Pub Date : 2011-06-01DOI: 10.5223/KJPGN.2011.14.2.113
J. Hwang
【Food allergies affect 7~8% of infants and young children, and their prevalence appears to have increased in recent years. Food allergy refers to an abnormal immunological reaction to a specific food. These reactions can be recurrent each time the food is ingested. Food allergy manifests itself with a wide spectrum of clinical characteristics including IgE-mediated diseases as immediate reactions, non-IgE-mediated disorders as delayed reactions, and mixed hypersensitivities. As a consequence, the clinical picture of a food allergy is pleomorphic. A well-designed oral food challenge is the most reliable diagnostic test for infants and young children whose clinical history and physical examination point towards a specific food allergy. Food specific IgE antibody tests (RAST, MAST, skin prick test, Uni-CAP, etc) are an alternative tool to determine oral food challenge for IgE-mediated disorders, but not for non-IgE-mediated allergies. Moreover, parents often impose their children on unnecessary diets without adequate medical supervision. These inappropriate dietary restrictions may cause nutritional deficiencies. This review aims to introduce clinical perspectives of food allergy in infants and young children and to orient clinicians towards different strains of diagnostic approaches, dietary management, and follow-up assessment of tolerance development.】
{"title":"Clinical Perspectives of Food Allergy in Infants and Young Children","authors":"J. Hwang","doi":"10.5223/KJPGN.2011.14.2.113","DOIUrl":"https://doi.org/10.5223/KJPGN.2011.14.2.113","url":null,"abstract":"【Food allergies affect 7~8% of infants and young children, and their prevalence appears to have increased in recent years. Food allergy refers to an abnormal immunological reaction to a specific food. These reactions can be recurrent each time the food is ingested. Food allergy manifests itself with a wide spectrum of clinical characteristics including IgE-mediated diseases as immediate reactions, non-IgE-mediated disorders as delayed reactions, and mixed hypersensitivities. As a consequence, the clinical picture of a food allergy is pleomorphic. A well-designed oral food challenge is the most reliable diagnostic test for infants and young children whose clinical history and physical examination point towards a specific food allergy. Food specific IgE antibody tests (RAST, MAST, skin prick test, Uni-CAP, etc) are an alternative tool to determine oral food challenge for IgE-mediated disorders, but not for non-IgE-mediated allergies. Moreover, parents often impose their children on unnecessary diets without adequate medical supervision. These inappropriate dietary restrictions may cause nutritional deficiencies. This review aims to introduce clinical perspectives of food allergy in infants and young children and to orient clinicians towards different strains of diagnostic approaches, dietary management, and follow-up assessment of tolerance development.】","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"33 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134261050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5223/KJPGN.2011.14.2.181
E. Yi, M. J. Kim, S. Ha, Yoo Min Lee, Kyong Eun Choi, Y. Choe
Eosinophilic gastroenteritis is a rare disease occurring especially in children, and shows various non-specific presentations with infiltration of eosinophils in the gastrointestinal organs. The pathophysiology of eosinophilic gastroenteritis is not yet clearly known, but allergic reactions are suspected to be related with the disease. Eosinophilic gastroenteritis is categorized into the mucosal, muscularis and subserosal types based on which layer of the intestinal wall is involved. There are different clinical manifestations according to the involved layer. Most cases to date have responded well to steroid therapy. In this study, we diagnosed and treated a case of non-IgE-mediated, subserosal eosinophilic gastroenteritis in a child with abdominal pain, diarrhea and ascites. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 181 ∼ 186)
{"title":"A Case of Non-IgE-mediated Eosinophilic Gastroenteritis Presenting as Ascites","authors":"E. Yi, M. J. Kim, S. Ha, Yoo Min Lee, Kyong Eun Choi, Y. Choe","doi":"10.5223/KJPGN.2011.14.2.181","DOIUrl":"https://doi.org/10.5223/KJPGN.2011.14.2.181","url":null,"abstract":"Eosinophilic gastroenteritis is a rare disease occurring especially in children, and shows various non-specific presentations with infiltration of eosinophils in the gastrointestinal organs. The pathophysiology of eosinophilic gastroenteritis is not yet clearly known, but allergic reactions are suspected to be related with the disease. Eosinophilic gastroenteritis is categorized into the mucosal, muscularis and subserosal types based on which layer of the intestinal wall is involved. There are different clinical manifestations according to the involved layer. Most cases to date have responded well to steroid therapy. In this study, we diagnosed and treated a case of non-IgE-mediated, subserosal eosinophilic gastroenteritis in a child with abdominal pain, diarrhea and ascites. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 181 ∼ 186)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129960480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5223/KJPGN.2011.14.2.130
H. Lee
Plain X-ray radiographs are the first line of investigation taken in the diagnosis of abdominal pathology and are considered an important diagnostic tool to provide guidelines for further imaging studies and comprehensive therapeutic management. Although most abdominal pathology demonstrates non-specific radiologic findings, the plain abdominal radiography is very useful in specific diseases, including certain gastrointestinal anomalies. This review provides image findings of normal plain abdominal radiography and some common abdominal pathology in infants and children. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 130∼136)
{"title":"Plain Abdominal Radiography in Infants and Children","authors":"H. Lee","doi":"10.5223/KJPGN.2011.14.2.130","DOIUrl":"https://doi.org/10.5223/KJPGN.2011.14.2.130","url":null,"abstract":"Plain X-ray radiographs are the first line of investigation taken in the diagnosis of abdominal pathology and are considered an important diagnostic tool to provide guidelines for further imaging studies and comprehensive therapeutic management. Although most abdominal pathology demonstrates non-specific radiologic findings, the plain abdominal radiography is very useful in specific diseases, including certain gastrointestinal anomalies. This review provides image findings of normal plain abdominal radiography and some common abdominal pathology in infants and children. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 130∼136)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134450303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5223/KJPGN.2011.14.2.171
J. Moon, K. Moon, Sang Kee Park, Y. Chung, Eun Young Kim
Purpose: The aim of this study was to assess changes in neuropeptide Y (NPY) immunoreactivity in the hypothalamus and interstitial cells of Cajal (ICC) in the small intestine of rats fed high-fat diets (HFD). Methods: Male Sprague-Dawley rats (200∼250 g body weight) were randomly divided into two groups, which were the control group (normal chow diet for 6 weeks), and the HFD group (rodent diet with 60% kcal fat for 6 weeks). The immunoreactivity of NPY in the hypothalamus and ICC in the small intestine was evaluated after every feed for 6 weeks. Results: NPY immunoreactivity was observed strongly in the hypothalamic nuclei in the HFD group compared to the control group. The numbers of NPY-immunoreactive (IR) cells were significantly higher in the paraventricular hypothalamic nucleus in the HFD group than in the control group. In the region of Auerbach’s plexus (AP) of small intestine, the staining intensity of the ICC-IR cells was reduced in the HFD group compared to the control group. The numbers of ICC in the small intestine with HFD, including ICC in the inner circular and outer longitudinal muscle were significantly lower than in the control group. Conclusion: This study suggested that increasing NPY-IR cells in the hypothalamus may reflect resistance of NPY action after a HFD, and decreasing ICC-IR cells in the small intestine after a HFD is functionally significant in gastrointestinal motility. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 171∼180)
{"title":"Changes in Neuropeptide Y-Immunoreactive Cells in the Hypothalamus and Cajal Interstitial Cells in the Small Intestine of Rats with High-Fat Diet","authors":"J. Moon, K. Moon, Sang Kee Park, Y. Chung, Eun Young Kim","doi":"10.5223/KJPGN.2011.14.2.171","DOIUrl":"https://doi.org/10.5223/KJPGN.2011.14.2.171","url":null,"abstract":"Purpose: The aim of this study was to assess changes in neuropeptide Y (NPY) immunoreactivity in the hypothalamus and interstitial cells of Cajal (ICC) in the small intestine of rats fed high-fat diets (HFD). Methods: Male Sprague-Dawley rats (200∼250 g body weight) were randomly divided into two groups, which were the control group (normal chow diet for 6 weeks), and the HFD group (rodent diet with 60% kcal fat for 6 weeks). The immunoreactivity of NPY in the hypothalamus and ICC in the small intestine was evaluated after every feed for 6 weeks. Results: NPY immunoreactivity was observed strongly in the hypothalamic nuclei in the HFD group compared to the control group. The numbers of NPY-immunoreactive (IR) cells were significantly higher in the paraventricular hypothalamic nucleus in the HFD group than in the control group. In the region of Auerbach’s plexus (AP) of small intestine, the staining intensity of the ICC-IR cells was reduced in the HFD group compared to the control group. The numbers of ICC in the small intestine with HFD, including ICC in the inner circular and outer longitudinal muscle were significantly lower than in the control group. Conclusion: This study suggested that increasing NPY-IR cells in the hypothalamus may reflect resistance of NPY action after a HFD, and decreasing ICC-IR cells in the small intestine after a HFD is functionally significant in gastrointestinal motility. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 171∼180)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126802680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5223/KJPGN.2011.14.2.148
H. Oh, H. Kang, K. Kang, Youn Woo Kim, J. Hong, K. Shin, Jin Sook Lee, Su Hyun Lee, Keun-Hwa Lee, M. Cho, D. Suh
Received:April 19, 2011, Revised:May 15, 2010, Accepted:May 19, 2011 Responsible author:Ki Soo Kang, M.D., Department of Pediatrics, Jeju National University School of Medicine, 102 Jejudaehakno, Jeju 690-756, Korea Tel: +82-64-7791-3232, Fax: +82-64-725-2593, E-mail: kskang@jejunu.ac.kr This work was supported by the research grant of the Jeju National University in 2008. 급성 로타바이러스 장염 소아에서 질환의 중증도와 로타바이러스 VP7 & VP4 유전형의 분포에 대한 연구
Received:April 19, 2011, Revised:May 15, 2010, Accepted:May 19, 2011 Responsible author:Ki Soo Kang, m.d.， Department of Pediatrics, Jeju National University School of Medicine, 102 Jejudaehakno，Jeju 690-756, Korea Tel: +82-64-7791-3232, Fax: +82-64-725-2593, E-mail: kskang@jejunu.ac.kr This work was supported by the research grant of the Jeju National University in 2008。对急性轮状病毒肠炎儿童疾病重症和轮状病毒VP7 & VP4典型分布的研究
{"title":"Distribution of Disease Severity and Group A Rotavirus Genotypes (VP7 & VP4) in Children with Acute Rotavirus Gastroenteritis","authors":"H. Oh, H. Kang, K. Kang, Youn Woo Kim, J. Hong, K. Shin, Jin Sook Lee, Su Hyun Lee, Keun-Hwa Lee, M. Cho, D. Suh","doi":"10.5223/KJPGN.2011.14.2.148","DOIUrl":"https://doi.org/10.5223/KJPGN.2011.14.2.148","url":null,"abstract":"Received:April 19, 2011, Revised:May 15, 2010, Accepted:May 19, 2011 Responsible author:Ki Soo Kang, M.D., Department of Pediatrics, Jeju National University School of Medicine, 102 Jejudaehakno, Jeju 690-756, Korea Tel: +82-64-7791-3232, Fax: +82-64-725-2593, E-mail: kskang@jejunu.ac.kr This work was supported by the research grant of the Jeju National University in 2008. 급성 로타바이러스 장염 소아에서 질환의 중증도와 로타바이러스 VP7 & VP4 유전형의 분포에 대한 연구","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117264093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5223/KJPGN.2011.14.2.122
B. Choe
The persistence of jaundice beyond the first 2 weeks of life require further investigation and this can be determined if the conjugated bilirubin levels are greater than 1.5 mg/dL or greater than 20% of the total bilirubin level. There is a diverse differential diagnosis for the cause of neonatal cholestasis due to hepatobiliary disease including biliary atresia, which eventually leads to liver cirrhosis if uncorrected before 60∼80 days of life. Long-established initial studies include abdominal ultrasonography, hepatobiliary scintigraphy and liver biopsy, but better diagnostic methods are needed. Promising new options are described including MRCP (magnetic resonance cholangiography), ERCP (endoscopic retrograde cholangiography), and PCC (percutaneous cholecysto-cholangiography). Though no single test can differentiate biliary atresia from other neonatal cholestasis with confidence, a combination of diagnostic methods is usually consistently beneficial. By excluding biliary atresia as early as possible, the risk of unnecessary explolaparotomy with intraoperative cholangiography is decreased. Further evaluation would be required for the diagnosis of neonatal cholestasis after excluding biliary atresia. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 122∼129)
{"title":"Early Exclusive Diagnosis of Biliary Atresia among Infants with Cholestasis","authors":"B. Choe","doi":"10.5223/KJPGN.2011.14.2.122","DOIUrl":"https://doi.org/10.5223/KJPGN.2011.14.2.122","url":null,"abstract":"The persistence of jaundice beyond the first 2 weeks of life require further investigation and this can be determined if the conjugated bilirubin levels are greater than 1.5 mg/dL or greater than 20% of the total bilirubin level. There is a diverse differential diagnosis for the cause of neonatal cholestasis due to hepatobiliary disease including biliary atresia, which eventually leads to liver cirrhosis if uncorrected before 60∼80 days of life. Long-established initial studies include abdominal ultrasonography, hepatobiliary scintigraphy and liver biopsy, but better diagnostic methods are needed. Promising new options are described including MRCP (magnetic resonance cholangiography), ERCP (endoscopic retrograde cholangiography), and PCC (percutaneous cholecysto-cholangiography). Though no single test can differentiate biliary atresia from other neonatal cholestasis with confidence, a combination of diagnostic methods is usually consistently beneficial. By excluding biliary atresia as early as possible, the risk of unnecessary explolaparotomy with intraoperative cholangiography is decreased. Further evaluation would be required for the diagnosis of neonatal cholestasis after excluding biliary atresia. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 122∼129)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129498058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-01DOI: 10.5223/KJPGN.2011.14.2.141
H. Park, J. We, J. Park
Purpose: Ultrasonography (US) is widely used as a screening test in patients with abdominal pain (AP). We investigated the usefulness of US by a pediatrician in children with AP. Methods: We retrospectively analysed the medical records of children with AP who undertook US from December, 2008 to July, 2010. Results: A total of 628 patients (325 male, 303 female) were enrolled in this study. The mean age of patients was 8.08±4.61 years. Duration of AP was acute in 427 and chronic in 201 patients. Localization of AP was diffuse (36.9%), periumbilical (24.4%), epigastric (21.0%), and right lower quadrant (8.1%). On the examination, there were no abnormal findings in 327 patients (52.1%). Abnormal ultrasonographic findings were mesenteric lymphadenitis (27.1%), intestinal mural thickening (10.0%), intussusception (3.0%), appendicitis (2.6%), choledochal cyst (1.6%), and pancreatitis (0.3%). We performed additional imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) in 39 patients who showed obscure findings on the US. In 33 patients (84.6%), the same results were obtained from CT or MRI. Two cases of appendicitis, one case of pancreatitis and one case of Henoch-Shonlein purpura were diagnosed by the CT examination. However, there were two cases of appendicitis diagnosed by US thathad no evidence of appendicitis on the CT. Diagnostic accuracy of initial US in children with abdominal pain was 99.4%. Conclusion: US by a pediatrician as a screening test in children with AP provides a rapid and accurate diagnostic indication and has non-invasive and radiation-free advantages. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 141∼147)
{"title":"Usefulness of Ultrasonographic Examination by a Pediatrician in Children with Abdominal Pain","authors":"H. Park, J. We, J. Park","doi":"10.5223/KJPGN.2011.14.2.141","DOIUrl":"https://doi.org/10.5223/KJPGN.2011.14.2.141","url":null,"abstract":"Purpose: Ultrasonography (US) is widely used as a screening test in patients with abdominal pain (AP). We investigated the usefulness of US by a pediatrician in children with AP. Methods: We retrospectively analysed the medical records of children with AP who undertook US from December, 2008 to July, 2010. Results: A total of 628 patients (325 male, 303 female) were enrolled in this study. The mean age of patients was 8.08±4.61 years. Duration of AP was acute in 427 and chronic in 201 patients. Localization of AP was diffuse (36.9%), periumbilical (24.4%), epigastric (21.0%), and right lower quadrant (8.1%). On the examination, there were no abnormal findings in 327 patients (52.1%). Abnormal ultrasonographic findings were mesenteric lymphadenitis (27.1%), intestinal mural thickening (10.0%), intussusception (3.0%), appendicitis (2.6%), choledochal cyst (1.6%), and pancreatitis (0.3%). We performed additional imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) in 39 patients who showed obscure findings on the US. In 33 patients (84.6%), the same results were obtained from CT or MRI. Two cases of appendicitis, one case of pancreatitis and one case of Henoch-Shonlein purpura were diagnosed by the CT examination. However, there were two cases of appendicitis diagnosed by US thathad no evidence of appendicitis on the CT. Diagnostic accuracy of initial US in children with abdominal pain was 99.4%. Conclusion: US by a pediatrician as a screening test in children with AP provides a rapid and accurate diagnostic indication and has non-invasive and radiation-free advantages. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 141∼147)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130263796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-03-01DOI: 10.5223/KJPGN.2011.14.1.74
H. Lee, Y. A. Park, S. Han, H. Koh
Purpose: Based on previous research findings, it is well-known that the timing of surgery is generally considered the most important prognostic factor for a Kasai por toenterostomy, the primary treatment for biliary atresia. This research aimed to identify the optimal timing of a Kasai portoenterostomy and to verify if the proposed optimal timing corresponds to previous studies. All patients were classified by the timing of surgery, and pre- and post-operative fibrotic changes of the liver were measured with the elasticity value from fibroscans. Methods: The stiffness scores of the pre- and post-operative fibroscans in 34 patients who were treated by Kasai portoenterostomy from October 2007 to September 2010 in Severance children's hospital were reviewed. Results: The earlier the patients were treated by Kasai portoenterostomy, the lower the fibroscan scores. When the patients were treated prior to the 8th week, the post-operative scores of the fibroscans were significantly better than those patients who were treated after the 8th week, and some even recovered partially. Moreover, when operated before the 8th week, the differences between each pre- and post- operative fibroscan score also showed statistical relevance (p=0.0002). Conclusion: The earlier the patient was treated by Kasai portoenterostomy, the less liver fibrosis that developed, the lower the level of post-operative fibrosis, and the less the degree of fibrotic progress before and after the operation. Thus, this research proposal reconfirms once more that the 8th week is the optimal timing for a Kasai portoenterostomy. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 74∼80)
{"title":"Tentative Proposal of Optimal Timing of Kasai Operation for Biliary Atresia Based on Fibroscan Results","authors":"H. Lee, Y. A. Park, S. Han, H. Koh","doi":"10.5223/KJPGN.2011.14.1.74","DOIUrl":"https://doi.org/10.5223/KJPGN.2011.14.1.74","url":null,"abstract":"Purpose: Based on previous research findings, it is well-known that the timing of surgery is generally considered the most important prognostic factor for a Kasai por toenterostomy, the primary treatment for biliary atresia. This research aimed to identify the optimal timing of a Kasai portoenterostomy and to verify if the proposed optimal timing corresponds to previous studies. All patients were classified by the timing of surgery, and pre- and post-operative fibrotic changes of the liver were measured with the elasticity value from fibroscans. Methods: The stiffness scores of the pre- and post-operative fibroscans in 34 patients who were treated by Kasai portoenterostomy from October 2007 to September 2010 in Severance children's hospital were reviewed. Results: The earlier the patients were treated by Kasai portoenterostomy, the lower the fibroscan scores. When the patients were treated prior to the 8th week, the post-operative scores of the fibroscans were significantly better than those patients who were treated after the 8th week, and some even recovered partially. Moreover, when operated before the 8th week, the differences between each pre- and post- operative fibroscan score also showed statistical relevance (p=0.0002). Conclusion: The earlier the patient was treated by Kasai portoenterostomy, the less liver fibrosis that developed, the lower the level of post-operative fibrosis, and the less the degree of fibrotic progress before and after the operation. Thus, this research proposal reconfirms once more that the 8th week is the optimal timing for a Kasai portoenterostomy. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 74∼80)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122088029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-03-01DOI: 10.5223/KJPGN.2011.14.1.67
Ji Jung, Youngmi Ahn, K. Moon
Purpose: Recently, the incidence of acute hepatitis A has increased nationwide and is related to a low rate of IgG anti-HAV production. To establish effective measures for preventing hepatitis A virus infection, an epidemiologic study on the seroprevalence of anti-HAV is needed. Thus, we investigated the seroprevalence of IgG anti-HAV in children living in Gwangju and Jeonnam. Methods: IgG anti-HAV levels were measured in a total of 1,435 patients who visited Chosun University Hospital between January 2009 and December 2009. Results: The overall seropositve rate was 40.8% (586/1,435). The seropositive rates were 41% among children under the age of 1 year, 49.9% for children 1∼5 years old, 51.1% among individuals 5∼10 years old, 12.9% for individuals 10∼15 years old, and 8.2% for subjects over 15 years old. There was no significant difference between genders in any group. The seropositive rates in Gwangju and Jeonnam were 57.3% and 32.9% for children under the age of 1 year, 52.5% and 44.3% for children 1∼5 years old, 60.2% and 33.9% among children 5∼10 years old, 14.1% and 9.7% for children 10∼15 years old, and 10.8% and 4.2% for individuals over 15 years old. Conclusion: The results demonstrated the low rates of IgG anti-HAV, particularly among subjects over 10 years old, which suggests the possibility of increasing clinical HAV infection rates among adults in the near future. We should actively prevent the spread of hepatitis A virus. Vaccination is the most effective means of preventing hepatitis A virus transmission among persons at risk for infection. Hepatitis A vaccination is recommended for children who have low IgG anti-HAV seropositive rates. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 67∼73)
{"title":"An Epidemiologic Study on the Seropositive Rate of Hepatitis A Virus in Children of Gwangju and Jeonnam","authors":"Ji Jung, Youngmi Ahn, K. Moon","doi":"10.5223/KJPGN.2011.14.1.67","DOIUrl":"https://doi.org/10.5223/KJPGN.2011.14.1.67","url":null,"abstract":"Purpose: Recently, the incidence of acute hepatitis A has increased nationwide and is related to a low rate of IgG anti-HAV production. To establish effective measures for preventing hepatitis A virus infection, an epidemiologic study on the seroprevalence of anti-HAV is needed. Thus, we investigated the seroprevalence of IgG anti-HAV in children living in Gwangju and Jeonnam. Methods: IgG anti-HAV levels were measured in a total of 1,435 patients who visited Chosun University Hospital between January 2009 and December 2009. Results: The overall seropositve rate was 40.8% (586/1,435). The seropositive rates were 41% among children under the age of 1 year, 49.9% for children 1∼5 years old, 51.1% among individuals 5∼10 years old, 12.9% for individuals 10∼15 years old, and 8.2% for subjects over 15 years old. There was no significant difference between genders in any group. The seropositive rates in Gwangju and Jeonnam were 57.3% and 32.9% for children under the age of 1 year, 52.5% and 44.3% for children 1∼5 years old, 60.2% and 33.9% among children 5∼10 years old, 14.1% and 9.7% for children 10∼15 years old, and 10.8% and 4.2% for individuals over 15 years old. Conclusion: The results demonstrated the low rates of IgG anti-HAV, particularly among subjects over 10 years old, which suggests the possibility of increasing clinical HAV infection rates among adults in the near future. We should actively prevent the spread of hepatitis A virus. Vaccination is the most effective means of preventing hepatitis A virus transmission among persons at risk for infection. Hepatitis A vaccination is recommended for children who have low IgG anti-HAV seropositive rates. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 67∼73)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117343024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-03-01DOI: 10.5223/KJPGN.2011.14.1.59
S. H. Baek, Sang Yong Kim, H. Koh
Purpose: We previously reported that concurrent reactivation of latent Epstein-Barr virus (EBV) in children with hepatitis A virus (HAV) infection is common and EBV reactivation with HAV infection adversely affects the clinical features of hepatitis. However, the incidence of concurrent reactivation was not accurate because the detection of EBV reactivation was based on serologic methods. Therefore, we studied the effects of polymerase chain reaction (PCR)-proven EBV reactivation, thus a more precise concurrence, on acute HAV infection in children. Methods: PCR were conducted in 34 patients, who had enrolled previous study and diagnosed with acute HAV infection between January 2008 and June 2010. Their medical records were reviewed. Results: Among 34 patients with acute HAV infection, 12 patients (35.3%) had EBV reactivation which was proven using serologic and molecular biologic techniques. There were significant differences in the peak levels of AST and ALT between the reactivated and non-reactivated groups (p=0.001 and p＜0.001, respectively). The duration of full recovery from hepatitis was more prolonged in the reactivated group (p＜0.001). Clinical parameters, such as serum protein (p＜0.001) and albumin concentrations (p＜0.001), atypical lymphocyte count (p=0.001), prothrombin time-international normalized ratio (PT-INR, p＜0.001), and splenomegaly (p＜0.001), showed significant differences. The clinical features in the reactivated sub-group ＞10 years of age revealed more liver dysfunction compared to the non-reactivated sub-group. A comparison with a previous study was performed. Conclusion: PCR-proven reactivation of latent EBV in children with HAV infection is common and EBV reactivation with HAV infection adversely affects the clinical features of hepatitis, especially in older children. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 59∼66)
{"title":"Effects of Reactivation of Latent Epstein-Barr Virus Using Polymerase Chain Reaction on Acute Hepatitis A in Children","authors":"S. H. Baek, Sang Yong Kim, H. Koh","doi":"10.5223/KJPGN.2011.14.1.59","DOIUrl":"https://doi.org/10.5223/KJPGN.2011.14.1.59","url":null,"abstract":"Purpose: We previously reported that concurrent reactivation of latent Epstein-Barr virus (EBV) in children with hepatitis A virus (HAV) infection is common and EBV reactivation with HAV infection adversely affects the clinical features of hepatitis. However, the incidence of concurrent reactivation was not accurate because the detection of EBV reactivation was based on serologic methods. Therefore, we studied the effects of polymerase chain reaction (PCR)-proven EBV reactivation, thus a more precise concurrence, on acute HAV infection in children. Methods: PCR were conducted in 34 patients, who had enrolled previous study and diagnosed with acute HAV infection between January 2008 and June 2010. Their medical records were reviewed. Results: Among 34 patients with acute HAV infection, 12 patients (35.3%) had EBV reactivation which was proven using serologic and molecular biologic techniques. There were significant differences in the peak levels of AST and ALT between the reactivated and non-reactivated groups (p=0.001 and p＜0.001, respectively). The duration of full recovery from hepatitis was more prolonged in the reactivated group (p＜0.001). Clinical parameters, such as serum protein (p＜0.001) and albumin concentrations (p＜0.001), atypical lymphocyte count (p=0.001), prothrombin time-international normalized ratio (PT-INR, p＜0.001), and splenomegaly (p＜0.001), showed significant differences. The clinical features in the reactivated sub-group ＞10 years of age revealed more liver dysfunction compared to the non-reactivated sub-group. A comparison with a previous study was performed. Conclusion: PCR-proven reactivation of latent EBV in children with HAV infection is common and EBV reactivation with HAV infection adversely affects the clinical features of hepatitis, especially in older children. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 59∼66)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128934942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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