• Journal of Preventive Medicine and Public Health
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• 제22권1호
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• pp.45-50
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• 1989

The purpose of this study was to select the manageable diseases which are prevalent in Korea for periodic health examinations and to evaluate the sensitivity and specificity of periodic health examination in detecting these diseases. The data was derived from reimbursement data of the Korea Medical Insurance Corporation over a two year period (April 15, 1986 to April 14,1988) and interviews with Yonsei Medical School professors. This study demonstrated that: 1. The manageable diseases which were selected for periodic health examinations are pulmonary tuberculosis, viral hepatitis, diabetes mellitus, syphilis groups, essential hypertension, renal disease groups, and iron deficiency anemia. 2. The sensitivity of the health screening for each disease was as follows: pulmonary tuberculosis 51.5%, viral hepatitis 60.3%, diabetes mellitus 64.7%, syphilis groups 63.3%, essential hypertension 49.9%, renal disease groups 44.0%, and iron deficiency anemia 80.9%. We conclude that peiodic health esaminations should focus on the manageable diseases that we have defined. The number of items in periodic health screening tests and hospital quality control should be increased for the diseases with a demonstrated low sensitivity.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.98-104
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• 2019

We report a rare case of Meckel's diverticulum in a boy who initially presented with chronic iron deficiency anemia (IDA) without any history of gastrointestinal (GI) bleeding at 8 years-old. Isolated small bowel Crohn's disease was suspected based on findings of small bowel ulcers on capsule endoscopy. At four years from initial presentation, he developed massive GI bleeding. Abdominal computed tomographic angiography and small bowel series revealed findings suggestive of Meckel's diverticulum. Meckel's diverticulum should be suspected in children with unexplained chronic IDA even in the absence of prominent GI bleeding and negative findings on repetitive Meckel's scans. Moreover, Meckel's diverticulum should be included in the differential diagnosis of isolated small bowel Crohn's disease when the disease is limited to a short segment of the distal small bowel, as ulcers and inflammation may result as a consequence of acid secreted from adjacent heterotopic gastric mucosa constituting the Meckel's diverticulum.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제6권2호
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• pp.112-119
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• 2003

목 적: Helicobacter pylori는 위염의 원인균으로 사춘기의 철 결핍성 빈혈 빈혈과 관계가 있다고 생각된다. H. pylori feoB 유전자는 철 결핍 상태에서 철의 획득에 있어 중심적인 역할을 한다. 본 연구는 철 결핍성 빈혈이 있거나 또는 없는 H. pylori 위염 환자들에 있어서 H. pylori feoB의 염기 구조 차이를 분석하려고 하였다. 방 법: 10~18세의 H. pylori가 양성인 14명을 철 결핍성 빈혈 유무에 따라 두 군으로 분류하였다. 8명의 환자들은 철 결핍성 빈혈로 진단 받았고 나머지 6명은 정상의 혈액학적 소견들을 나타내었다. 위장의 생검 조직에서 배양된 H. pylori에서 genomic DNA를 분리하였다. feoB 유전자의 PCR 증폭을 위해 5개의 primer를 사용하였다. PCR의 결과로 1.93 kb의 feoB region이 생성되었다. H. pylori J99와 26695의 feoB 유전자 염기 배열과 임상 균주를 비교하였다. 또한 철결핍성 빈혈 동반 유무에 따른 두 군 사이에 feoB 유전자를 비교하였다. 결 과: feoB 유전자의 분석으로 16개의 다형성 위치를 밝혀내었다. 이중에서 3개의 다형성 (Glu/Thr254Ala, Ile263Val과 Lys511Gln)은 한국에 고유한 것이었다. 비록 철 결핍성 빈혈 유무에 따른 비교에서 4곳에 통계학적인 차이가 나타나기는 했으나 이것이 실제적인 차이라고 보기에는 검체의 수가 적었다. 결 론: 철 결핍성 빈혈 유무에 따른 군 간 비교에서 4곳의 feoB 다형성 차이를 보였으나 대상 균주 수가 적어 의미를 두기에는 아직 불명확하다. 더 많은 다원적 연구가 필요할 것으로 보인다.

• Clinical and Experimental Pediatrics
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• 제51권5호
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• pp.468-473
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• 2008

목 적 : IDA로 진단된 영유아의 어머니를 대상으로 수유 방법과 이유 진행사항 등의 실태를 조사하였고, 설문지 답변을 통하여 어머니가 가지고 있는 이유식에 대한 지식을 알아보았고, 그들의 이유식 관련 지식과 실제 나타나는 현실과의 차이점을 분석하였다. 방 법 : 2006년 3월부터 2007년 5월까지 인하대병원 외래 또는 입원한 영유아 중 IDA로 진단 받은 6-40개월 환아 111명(남:여=1.6:1)의 어머니를 대상으로 이유 실태 조사 및 이유지식에 관한 설문조사를 하여 다음과 같은 결과를 얻었다. 결 과 : 1) 혈액학적인 분포는 Hb는 $9.5{\pm}1.0g/dL$이었고, Hb 8 g/dL미만이 8.1%이었고, 9 g/dL 미만이 27.9%에 달하였다. MCV 70미만이 92명(82.8%)이었다. IDA가 분명한데도 페리틴 10 ng/dL 이상인 경우가 54명(48.6%)에 달하였다. 2) 이유식을 3개월 또는 그 이전에 이유식을 시작한 경우는 한 예도 없었고, 7개월 이후에 시작한 경우가 33.3%에 달하였다. 이유식의 평균 시작시기는 6.4 개월이었으며, 4-6개월에 시작한 경우(n=74)의 Hb은 $9.6{\pm}1.0g/dL$으로서, 7개월 이후에 시작한 경우(n=37)의 Hb $9.3{\pm}1.0g/dL$에 비하여 유의하게 높았다. 3) 이유식의 시작 시기가 늦을수록 Hb 수치가 낮게 나타났고, 생후 6개월까지 모유수유만 하고 이유식을 시작하지 않은 영유아들의 Hb 수치가 낮게 나타났다(P<0.05). 4) 처음 시도하는 이유식으로는 미음(82.6%), 과일즙(10.8%), 선식(4.5%) 등 순이었고, 주로 먹는 이유식의 종류는 야채죽(38.7%), 미음(36.9%), 과일즙(17.1%)의 순이었다. 주로 사용한 이유식은 집에서 만든 것이 87명(78.3%)이었고, 상품화된 이유식 사용은 7명(6.3%)이었다. 5) 어머니의 이유지식 점수는 대졸이상 그룹과 고졸 그룹 사이에 유의한 차이를 보이지 않았다. 또한 이유지식이 IDA중증도에 미치는 영향도 유의하지 않았다. 6) 이유식을 시도하여 4주 이내에 완성된 경우가 56명(50.4 %) 이었고, 나머지는 1개월 이상 걸렸으며, 3개월 이상 걸린 경우도 22명(20.0%)에 달하였다. 결 론 : 급성 감염이나 발열시에 페리틴 측정만으로 철결핍 및 IDA 진단을 내리기에는 한계가 있으며, 소구성 적혈구증 역시 IDA를 판정하는 중요한 지표가 될 수 있을 것이다. 많은 어머니가 이유지식이 부족하였고, 또한 상당한 이유지식을 가지고 있음에도 그 자녀에서 IDA가 발견되었으므로, 현재와 같은 이유식 방법을 지양하고, 이유식에 관한 교육 및 홍보를 강화한 좀더 개선된 방법이 모색되어야 할 것이다.

• 대한임상검사과학회지
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• 제43권1호
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• pp.12-18
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• 2011

The purpose of this study was to evaluate the significance of higher than normal mean corpuscular volume (MCV) and lower than normal mean corpuscular hemoglobin concentration (MCHC) in 20 patients. The hemoglobin (Hb), red blood cell indices (MCV, MCH, MCHC,), red cell distribution width (RDW), serum ferritin, serum iron (Fe) and total iron binding capacity (TIBC) were measured and the transferrin saturation were calculated. 18 (90.0%) cases were categorized as chronic diseases. Chronic renal failure, malignancy, and bleeding were all related to the cases. The mean values of hemoglobin was $9.5{\pm}2.14g/dL$; the MCV was $29.0{\pm}2.8fL$; the MCH was $30.9{\pm}1.0pg$; the MCHC was $31.2{\pm}0.5%$; the RDW was $17.0{\pm}3.6%$; serum Fe was $39{\pm}21{\mu}g/dL$; the TIBC was $219.7{\pm}108.8{\mu}g/dL$; transferrin saturation was $19.2{\pm}9.9%$ and ferritin was $445.5{\pm}499.6{\mu}g/L$ in the patients. The WHO criteria for hemoglobin of patients confirms anemia in 18 of the 20 (90.0%) cases. Anemia of chronic disease was shown in 11 (73.3%) cases; acute gastric ulcer with hemorrhage in 1 (6.7%) case; iron deficiency anemia in 1 (6.7%) case; 2 patients (13.3%) were of normal cases. There were changes in the baseline Hb level results of the 19 (95.0%) cases while no change was shown in 1 case. As a result, diseases associated with anemia and bleeding where the MCV is higher than the normal range and MCHC is lower than normal range are considered relevant findings.

• 생약학회지
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• 제19권2호
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• pp.111-119
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• 1988

Melanterite(Green vitriol) is a kind of mineral crude drug which has been used for a hemostatic and hematic, and it contained iron, zinc, magnesium, copper, calcium and manganese etc., and the contents of those matals were 14.34%, 1.21%, 0.91%, 0.41%, 0.37% and 0.15%, respectively. In the acute toxicity in mice its $LD_{50}$ was over 3,000 mg/kg and 2,000 mg/kg by the oral and subcutaneous administration, respectively, but the $LD_50$ by the intraperitoneal administration was 1,810 mg/kg. On the experimental anemia induced by the free bleeding in rabbits and by the phenylhydrazine in rats the reduced RBC, hemoglobin and hematocrit were rapidly recovered.

• Journal of Community Nutrition
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• 제5권1호
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• pp.37-43
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• 2003

Iron deficiency and anemia are severe nutrition problems in most of Korea. Iron intake, especially iron with better bioavailability is insufficient over a total age group. Recent changes in diet and life style of Koreans have been repeatedly suggested problems caused by excess nutrient intake rather than under intake. Despite the changes in diet patterns, iron deficient anemia is still prevalent in many parts of Korea. Eight hundred and fifty subjects (323 male and 527 female subjects) in Asan were recruited from farming, factory and urban area. Each subject was interviewed to assess nutrients intakes according to a 24hr-recall method. Twelve hour fasting blood samples were collected to vacutainer with EDTA for hemoglobin (Hb) and separate the tubes for serum iron (SI) and total iron binding capacity (TIBC). The mean serum iron value of female subjects in the factory area was significantly higher (p < 0.05) than that of the female subjects in the urban area although subjects in urban area showed significantly higher the dietary iron intake for both the men and woman (p < 0.05). Dietary iron intake for the younger women was lowest in the farming area and those in the urban area showed the highest dietary iron intake (p < 0.05). When the dietary iron intake was compared by different the age groups, dietary iron intake of the older women from animal sources was less than that of younger women in the urban area (p < 0.05). Dietary iron intake of Asan residents was not sufficient regardless of age, sex and regions and intake of heme iron was especially lower than nonheme iron. (J Community Nutrition 5(1) : 37∼43, 2003)

• Clinical and Experimental Pediatrics
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• 제46권1호
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• pp.11-16
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• 2003

목 적 : 영양 상담을 통하여 IDA 환아의 식이력을 평가하고 상담에 대한 보호자의 만족도와 순응도를 평가하기 위해 이 연구를 시행하였다. 방 법 : 1997년부터 2001년 8월까지 IDA로 진단받은 120명의 6-36개월 영유아를 대상으로 하였으며, 부모를 대상으로 수유방법 및 이유방법에 대하여 설문조사와 영양상담을 시행하여 다음과 같은 결과를 얻었다. 결 과 : 1) IDA로 진단받은 120명은 호흡기 감염으로 병원에 내원하거나 입원해서 발견된 경우가 47례(39.1%)로 가장 많았으며, 창백이나 빈혈 증상으로 평가를 위해 내원한 경우는 27례(22.5%)였다. 2) 총 120명 중 82명의 보호자들이 영양상담을 받았으며, 그중 56명(68.3%)이 이유식을 하고 있었다. 주요 이유식으로는 쌀죽이나 미음이 30례(53.6%)로 가장 많았으며, 철분강화 이유식이 9례(16.1%), 달걀이나 고기, 생선 등 철분이 풍부한 음식의 경우는 3례(5.4%)였다. 3) 영양상담을 받은 환아들의 문제점으로는 단계적인 이유를 시행하지 않고 우유병을 12개월 이상 사용하는 경우가 40례(48.8%)였고, 철분강화 이유식을 시행하지 않고 모유 수유만을 하는 경우는 26례(31.7%)였다. 4) 영양상담을 시행한 후 만족도는 87.8%로 높았으며, 치료에 대한 순응도는 영양상담을 시행한 군에서 철분제제만으로 치료한 군보다 유의하게 높았다(85.4% vs 72%). 결 론 : IDA를 갖는 환아들의 공통적인 식이력은 주 영양 공급원이 탄수화물인 경우로 다섯 식품군이 골고루 섭취되지 않을때, 12개월 이상이 되어도 고형식의 섭취는 거의 없으면서 액상식품을 우유병으로 먹이고 있을 때, 과자 등의 스낵이나 쥬스등의 섭취, 6개월 이후 철분강화 이유식을 시행하지 않고 모유 수유만을 하는 경우, 알레르기 등의 질환으로 임의적인 음식의 제한을 하는 경우, 12개월 전에 생우유를 먹이거나 하루에 700cc 이상 먹인 경우 6가지로 정리해 볼 수 있었다. 그리고 전문적인 영양평가 및 IDA 치료의 순응도를 높이기 위해서 영양상담의 필요하다고 사료된다.

• Clinical and Experimental Pediatrics
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• 제50권6호
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• pp.511-518
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• 2007

To understand the hemolytic anemia (HA) in children, the diagnostic approach and management of hereditary and acquired HA are described. The hereditary hemolytic anemia (HHA) can be classified according to the pathogenesis into three types : RBC membrane defects, hemoglobinopathies, and RBC enzymopathies. Clinical characteristics, laboratory findings and molecular defects of these three types are presented briefly. In Korea, HHA due to the RBC membrane defect, hereditary spherocytosis had been reported often but HHA due to hemoglobinopathies and RBC enzymopathies had been thought to be relatively rare. With recent development in the molecular diagnosis, ${\beta}$ thalassemia, mostly heterozygote, G6PD and pyruvate kinase deficiency have been reported with gene characterization. If the patients with microcytic hypochromic anemia show unproportionally low MCV or MCH or refractory to the iron therapy, hemoglobin electrophoresis and gene analysis for thalassemia or other unstable hemoglobinopathies need to be done accordingly. The global movement of the population especially from the region prevalent of hemoglobinopathies or enzymopathies to Korea warrants considering broad spectrum of etiology for the diagnosis of HHA. Aquired HA resulting from extracellular factors such as autoimmune HA from warm antibody, cold agglutinin and paroxysmal cold hemoglobinuria as well as nonimmune HA are described briefly.

• 대한핵의학회지
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• 제1권2호
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• pp.41-59
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• 1967

This study was aimed; firstly to observe various clinical symptomatology with reiation to the number of Ancylostoma duodenale larvae orally given to the human beings, secondly to evaluate the effects of some drugs like steroid hormones, antihistaminic3 and antitussives, and, thirdly to study the influences of some iron compounds in prevention and treatment of anemia of such origin. Ten healthy volunteers free from the previous history of hookworm infection were divided into 4 groups, to whom various numbers of actively moving filariform Ancylostoma duodenale larvae were orally given; 500 to 4 cases, 250 to 3 cases and 100 to 3 cases. Following were the results: 1. Clinical symptomatology 1. The most frequently encountered symptoms and signs were general malaise, cough and hoar seness. The tracheal itching and pain low back pain, arthralgia, sputum and salivation, acid belching, loss of appetite, abdominal pain and vomiting were also noted. 2. If the larger number of the larvae was given, the clinical symtomatology was more severe. 3. Prednisolone medication caused some improvement of such symptomatology, while the antihistaminics and antitussives like codeine or ephedrine were ineffective. 4. In volunteers whose nutritional conditions were rather poor appeared to show more severe symptomatology. 2. Effects of iron compounds 1. The oral administration of ferrous fumarate induced a slight increase of serum iron levels in the initial stage of the infection, then a decrease from $15{\sim}20$ days later and a recovery after 2 months. 2. The intravenous administration of saccharated ferric oxide induced a steady upkeep of the serum iron levels. 3. The hemoglobin contents also showed the upkeeps after either the oral or intravenous administration of the iron compounds. 4. The iron compounds, therefore, are considered to have the preventive as well as the therapeutic effects on hookworm anemia, which may strongly suggest that hookworm anemia is essentially the iron deficiency type. 3. Hematological changes 1. The severity of hookworm anemia generally correlated with the number of larvae given. 2. The moderate leucocytosis was observed in all cases regardless of the number of larvae given, which reached to a peak in $25{\sim}35$ days. 3. Eosinophilia was observed in all cases, but was more severe in cases given larger number of larvae, which was slightly less evident after the medication of prednisolone. 4. Red cell survival time The red cell survival time determined by $^{51}Cr$ was generally in the normal ranges except for the severe anemia patients.