was conducted to evaluate the clinical effects of Injinho-tang on hyperbilirubinemia in hepatobiliary disorders. Methods: We searched for randomized controlled clinical trials that had administered Injinho-tang as an intervention in the following medical databases: Public/Publisher MEDLINE (PubMed), Excerpta Medica dataBASE (EMBASE), Cochrane library, Research Information Sharing Service (RISS), ScienceON, Oriental Medicine Advanced Searching Integrated System (OASIS), and China National Knowledge Infrastructure (CNKI). Among the retrieved studies, only trials that met the inclusion criteria were selected, and serum total bilirubin values were extracted and analyzed from the finally selected trials. Results: The serum total bilirubin values of 1,302 patients with various hepatobiliary diseases were synthesized through a meta-analysis, which confirmed a decrease in serum total bilirubin of 21.03 𝜇mol/L (95% CI -29.58~-12.49, p<0.01) in the group administered with Injinho-tang compared with the control group. Conclusions: Injinho-tang is effective in alleviating hyperbilirubinemia in hepatobiliary diseases when administered with conventional treatment. However, the potential risk of bias, high heterogeneity among the included trials, and differences in herbal composition are limitations of the results of this meta-analysis.

• Nutrition Research and Practice
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• 제14권1호
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• pp.12-19
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• 2020

BACKGROUND/OBJECTIVES: Vitamin D is a pleiotropic hormone that affects various body organ systems. We evaluated the prevalence of a vitamin D deficiency (VDD) and its potential role in the clinical condition of critically ill Korean children. SUBJECTS/METHODS: Patients under 18 years old with a 25(OH) vitamin D measurement on the first day of PICU admission were included from among the children admitted to the pediatric intensive care unit (PICU) of our tertiary children's hospital between October 2017 and January 2019. RESULTS: A total of 172 pediatric patients were enrolled. The mean 25(OH) vitamin D level was 17.5 ± 12.8 ng/mL. There was a 65.1% prevalence of VDD (25(OH) vitamin D level < 20 ng/mL). VDD was associated with age at PICU admission, gastrointestinal/hepatobiliary disorders, International Society of Thrombosis and Hemostasis disseminated intravascular coagulation (ISTH DIC) score, pediatric multiple organ dysfunction syndrome (pMODS) score and with several laboratory test findings including hemoglobin, platelet, C-reactive protein, serum albumin, total bilirubin, prothrombin time, and anti-thrombin III levels. Most of these parameters also showed significant linear correlations with the 25(OH) vitamin D level (P < 0.05). However, no statistically meaningful association was found between VDD and other clinical conditions such as the need for a mechanical ventilator, requirement for vasoactive drugs, duration of the PICU and hospital stays, or PICU mortality. CONCLUSION: There is a high prevalence of VDD in critically ill Korean children. There were significant associations between the 25(OH) vitamin D level and gastrointestinal/hepatobiliary disorders, the pMODS score and with coagulation related factors. Further large-scale studies with more specific subgroup analyses are required to more precisely assess the clinical implications of VDD in critically ill pediatric patients.

• 사상체질의학회지
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• 제25권3호
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• pp.195-207
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• 2013

Objectives This study aimed to examine differences in the hepatic function disorders and prevalence rates of liver diseases in accordance with the Sasang constitutional type, and to analyze whether Sasang constitution is a significant risk factor for fatty liver. Methods A total of 1211 patients who underwent health check-up at the Ilsan Hospital of Dongguk University and had their physical constitutions diagnosed by a specialist in Sasang constitutional medicine from October 31, 2011 to September 28, 2012 were used as the subjects of this study. Presence of hepatobiliary diseases was analyzed from the results of the hepatic function test, lipid test and viral hepatitis infection marker test in the biochemistry tests, and abdominal ultrasonography. Results & Conclusion Subjects of the study were composed of 691 males and 520 females and, in terms of Sasang constitution distribution, 550 Taeeumin, 343 Soeumin and 318 Soyangin. As the results of analysis of prevalence rates in accordance with Sasang constitutions, significant differences were observed in the prevalence rates of abnormal groups in the cases of AST, ALT, GGT, Triglyceride, HDL-cholesterol and LDL-cholesterol, and all of their prevalence rates were in the descending order of Taeeumin, Soyangin and Soeumin. Soeumin displayed significantly higher positive rate for HBs Ab in comparison to Taeeumin and Soyangin. In the results of abdominal ultrasonography, the prevalence rates of fatty liver displayed significant differences and were in the descending order of Taeeumin, Soyangin and Soeumin. And as the result of logistic regression analysis in order to find the risk factors of fatty liver, the Sasang constitution was found to be a significant risk factor for fatty liver. The odds ratio of Taeeumin in fatty liver was found to be 1.634 higher than Soeumin and 1.773 higher than Soyangin

• 대한한방내과학회지
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• 제45권1호
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• pp.55-74
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• 2024

Objectives: This study reviewed the status of adverse event (AE) reporting in VigiAccess using anti-obesity agents as examples and explored the possibility of its use and future challenges. Methods: AE reports related to some representative drugs among herbal medicines (HMs), complex HM prescriptions, ingredients of supplements, and over-the-counter and prescription medicines were investigated using VigiAccess on February 1, 2024. Results: AE reports on prescription drugs were overwhelmingly higher than those on HMs or supplements. Although most reports were submitted from North America, reports on Ephedra sinica and green tea extract (GTE) were more from Asia and Europe, respectively. The female population reported more, and the difference in the sex ratio was the smallest for Ephedra spp. The age group was concentrated on young adults, but many older patients reported GLP-1 receptor agonist-related AEs. Symptoms related to the gastrointestinal and nervous systems were most commonly reported, but mental and cardiac disorders were common in Ephedra-type HMs. Hepatobiliary disorders are also commonly found in GTE-related reports. Conclusions: VigiAccess was useful for easily checking the global status of AE reporting for prescription drugs. However, several limitations were observed in using VigiAccess for HMs because of the few reports. Thus, it is necessary to increase the number of reports by education and to promote AE reporting among HM prescribers and users. The full range of HMs should be included in the pharmacovigilance system, and the coding and classification of HMs should be revised.

• Neonatal Medicine
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• 제18권2호
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• pp.391-394
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• 2011

저자들은 다형 홍반과 구강 궤양으로 발현하였고 빈혈, 혈소판 감소증, 간기능 이상 등을 동반한 신생아 루푸스 환아의 확진과 신생아 진단을 통하여 무증상 산모 루푸스를 역으로 진단한 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Biomolecules & Therapeutics
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• 제5권2호
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• pp.194-201
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• 1997

The hepatoprotective activity of six extracts (BE, EE, HH, PS-1, PS-2, KP) from Artimisia iwayomogi was investigated against experimentally produced hepatic damages. Silymarin, DDB and UDCA were used as reference compounds. Treatment with PS-1 extract reduced hepatic demages induced by $CCl_4$, acetaminophen and ANIT but it did not alter ethionine-induced hepatotoxicity In addition, PS-1 extract showed a protective effect against chronic $CCl_4$-induced hepatotoxicity as well as liver regeneration. PS-2 and KP extracts exhibited significant antihepatotoxic effects on D-galactosamine-induced hepatitis. Treatment with EE extract inhibited ethionine-induced fatty liver. These data indicate that the PS-1 extract is the roost hepato-protective constituent and rationalize the traditional use of this plant in hepatobiliary disorders.

• 대한한의학회지
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• 제33권1호
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• pp.107-120
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• 2012

Objectives: Clinically, patients with dyspepsia often complain of several gastrointestinal (GI) and extra-GI symptoms. However, there have been few studies investigating the relationship between GI symptoms and extra-GI symptoms. The aim of this study was to characterize the clinical features of the 991 outpatients with GI and extra-GI symptom and the relationships between GI and extra-GI symptoms. Methods: 991 patients newly visiting Weedahm Oriental Hospital for GI symptoms were included. Those who had disorders caused by the hepatobiliary-pancreatic system were excluded. The 991 outpatients were interviewed with a standardized questionnaire inquiring about demography, past medical history, past institutional care, GI symptoms and extra-GI symptoms. Results: Among 991 patients, 780 (78.7%) had more than three GI symptoms and 451 (45.5%) had more than five. Among 991 patients, 545 (55.0%) had more than three extra-GI symptoms and 285 (28.8%) had more than five. There was a statistically significant correlation between GI symptoms and extra-GI symptoms such as headache, fatigue, forgetfulness, eyeball pain, unrest, dizziness, muscle pain, chest pain, and dyspnea. Conclusions: We found that there was statistically significant correlation between GI symptoms and extra-GI symptoms, which suggests the possibility of main common pathophysiology between GI symptoms and extra-GI symptoms. Further studies will be required to elucidate the main common pathophysiology between GI symptoms and extra-GI symptoms.

• 정신신체의학
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• 제6권1호
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• pp.3-12
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• 1998

Objective : The sensation of dysphagia, heartburn, globus hystericus, and functional dyspepsia are common symptoms of the functional upper gut disorders. This study was designed to investigate quantity of perceived stress, depression, and anxiety in the patients with functional upper gut symptoms whose esopahgeal manometry(EM) and gatroesophageal reflux (GERT) test were normal. Methods : A total of 38 patients who complained of the symptoms had been tested with 24-hour ambulatory EM and conventional GERT in our gastrointestinal clinic. Thirty patients whose tests had been normal(patients group) were assessed with Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), and Spielberger Stait-Trait Anxiety Inventory(STAI) and compared with 30 patients(control group) without functional upper gut symtpoms in the hepatobiliary clinic. The two groups were also assessed by quantity of perceived stress during the last year through self-report. Results: 1) These patients tended to be predominently female, older, and possessed a lower education than control group. 79% of 38 patients who had been tested were normal. 2) Compared to the control group, the patients had significantly higher mean scores on four subscales(somatization, depression, anxiety, and positive symptom distress index). 3) The patient group had significantly more perceived stress than the control group. 4) The patients group had significantly higher levels of depression than the control gorup, but there was not any significant difference in the STAI. 5) There were significant positive correlations between the BDI score and the STAI-trait, the STAI-stait and the STAI-trait, the quantity of perceived stress and the STAI-trait. Conlusion : The patients with functional upper gut symptoms displayed more, psychological distress, sornatization, anxiety, and deperssion. Among them, patients had higer depression than control group. Functional upper gut symtoms could be more appropriately viewed as somatic symptoms of depression. These findings suggest that such patients need to have psychiatric intervention and treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권4호
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• pp.377-386
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• 2019

Purpose: Percutaneous liver biopsy (PLB), a diagnostic procedure to identify several hepatobiliary disorders, is considered safe with low incidence of associated complications. While postoperative monitoring guidelines are suggested for adults, selection of procedural recovery time for children remains at the discretion of individual operators. We aim to determine if differences exist in frequency of surgical complications, unplanned admissions, and healthcare cost for children undergoing outpatient PLB for cohorts with same-day vs. overnight observation. Methods: We performed a retrospective cohort study in children 1 month to 17 years of age undergoing ultrasound-guided PLB from January 2009 to August 2017 at a tertiary care, pediatric referral center. Cohorts were defined by postprocedural observation duration: same-day (${\leq}8$ hours) vs. overnight observation. Outcomes included surgical complications, medical interventions, unscheduled hospitalization within 7 days, and total encounter costs. Results: One hundred and twelve children met study criteria of which 18 (16.1%) were assigned to same-day observation. No differences were noted in demographics, anthropometrics, comorbidities, biopsy indications, or preoperative coagulation profiles. No major complications or acute hospitalizations after PLB were observed. Administration of analgesia and fluid boluses were isolated and given within 8 hours. Compared to overnight monitoring, same-day observation accrued less total costs (US $992 less per encounter). Conclusion: Same-day observation after PLB in children appears well-tolerated with only minor interventions and complications observed within 8 hours of procedure. We recommend a targeted risk assessment prior to selection of observation duration. Same-day observation appears an appropriate recovery strategy in otherwise low-risk children undergoing outpatient PLB.