• Journal of Korean Academy of Nursing
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• v.54 no.3
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• pp.386-402
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• 2024

Purpose: The purpose of this study was to conduct a pre-conception care program for women of childbearing age with inflammatory bowel disease (IBD) in Korea and verify its effects on self-efficacy for IBD management, IBD-related pregnancy knowledge, and IBD-related pregnancy anxiety. It also aimed to explore the changes in participants through the program. Methods: A convergent mixed-methods study design was adopted. In the quantitative phase, 35 women (17 and 18 in the intervention and control group, respectively) participated. The intervention group attended a program that included small-group sessions and individual tele-coaching. To confirm the effects, data were collected before and one and four weeks after the intervention. In the qualitative stage, focus group interviews and tele-coaching were conducted with the intervention group. Results: After the program ended, significant differences were observed over time between the intervention and control groups for self-efficacy for IBD management (Wald χ² = 4.41, p = .036), IBD-related pregnancy knowledge (Wald χ² = 13.80, p < .001) and IBD-related pregnancy anxiety (Wald χ² = 8.61, p = .003). Qualitative data analysis revealed the following themes: (1) improving confidence in IBD management and awareness for planned pregnancy; (2) improving IBD awareness related to pregnancy and childbirth; and (3) relieving anxiety about and actively facing pregnancy. Conclusion: This study is meaningful in that, to the best of our knowledge, it is the first to develop a pre-conception care program for women diagnosed with IBD and confirm its effectiveness. Furthermore, this program is expected to be suitable for patient counseling and education in clinical practice.

• Clinical and Experimental Pediatrics
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• v.53 no.5
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• pp.661-665
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• 2010

Anemia caused by vitamin B12 deficiency resulting from inadequate dietary intake is rare in children in the modern era because of improvements in nutritional status. However, such anemia can be caused by decreased ingestion or impaired absorption and/or utilization of vitamin B12. We report the case of an 18-year-old man with short stature, prepubertal sexual maturation, exertional dyspnea, and severe anemia with a hemoglobin level of 3.3 g/dL. He had a history of small bowel resection from 50 cm below the Treitz ligament to 5 cm above the ileocecal valve necessitated by midgut volvulus in the neonatal period. Laboratory tests showed deficiencies of both vitamin B12 and iron. A bone marrow examination revealed dyserythropoiesis and low levels of hemosiderin particles, and a cytogenetic study disclosed a normal karyotype. After treatment with parenteral vitamin B12 and elemental iron, both anemia and growth showed gradual improvement. This is a rare case that presented with short stature and delayed puberty caused by nutritional deficiency anemia in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.4935-4937
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• 2016

Objective: To compare dosimetric parameters of 3 dimensional conformal radiotherapy (3 DCRT) and intensity modulated radiotherapy (IMRT) in terms of target coverage and doses to organs at risk (OAR) in the management of rectal carcinoma. Methods: In this prospective study, conducted between August 2014 and March 2016, all patients underwent CT simulation along with a bladder protocol and target contouring according to the Radiation Therapy Oncology Group (RTOG) guidelines. Two plans were made for each patient (3 DCRT and IMRT) for comparison of target coverage and OAR. Result: A total of 43 patients were recruited into this study. While there were no significant differences in mean Planning Target Volume (PTV) D95% and mean PTV D98% between 3 DCRT and IMRT, mean PTV D2% and mean PTV D50% were significantly higher in 3 DCRT plans. Compared to IMRT, 3 DCRT resulted in significantly higher volumes of hot spots, lower volumes of cold spots, and higher doses to the entire OAR. Conclusion: This study demonstrated that IMRT achieves superior normal tissue avoidance (bladder and bowel) compared to 3 DCRT, with comparable target dose coverage.

• Advances in pediatric surgery
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• v.10 no.2
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• pp.112-116
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• 2004

Midgut volvulus secondary to intestinal malrotation usually presents within the first month of life. Diagnostic delay may result in midgut infarction and mortality. In this retrospective study, we review seventeen cases of midgut volvulus to assess the importance of early recognition for midgut volvulus in pediatric patients of any age.. These patients were diagnosed as having a midgut volvulus by operation at Ewha Womans University Hospital. Eleven patients (64.7 %) were less than 1 month of age, and fifteen were boys (88.2 %). The mean gestational age was 38.3 weeks and the birth weight was 3.1 kg. Eight patients (47.1 %) had one or more combined anomalies such as heart malformation, brain ischemia, Down's syndrome or duodenal atresia. Vomiting was the most common symptom. Only thirteen patients underwent preoperative diagnostic procedures; 13 abdominal sonography demonstrated the whirlpool sign in 8 patients, upper gastrointestinal tract roentgenography showed a cork-screw pattern in 7 patients, and barium enema or small bowel series demonstrated positive findings in 7 patients. A Ladd's procedure was was formed on all patients.. There was no mortality or severe morbidity such as short bowel syndrome. Midgut volvulus should be included in the differential diagnosis in any infant or child who presents with the symptoms of acute abdomen, especially with vomiting.

• Archives of Pharmacal Research
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• v.21 no.2
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• pp.179-186
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• 1998

Dextran-5-aminosalicylic acid ester (dextran-5-ASA) was synthesized as a colon-specific prodrug of 5-aminosalicylic acid (5-ASA) which is active against inflammatory bowel diseases. Chemical stability of dextran-5-ASA in the bath of pH 1.2 or 6.8 was investigated at $37^{\circ}C$ for 6 hrs, and 5-ASA was not released on such conditions. Depolymerization (%) of dextran-5-ASA by dextranase with the degree of substitution (DS) of 18, 23, or 30 was 92, 62 or 45 in 8 hrs respectively, but was not affected by the MW of dextran (9,000, 40,600, 80,200 or 580,000). Distribution of 5-ASA in dextran, determined by gel filtration chromatography, appeared to be relatively uniform. Incubation of dextran-5-ASA (DS 18) in cecal contents of rats released 20% (28 g) and 35% (49 g) of 5-ASA in 8 hrs and 24 hrs, respectively, but no 5-ASA was liberated from small intestinal contents.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.204-207
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• 2014

Non-occlusive mesenteric ischemia (NOMI) encompasses all forms of mesenteric ischemia with patent mesenteric arteries. NOMI is commonly caused by decreased cardiac output resulting in hypoperfusion of peripheral mesenteric arteries. We report a case of NOMI secondary to hemorrhagic shock and rhabdomyolysis due to trauma. A 42-year-old man presented to our trauma center following a pedestrian trauma. On arrival, he was drowsy and in a state of hemorrhagic shock. He was found to have multiple fractures, both lung contusion and urethral rupture. An initial physical examination and abdominal computed tomography (CT) scan revealed no evidence of intra-abdominal injury. High doses of catecholamine were administered for initial 3 days due to unstable vital sign. On day 25 of hospitalization, follow-up abdominal CT scan demonstrated that short segment of small bowel loop was dilated and bowel wall was not enhanced. During exploratory laparotomy, necrosis of the terminal ileum with intact mesentery was detected and ileocecectomy was performed. His postoperative course was uneventful and is under rehabilitation.

• Clinical and Experimental Pediatrics
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• v.48 no.4
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• pp.433-437
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• 2005

Bezoars are concretions commonly found in the stomach and small bowel, and four types of bezoars have been described based on their composition : trichobezoar, phytobezoar, lactorbezoar, and miscellaneous. Bezoars most often develop after gastric operations that alter the motility, emptying, and grinding of food in the stomach. Trichobezoars are most common in female children with normal gastrointestinal function and are usually associated with pica, mental retardation, and psychiatric disorders. Although uncommon, bezoars are a well-recognized cause of chronic abdominal complaints which, when undiagnosed, can result in serious complications including gastric ulceration, bleeding, perforation, intussusception and small bowel obstruction. Mortality rates of up to 30 percent have been reported in adults. Trichotillomania is behaviors surrounding hair-pulling, including stroking and playing with hair before pulling, or biting and swallowing the hair after it has been pulled(trichophagia). The most notorious of the medical sequelae of trichotillomania is the trichobezoar. We experienced a case of trichobezoar in an 11-year-old girl who frequently swallowed her hairs from age 4 years up to age 7 years, resulting in intermittent abdominal pain, nausea, and vomiting.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.12
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• pp.6346-6352
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• 2013

Radiotherapy of rectal cancer requires a stabilized image but the movement of patients is almost unavoidable in radiotherapy. In this study, the setup error using the radiation treatment technique was compared according to the loading time and BMI(Body Mass Index) for 14 patients with rectal cancer. In addition, the variation of the dose by the average setup error was compared. Therefore, the technique of a selective standard was established. As a result, 3DCRT(3-Dimensional Radiation Therapy) and VMAT(Volumetric Modulated Arc Therapy) showed a similar time and error. In comparison, IMRT(Intensity Modulated Radiation Therapy) increased the time two fold and the error four fold. In BMI, a more pyknic patient showed a larger error for all techniques. Regarding the dose, IMRT and VMAT increased much more than 3DCRT in the average error at the small bowel. Therefore, 3DCRT of the short time will be applied to pyknic rectal cancer. Moreover, VMAT selects than IMRT in the overexposure of the small bowel.

• Journal of Nutrition and Health
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• v.29 no.9
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• pp.934-942
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• 1996

This study was performed to investigate the influence of dietary fibers on the serum lipid level and bowel function in aged rats. Fiber sources of experimental diets were made from mugwort(M), butterbur(B), apple(A), sea mustard(S) by drying and milling. Each of fiber sources was mixed into the diet at the level of 5, 15% of diet. Sprague-Dawley strain, 13 month old male rats were divided into 9 groups by randomized complete block design : C, M5, B5, A5, S5, M15, B15, A15, S15. The animals were fed ad libitum each of experimental diets for 4 weeks. Control group showed lower food intake compare to the other groups. There were no significant difference between 5% groups and 15% groups in food intake. Fecal weight, dry fecal weight and fecal water content of control group were significantly lower than those of experimental groups, and fecal water content was increased by increasing level of dietary fibber. Apple group showed the lowest values, sea mustard group showed the highest. The shorter transit time was observed in the group of higher intake of dietary fiber. At the same level of dietary fiber, transit time of sea mustard group was shorter than the other groups. With increasing age, serum triglycerides, total cholesterol were increased and HDL-cholesterol was decreased. Fiber fed groups showed lower serum TG, TC and higher HDL-c level compare to the control group. Absorption rates of calcium, magnesium and phosphorus was tend to be lower in the group fed dietary fiber sources than control group. Mucosa weight and maltase activity in the small intestine were decreased by increasing age. As intake of dietary fiber increaed, mucosa weight in the small intestine was not different but maltase activity was decreased.

• Advances in pediatric surgery
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• v.15 no.1
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• pp.44-51
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• 2009

This study is a retrospective analysis of 1244 cases of the inguinal hernia in children under the age of fifteen years who were operated at the department of pediatric surgery, Inje University Busan Paik Hospital from March, 1997 to February, 2007. The ratio of male to female was 3.6:1. The type of hernia was indirect in all of the cases. The hernia was on the right side in 656 cases (53.9 %), left side in 467 cases (37.5 %), and bilateral in 121 cases (9.7 %). The hernia presented most frequently in infants under age 12 months; 364 cases (29.2 %). Fifty-nine cases (21.7 %) were in female and 305 cases (31.3 %) in male. There were 428 cases (33.6 %) in 1-3 years age group, 295 cases (23.7 %) in 4-6 years, 112 cases (9.0 %) in 7-9 years, 39 cases (3.1 %) in 10-12 years and 16 (1.2 %) in 13-15 years. The content of hernia sac was small bowel (59 %), omentum (31 %) in males and the ovary and tube (54 %) and small bowel (26 %) in female. The incidence of combined operation at the time was 3.2 %, and consisting of orchiopexy (67.5 %), frenulotomy (12.5 %), appendectomy (10 %), circumcision (5 %), and fistulotomy (5%). The incidence of combined disease was 2.8 % and consisting of undescended testis, Hirschsprung's disease, idiopathic hypertrophic pyloric stenosis, imperforate anus, and congenital heart disease. After unilateral inguinal hernia repairs, contralateral hernias developed in 34 patients. The laterality of the primary site of hernias were left in 19 cases (55.8 %), and right 15 cases (44.1 %). The 936 cases (75.2 %) were operated under general anesthesia; Mask bagging 663 cases (53.2 %), endotrachea intubation 257 cases (20.6 %), and laryngeal mask 16 cases (1.2 %). The remainder 308 cases (24.7 %) were operated under regional caudal anesthesia.