• Clinical and Experimental Pediatrics
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• v.52 no.4
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• pp.453-457
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• 2009

Purpose : Our aim was to describe the clinical features of noroviral gastroenteritis in children. Methods : This study included 22 children with noroviral gastroenteritis, as confirmed by stool RT-PCR, who were admitted to Bundang CHA Hospital between July 2006 and June 2008. Their medical records were reviewed and compared with those of 45 children with rotaviral gastroenteritis. Results : In the norovirus group, 19 (86.4%) children showed vomiting and 21 (95.5%) children showed diarrhea, while all children in the rotaviral group showed both vomiting and diarrhea. The duration of vomiting was not different in the two groups, but mean episodes of vomiting/24 h were higher in the norovirus group than in the rotavirus group. The duration of diarrhea was longer and mean episodes of diarrhea/24 h were higher in the rotavirus group. The Vesikari Scale was not different in the two groups. Frequency and duration of fever did not show a significant difference. Most children in both groups were below 2 years of age. Conclusion : Clinical features of noroviral gastroenteritis were largely similar to those of rotaviral gastroenteritis, but vomiting was more severe in noroviral infection, and diarrhea was more severe and prolonged in rotaviral infection. With regard to noroviral infection, further epidemiologic investigations and preventive efforts are essential.

• Journal of Society of Preventive Korean Medicine
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• v.24 no.2
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• pp.71-82
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• 2020

Objectives : The purpose of this study is to evaluate clinical utilization by measuring compliance with the use of mobile health applications (AtopyPHR developed in a previous study) for patients with atopic dermatitis. Methods : Based on the AtopyPHR and the input period and frequency survey results for each symptom item, a scenario for measuring compliance was derived. The study period was 4 weeks. Participants installed AtopyPHR app and Telegram app on their smartphones, conducted user training on the app, and recorded symptoms using the app for 4 weeks. At the 2nd and 4th week visits, the AtopyPHR data recorded by the user can be viewed on the web page and used for medical decision. Compliance was analyzed by the date the symptoms were recorded. Results : There were 28 participants, all (100%) were compliant, and the compliance was 96.8. The patients were 1 to 18 years old, and the average age was 8.2±5.7 years, 10 males and 18 females. The actual date of participation in recording symptoms was 28.6±0.56 on average. Compared to Week 1, compliance decreased at Week 2, and Week 4 had the highest compliance. Daily check, daily emotion, stool/urine/sleep, and meal management showed high compliance, SCORAD and quality of life were higher than required to record. Conclusions : AtopyPHR was effective in compliance. The results of this study could be used to collect personal health data in daily life through the AtopyPHR, improving participant compliance. It is considered to be meaningful because it measured the compliance with the symptom record actually recorded using the mobile app rather than a questionnaire. This study may be useful not only for personal health care but also for medical decisions, as opinions are given by experts who treat atopic dermatitis.

• Korean Journal of Microbiology
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• v.46 no.1
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• pp.52-62
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• 2010

The aim of this study was to evaluated the efficacy of mixture of Lactic Acid Bacteria (LAB) and bifidobacteria supplement, which are contained with Lactobacillus acidophilus, Bifidobacterium longum SPM1205, and Pediococcus pentosaceus for the management of constipation in animal model and clinical trials. 5 ICR mice and 4 female constipation subjects were orally taken mixture of LAB and bifidobacteria for 2 weeks. We investigated the number of fecal LAB and harmful enzymes activities before and after mixture of LAB and bifidobacteria application. As a result, fecal LAB count was increased and harmful enzymes activities of intestinal microflora were generally decreased after mixture of LAB and bifidobacteria application. Also, 61 female subjects were randomly assigned to receive either mixture of LAB and bifidobacteria or lactose and were taken three times a day for 2 weeks. Then, we analyzed mixture of LAB and bifidobacteria effect through the questionnaires. Daily consumption of this mixture of LAB and bifidobacteria improved the constipation in constipation group (56.3%) compared with lactose application group (26.7%). Furthermore, after mixture of LAB and bifidobacteria treatment, frequency of hard stool decreased from 0.22 to 0.03. These results indicated that mixture of LAB and bifidobacteria application is effective to improve the constipation.

• The Journal of Korean Medicine
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• v.35 no.1
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• pp.157-170
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• 2014

Objectives: The purpose of this study was to develop a standard instrument of diagnosis and assessment for spleen qi deficiency pattern. Methods: Reports published in Korea and China related to spleen qi deficiency pattern were selected. Assessments of selected references were performed to select major symptoms of spleen qi deficiency pattern. Korean translation and review by a Korean linguist were performed to create a draft of [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)]. The final [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)] was completed after assessment on inclusion or exclusion, on importance of items and on validity of translation by an expert committee, consisting of professors from the National College of Korean Medicine. Results & Conclusions: 1. 14 major symptoms were selected by frequency from 45 references which were related to standard identification of spleen qi deficiency pattern, translated into Korean and reviewed by a Korean linguist. 2. 11 symptoms were selected after assessment on inclusion yes or no by the expert group. Items were listed in order of importance: tiredness of extremities (肢体倦怠), sallow complexion (面色萎黃), reduced appetite (食欲减退), abdominal distension after eating (腹胀食後尤甚), inability to eat (納少), pale tongue and white fur (舌淡苔白), lethargy (神疲), emaciation (消瘦), loose stool (大便溏薄), shortness of breath and reluctance to speak (少氣懶言), and weak pulse (脈緩弱). 3. Final [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)] was completed after assessment of translation validity, reflection of individual opinions by the expert committee, and application of weighted value computed from assessment on importance of items.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.24-30
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• 2004

Purpose: Acute diarrhea in young children is a major problem in pediatric hospitals worldwide. We evaluated the clinical efficacy of orally administered Lactobacillus acidophilus in the treatment of acute diarrhea in children. Methods: From September 2002 to July 2003 at National Police Hospital 41 children aged 3 months to 5 years with acute diarrhea were enrolled in this study. The patients were randomized to one of two groups to receive either $0.5{\times}10^8$ colony forming unit (CFU) of L. acidophilus or matching placebo on admission and every 8 hours during hospitalization. Results: The mean duration of diarrhea in all 41 children was decreased (p=0.001) in the L. acidophilus (40.5 hours) group compared to the placebo (56.6 hours) group. Stool frequency was also reduced (p=0.01) on the 3rd day in the L. acidophilus group. Rotavirus was identified in 58% of the patients. The decrease of duration of diarrhea was more significant in rotavirus-negative patients (p=0.002) compared to the rotavirus-positive patients (p=0.027). Conclusion: L. acidophilus shows to be an effective therapeutic agent in acute diarrhea in children. Further studies are needed to confirm the present findings.

• Journal of Nutrition and Health
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• v.39 no.1
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• pp.35-43
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• 2006

This study aimed to evaluate the effect of dietary fiber supplementation with snack type on functional constipation. We conducted a double blind case-control study with 3 groups; placebo, low dose group (LD: insoluble fiber 7 g/d + soluble fiber 1.2 g/d) and high dose group (HD: insoluble fiber 14 g/d + soluble fiber 2.4 g/d) , which were randomly assigned out of subjects with functional constipation, defined by modified Rome II criteria. We measured anthropometric parameters and evaluated the bowel movement frequency, stool type, straining, sense of complete evacuation, abdominal discomfort/pain, abdominal inflation, relief and colon transit time before, during the supplementation. Both LD and HD groups had significant improvement in straining, sense of complete evacuation and satisfactory relief compared with placebo group (p < 0.05). When subdivide by baseline colon transit time (less than 24 hrs/ 24 hrs or more and less than 72 hrs / 72 hrs or more), only HD group had significantly improvement; colon transit time recovered near by 24 hrs in subjects of 'less than 24 hrs' (from $7.57{\pm}1.40$ hrs to $25.2{\pm}3.91$ hrs, p < 0.01) and reduced in those of '24hr or more and less than 72 hr' (from $47.0{\pm}3.36$ hrs to $31.3{\pm}4.31$ hrs, p < 0.01) and '72 hr or more' (from $106.7{\pm}10.7$ hrs to $85.0{\pm}13.1$ hrs, P < 0.05) subjects. Particularly, positive effect of fiber supplementation on straining and sense of complete evacuation in test groups seemed to be greater in subjects of '24 hrs or less' and '24 hrs or more and less' than 72 hrs' than those of '72 hrs or more'. In conclusion, subjects with functional constipation, particularly those having colon transit time less than 72 hrs can significantly improve, at least in part, symptom related to constipation by fiber supplementation of snack type without serious side effects.

• Pediatric Infection and Vaccine
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• v.8 no.1
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• pp.123-128
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• 2001

Clonorchiasis, known as the parasitic fluke in the intrahepatic bile ducts, occurs throughout Korea, Japan, Taiwan, and Vietnam with high frequency. Most of the infections follow the consumptions of raw or undercooked freshwater fish, which explains its rare occurrence to childhood even in those areas mentioned earlier above. The authors have experienced it with an 8 year old boy. Abdominal ultrasonogram revealed multiple low echogenic nodules in the right lobe of liver and lymph nodes proliferation around the porta hepatis area. And abdominal C.T. scan also found multiple low attenuated nodules with delayed enhancement in liver parenchyma with hepatomegaly and multiple conglomerated lymph nodes in porta hepatis. Both abdominal ultrasonogram and C.T. scan didn't show any dilatation of peripheral intrahepatic bile ducts. In repeated stool examination, Clonorchis sinensis eggs were found in feces and the result of the skin test for Clonorchis sinensis was positive. The patient had a history of having eaten raw pond smelt back in Cheongju a month before the symptom onset. On the basis of the patient's history and the fact that Clonorchis eggs were found in feces 3 weeks after eosinophilia and symptoms were noted, the authors estimated that the findings of the patient's abdominal sonogram and C.T. scan were the radiologic findings of the acute phase of clonorchiasis, of which no report had ever been made before. So the authors report a case of clonorchiasis with atypical radiologic findings in an 8 year old boy.

• Parasites, Hosts and Diseases
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• v.23 no.2
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• pp.241-246
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• 1985

The epidemiological status of ascariasis was analyzed in 8 rural villages in Korea, through observation of its epidemiological parameters such as prevalence, worm burden and basic reproductive rate. Total 978 inhabitants were subjected to stool examination and recovery of worms after chemotherapy with pyrantel pamoate. The results were as follows: 1. The worm positive rate in each village was 16.5~79.5%, while the egg positive rate was 9~18% lower, 3.3~66.7%. The average worm burden (among all inhabitants) ranged from O. 21 to 8. 44 by villages and the frequency of cases with each worm burden showed negative binomial distributions with 'k' values of O. 38-0. 54. 2. The prevalence rates (worm) in each village was almost identical with the theoretical ones from Anderson and May's equation; $p=1-(1+M^*/k)^{-k}$, where 'p' is worm prevalence and '$M^*$' equilibrium average worm burden. The basic reproductive rate 'R' was calculated from 1.03 to 2.11. lt is suggested that, although 'R' in lower endemic areas is approaching to the breakpoint of reinfection (R=1), control programs of ascariasis in Korea should be continued until it becomes below the level nationwidely.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.628-642
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• 2018

Background/Aims A Subset of patients with irritable bowel syndrome (IBS) may have mild inflammation due to immune activation. Toll-like receptors (TLRs) and cytokines may cause intestinal inflammation. We studied their expression in relation to gut microbiota. Methods Expression of TLRs and cytokines was assessed in 47 IBS patients (Rome III) and 25 controls using quantitative real-time polymerase chain reaction. Immunohistochemistry was further performed to confirm the expression of TLR-4 and TLR-5. Results Of 47 patients with IBS, 20 had constipation (IBS-C), 20 diarrhea (IBS-D), and 7 unclassified (IBS-U). The mRNA levels of TLR-4 and TLR-5 were up-regulated in IBS patients than controls (P = 0.013 and P < 0.001, respectively). Expression of TLR-4 and TLR-5 at protein level was 4.2-folds and 6.6-folds higher in IBS-D than controls. The mRNA levels of IL-6 (P = 0.003), C-X-C motif chemokine ligand 11 (CXCL-11) (P < 0.001) and C-X-C motif chemokine receptor 3 (CXCR-3) (P < 0.001) were higher among IBS patients than controls. Expression of IL-6 (P = 0.002), CXCL-11 (P < 0.001), and CXCR-3 (P < 0.001) were up-regulated and IL-10 (P = 0.012) was down-regulated in IBS-D patients than controls. Positive correlation was seen between TLR-4 and IL-6 (P = 0.043), CXCR-3, and CXCL-11 (P = 0.047), and IL-6 and CXCR-3 (P = 0.003). Stool frequency per week showed positive correlation with mRNA levels of TLR-4 (P = 0.016) and CXCR-3 (P = 0.005), but inversely correlated with IL-10 (P = 0.002). Copy number of Lactobacillus (P = 0.045) and Bifidobacterium (P = 0.011) showed correlation with IL-10 in IBS-C, while Gram-positive (P = 0.031) and Gram-negative bacteria (P = 0.010) showed correlation with CXCL-11 in IBS-D patients. Conclusions Altered immune activation in response to dysbiotic microbiota may promote intestinal inflammation in a subset of patients with IBS.

• Pediatric Infection and Vaccine
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• v.19 no.1
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• pp.12-18
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• 2012

Purpose : This study attempted to investigate the frequency, duration, and risk factors of antibiotic-associated diarrhea (AAD) in infants hospitalized due to febrile urinary tract infection (UTI). This is a basic research on the probiotics used in the prevention and treatment of AAD in infants. Methods : Medical records of the infants aged 3-6 months hospitalized in Gachon University Gil Hospital from January 2008 to September 2010 due to the febrile UTI were retrospectively reviewed. The episodes of loose or watery stool were investigated for frequency, onset, and duration. Those who had AAD and those who did not (non-AAD) were compared. The antibiotic regimens and the episodes of diarrhea were investigated in AAD group. Result : Total 147 infants were included. Fifty-four (36.7%) showed AAD. Intravenous third-generation cephalosporin ($3^{rd}$ CS) single therapy was used for 102 patients (69.4%), the $3^{rd}$ CS and non-$3^{rd}$ CS combination therapy for 24 (16.3%), and non-$3^{rd}$ CS combination therapy for 21 (14.3%). There was no significant difference in the dose of cefotaxime between AAD and non-AAD group (P=0.601). According to the antibiotic therapies above, in AAD group, there was no significant difference in the onset and duration of diarrhea respectively (P=0.717, P=0.830). Although the frequency of diarrhea was higher for the $3^{rd}$ CS and non-$3^{rd}$ CS combination therapy subgroup with $9.25{\pm}5.30$ times/day than the other two subgroups ($7.58{\pm}2.97$ times/day in $3^{rd}$ CS single therapy subgroup, $6.75{\pm}4.40$ times/day in non-$3^{rd}$ CS combination therapy subgroup), there was no statistical significance (P=0.078). Conclusion : AAD seems common to the infants aged 3-6 months with febrile UTI, regardless of regimen and amount of antibiotics in usual dosage. Further research on the effects of probiotics used in the prevention and treatment of AAD in infants is warranted.