• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.5
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• pp.387-395
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• 2022

Purpose: Toxins produced by Clostridioides difficile infection (CDI) can cause enteritis and diarrhea. Although the number of pediatric CDI cases is increasing, the clinical management of pediatric CDI, including patient characteristics and prognosis, remains unclear. This study aimed to elucidate the background and clinical course of patients with CDI and evaluate the reliability of diagnostic tests in a tertiary pediatric hospital in Japan. Methods: We retrospectively analyzed the clinical data of children diagnosed with CDI between 2011 and 2021 at the Saitama Children's Medical Center in Saitama, Japan. Results: During the study period, 1,252 C. difficile antigen/toxin tests were performed, and 37 patients were diagnosed with CDI. The main underlying diseases among the patients were hematological and malignant disorders and gastrointestinal diseases, including inflammatory bowel disease (IBD) (59.4%). Two patients (5.4%) had an unremarkable medical history. Among the 37 patients, 27 (73.0%) were immunocompromised, 25 (67.6%) had a history of antibiotic use within the past two months, and 6 (16.2%) were negative on the initial test but were positive on the second test. Finally, 28 patients (75.7%) required primary antibiotic therapy only, and two patients with IBD required additional antibiotic therapy as secondary treatment. Conclusion: The number of pediatric patients with CDI is increasing. Both a comprehensive interview, including underlying diseases and history of antibiotic use, and an understanding of the features of clinical examinations should be emphasized to appropriately diagnose and treat CDI.

• Journal of the Korean Dietetic Association
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• v.21 no.1
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• pp.37-56
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• 2015

This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus-specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoring evaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.1
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• pp.17-22
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• 2015

Purpose: This study aims to investigate Saccharomyces boulardii CNCM I-745 during Helicobacter pylori eradication in children. Methods: One hundred ninety-four H. pylori positive children were randomized in two groups. Therapy (omeprazole+ clarithromycin+amoxicillin or omeprazole+clarithromycin+metronidazole in case of penicillin allergy) was given to both groups during two weeks. In the treatment group (n: 102) S. boulardii was added to the triple therapy, while the control group (n: 92) only received triple therapy. The incidence, onset, duration and severity of diarrhea and compliance to the eradication treatment were compared. A $^{13}C$ urea breath test was done 4 weeks after the end of eradication therapy in two groups of 21 patients aged 12 years and older to test the H. pylori eradication rate. Results: In the treatment group, diarrhea occurred in 12 cases (11.76%), starting after $6.25{\pm}1.24days$, lasting $3.17{\pm}1.08days$, and compliance to eradication treatment was 100%. In the control group, diarrhea occurred in 26 cases (28.26%), starting after $4.05{\pm}1.11days$, lasting $4.02{\pm}0.87days$, and in six cases eradication treatment was stopped prematurely (p<0.05). The $^{13}C$ urea breath test showed successful H. pylori eradication in 71.4% of the patients in the treatment and in 61.9 % in the control group (not significant). Conclusion: S. boulardii has a beneficial effect on the prevention and treatment of diarrhea during H. pylori eradication in children. Although S. boulardii did only slightly increase H. pylori eradication rate, compliance to eradication treatment was improved.

• Journal of the Korean Dietetic Association
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• v.11 no.2
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• pp.223-232
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• 2005

The purpose of this study was to investigate the dietary behavior of people with type 2 diabetes mellitus and to improve their quality of life through medical nutrition therapy. The subjects were 38 persons with type 2 diabetes mellitus visiting a public health center to participate in a dietary education program from Jun, 2003 to Nov. 2003 in Daegu, Korea. The interviews were tape-recorded and analyzed attitude, knowledge, and awareness of patients by focus group interview. Most of the patients were mainly dependent on drug therapy and had little experience of diet education. Barriers to dietary practice adherences were limitations in food selection, lack of will and feel of burden. Barriers to follow guidelines were lack of self-control, confliction with food habits of their family, accessibility, economical problems, fear for the change after dietary practice, food difficulties in meal distribution and difficulties for eating out. After 4 weeks of intensive nutrition education, fasting blood sugar levels were decreased and postprandial and waist circumference were significantly decreased in all patients and 26.9% of patients were under decreased oral hypoglycemic agent dosage due to improved blood sugar level. dietary knowledge of subjects were greatly improved in such items as dietary intake, saturated fat, HbA1C, ideal body weight, and waist circumference.

• Journal of the Korean Society of Food Culture
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• v.30 no.4
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• pp.395-405
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• 2015

Insamsokmieum (人蔘粟米飮), which is a kind of water gruels made with millet, ginseng, glutinous rice, and some minor ingredients, was frequently used as a medicinal food for the royal family, and it appeared first at the 10th year of King Sukjong's reign. We investigated Insamsokmieum through a literature review and the "SeungjeongwonIlgi(承政院日記)" of King Sukjong (肅宗) from his 1st year (1674) to 46th year (1720). We analyzed the nutritional value and efficacy of Insamsokmieum. In Oriental medicine, Insamsokmieum is prescribed mainly to treat symptoms such as nausea, languidness, and exhaustion in King Sukjong and Queen Inhyun (仁顯王后). In nutritional terms, Insamsokmieum has higher nutrition density than that of rice porridges (白粥) and has relatively high vitamin and mineral contents. Some nutrients such as leucine and glutamic acid, which are contained in the millet, are also known to help alleviate these symptoms. Whereas there have been studies on the efficacy and types of diet during the Joseon Dynasty, studies regarding nutrition characteristics are lacking. This study will demonstrate the superiority of dietary treatments of the Joseon Dynasty and their potential for application to modern nutrition.

• Journal of the East Asian Society of Dietary Life
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• v.18 no.5
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• pp.725-731
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• 2008

The principal objective of this study was to assess the effects of low-calorie diets(LCD) for 8 weeks of medical nutrition therapy in individuals with BMI in excess of $23\;kg/m^2$. 41 over-weight or obese individuals (male=14, female=27, age $28.6{\pm}8.9\;yrs$), none of whom were diagnosed with a medical disease, were administered MNT 4 times over the study period. Approximately $1,100{\sim}1,300\;kcal/day$ were prescribed by a dietitian, via individualized counseling. Anthropometric parameters, daily nutrient intake, and blood levels of leptin, insulin, and lipid profiles were measured prior to and after the 8 weeks of the intervention period. We noted significant reductions in body weight, body mass index (BMI), fat mass (FM), visceral adipose tissue (VAT), abdominal skin-fold thickness, and waist circumference in both men and women. The mean body weight losses in men and women were $3.2{\pm}0.6\;kg$/8 weeks and $2.8{\pm}0.6\;kg$/8 weeks, respectively. However, the % of lean body mass (LBM) in men and women was shown to increase significantly (p<0.05). The daily intake of calorie, fat, protein, vitamin E, folate, and iron were significantly reduced during the LCD period. Blood levels of lipids and glucose were in normal range, and evidenced no changes after LCD. However, the serum levels of leptin in female subjects were significantly reduced (p<0.00l) from $8.9{\pm}4.8\;ng/mL$ to $6.9{\pm}4.8\;ng/mL$. In conclusion, 8 weeks of LCD with individualized counseling by a dietitian effectively reduced body fat and visceral fat in both men and women with BMI in excess of $23\;kg/m^2$.

• Journal of the Korean Dietetic Association
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• v.24 no.2
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• pp.117-140
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• 2018

The number of patients is increasing and their mean age is also increasing. Proper dietary adjustments are necessary to prevent protein-calorie malnutrition or complications but it is difficult for dialysis patients to adapt to diet therapy due to stress or anorexia. Education does not consider the individual characteristics, knowledge, dietary inhabit education demands, and initial education. The purpose of this study was to identify dialysis patient's nutrition knowledge and, dietary practice and compare those with nutrition education or counseling demands for providing basic data of desirable nutrition management. The data were collected by a survey consisting of the general characteristics, disease related characteristics, nutrition education and counsel characteristics, level of nutrition knowledge, diet therapy, and nutrition education and counsel demands from the 28th March to 22th July 2017. The total number of subjects were 33 patients among dialysis patients at two tertiary medical institutions and an artificial kidney room at a private hospital in Incheon Gyeonggi. The data collected were analyzed statistically using the SPSS program 23.0, followed by further analyses using frequency analysis, one-way ANOVA, cross analysis, and correlation analysis. The results of the dialysis patients showed that younger (P<0.05), female (P<0.05), abnormal high school diploma (P<0.001) groups had high nutrition scores. In addition, dietary practice and nutrition education and counsel demands showed a positive correlation (P<0.05, P<0.01). In particular, females were higher than males in nutrition knowledge, dietary practice, nutrition education, and counseling demand scores.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.4
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• pp.347-350
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• 2018

Drug-induced autoimmune hepatitis (DIAIH) is an increasingly recognized form of drug-induced liver injury that leads to a condition similar to idiopathic autoimmune hepatitis. A number of drugs have been associated with DIAIH, minocycline is one of the most well characterized. Minocycline is a semisynthetic tetracycline antibiotic used in the treatment of acne vulgaris. Minocycline-induced autoimmune hepatitis presents with serologic and histologic features similar to idiopathic autoimmune hepatitis. However, the natural history and outcomes of these two conditions differ significantly. The majority of patients with minocycline-induced autoimmune hepatitis experience complete resolution of symptoms after withdrawal of the medication. Some patients may require a short course of steroids and rarely use of an immunomodulator to achieve resolution of disease. Recurrence of symptoms is rare and typically only occurs with reintroduction of minocycline. It is important for primary care providers to consider minocycline-induced autoimmune hepatitis when liver injury develops during minocycline therapy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.269-274
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• 2005

Esophageal candidiasis is an opportunistic infection, often reported in patients who have acquired immune deficiency syndrome (AIDS), a neoplastic disease, or undergoing protracted antibiotic therapy. Impaired cell mediated immunity was often considered as the major predisposing factor in patients of esophageal mucosal colonization of Candida spp. However, it is increasingly reported that the occurrence of esophageal candidiasis with no underlying disease or immune suppression. We have experienced a case of esophageal candidiasis in a 15-year-old girl who was immunologically normal and have no underlying disease and whose main symptoms were epigastric and retrosternal pain with dysphagia. This case suggests the possibilities of candidal infections in children without predisposing factors such as immune compromised conditions, so it will be needed to differentiate the esophageal candidiasis among healthy children with symptoms of odynophagia and dysphagia.

• Nutritional Sciences
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• v.7 no.4
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• pp.214-217
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• 2004

Dietary intervention and simvastatin is beneficial in the prevention cardiovascular diseases by lowering plasma lipid levels. Endothelial dysfunction is associated with coronary artery disease and its risk factors and is reversed by dietary intervention. It has been suggested that hyperlipidemia contributes to the development of atherosclerosis by increasing inducible nitric oxide synthase (iNOS) expression via intimal thickening. Statins treatment has been found to decrease iNOS expression and atherogenensis in animal models. We hypothesized that dietary intervention and simvastatin therapy could decrease plasma nitric oxide in hypercholesterolemic patients, which would suggest the opportunity for modulation of iNOS expression through the use of statins in a clinical situation. We measured the plasma levels of nitrite and nitrate (NOx) in 19 hyperlipidemia patients. The subjects were under dietary intervention following simvastatin therapy for 12 weeks. As a result, the plasma level of NOx, stable metabolites of nitric oxide (NO), saw a two-fold elevation in hyperlipidemic patients as compared to normal levels. Although 12 weeks of dietary intervention did not lower NOx levels, subsequent 12-week simvastatin (10 mg/day) treatment, along with dietary intervention, lowered NOx levels significantly. This NOx reduction, induced by simvastatin therapy, positively correlated with lowered coronary risk factors (r=0.40, p=0.02). It indicated that simvastatin therapy decreases plasma NOx levels by, perhaps, decreasing iNOS expression or activity leading to the attenuation of the development of neointima.