Pub Date : 2010-03-01DOI: 10.5223/KJPGN.2010.13.1.7
H. Yang, J. Ko, J. Seo
Purpose: Nodular gastritis is a characteristic finding of Helicobacter pylori infection in children. The aim of this study was to evaluate the difference in gene expression in the gastric mucosa of H. pylori-infected and non-infected children, and to analyze the difference in gene expression using cDNA microarray analysis of nodular gastritis caused by H. pylori infection. Methods: Twelve children (6 boys and 6 girls; mean age 9.8 years) who underwent upper gastrointestinal endoscopy and biopsy at Seoul National University Bundang Hospital were included in the study. The subjects were divided into three groups according to the presence of H. pylori infection and nodular gastritis on endoscopic examination. Gastric mucosa tissue was kept at −70 o C and RNA was extracted to perform cDNA microarray analysis in each patient. Results: cDNA microarray analysis in children revealed a clear distinction between H. pylori-infected and non-infected gastric mucosa. Specifically, 182 over-expressed genes and 29 under-expressed genes were identified in H. pylori-infected gastric mucosa compared to non-infected mucosa. H. pylori-infected nodular gastritis revealed different gene expression patterns from H. pylori-infected normal gastric mucosa; five genes were over-expressed and five genes were under-expressed. Conclusion: In the presence of H. pylori infection, gastric mucosa shows distinct differences in gene expression, and nodular gastritis with H. pylori infection in children may be associated with over- or under-expression of some genes. Further studies are required to clarify the host response and the pathogenesis of nodular gastritis in children. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 7∼22)
{"title":"Analysis of Gene Expression in Helicobacter pylori-associated Nodular Gastritis in Children Using Microarray","authors":"H. Yang, J. Ko, J. Seo","doi":"10.5223/KJPGN.2010.13.1.7","DOIUrl":"https://doi.org/10.5223/KJPGN.2010.13.1.7","url":null,"abstract":"Purpose: Nodular gastritis is a characteristic finding of Helicobacter pylori infection in children. The aim of this study was to evaluate the difference in gene expression in the gastric mucosa of H. pylori-infected and non-infected children, and to analyze the difference in gene expression using cDNA microarray analysis of nodular gastritis caused by H. pylori infection. Methods: Twelve children (6 boys and 6 girls; mean age 9.8 years) who underwent upper gastrointestinal endoscopy and biopsy at Seoul National University Bundang Hospital were included in the study. The subjects were divided into three groups according to the presence of H. pylori infection and nodular gastritis on endoscopic examination. Gastric mucosa tissue was kept at −70 o C and RNA was extracted to perform cDNA microarray analysis in each patient. Results: cDNA microarray analysis in children revealed a clear distinction between H. pylori-infected and non-infected gastric mucosa. Specifically, 182 over-expressed genes and 29 under-expressed genes were identified in H. pylori-infected gastric mucosa compared to non-infected mucosa. H. pylori-infected nodular gastritis revealed different gene expression patterns from H. pylori-infected normal gastric mucosa; five genes were over-expressed and five genes were under-expressed. Conclusion: In the presence of H. pylori infection, gastric mucosa shows distinct differences in gene expression, and nodular gastritis with H. pylori infection in children may be associated with over- or under-expression of some genes. Further studies are required to clarify the host response and the pathogenesis of nodular gastritis in children. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 7∼22)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131253025","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 : 2010-03-01DOI: 10.5223/KJPGN.2010.13.1.1
J. Ko
The small bowel is the most difficult intestinal segment to examine. Radiologic tests are mostly insensitive and double-balloon enteroscopy is unsuitable for the younger child. Capsule endoscopy is a novel wireless method of investigation of the small bowel. The primary indications for capsule endoscopy include evaluation of obscure gastrointestinal bleeding, small bowel Crohn's disease, and polyposis syndromes. Capsule endoscopy offers an accurate and effective means of investigating the small bowel in children. Capsule retention is a potential complication of capsule endoscopy. This review provides the indications, safety, and limitations of wireless capsule endoscopy in children. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 1∼6)
{"title":"Capsule Endoscopy in Children","authors":"J. Ko","doi":"10.5223/KJPGN.2010.13.1.1","DOIUrl":"https://doi.org/10.5223/KJPGN.2010.13.1.1","url":null,"abstract":"The small bowel is the most difficult intestinal segment to examine. Radiologic tests are mostly insensitive and double-balloon enteroscopy is unsuitable for the younger child. Capsule endoscopy is a novel wireless method of investigation of the small bowel. The primary indications for capsule endoscopy include evaluation of obscure gastrointestinal bleeding, small bowel Crohn's disease, and polyposis syndromes. Capsule endoscopy offers an accurate and effective means of investigating the small bowel in children. Capsule retention is a potential complication of capsule endoscopy. This review provides the indications, safety, and limitations of wireless capsule endoscopy in children. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 1∼6)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"57 65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122037557","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 : 2010-03-01DOI: 10.5223/KJPGN.2010.13.1.81
Jeong Ok Shim, Seungkoo Lee
Melanosis coli is described as a black or brown discoloration of the mucosa of the colon. Such a discoloration is largely due to pigment granule deposition in macrophages in the colonic mucosa, which arises from anthraquinone-containing laxative abuse. Melanosis coli has usually been reported in the elderly. We present the first case of melanosis coli associated with aloe consumption in a Korean child. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 81∼85)
{"title":"Melanosis Coli Associated with Aloe Consumption in a Child","authors":"Jeong Ok Shim, Seungkoo Lee","doi":"10.5223/KJPGN.2010.13.1.81","DOIUrl":"https://doi.org/10.5223/KJPGN.2010.13.1.81","url":null,"abstract":"Melanosis coli is described as a black or brown discoloration of the mucosa of the colon. Such a discoloration is largely due to pigment granule deposition in macrophages in the colonic mucosa, which arises from anthraquinone-containing laxative abuse. Melanosis coli has usually been reported in the elderly. We present the first case of melanosis coli associated with aloe consumption in a Korean child. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 81∼85)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121727363","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 : 2010-03-01DOI: 10.5223/KJPGN.2010.13.1.23
Eun Hye Lee, H. Yang, J. Ko, J. Seo
목 적: 본 연구에서는 소아의 내시경 시술 전 출혈의 위험성을 예측하는 검사로 혈소판과 혈액 응고 검사의 임상적 의의를 평가하고자 하였다. 방 법: 2004년 3월부터 2009년 12월까지 분당서울대학교병원 소아청소년과 외래 및 입원 환자 중에서 위장관 내시경 검사를 시행 받은 소아청소년 환자의 의무기록과 혈소판 수치 및 혈액 응고 검사 결과들을 후향적으로 분석하였다. 결 과: 총 1,476건의 검사 결과, 혈소판 수치가 정상보다 낮은 경우는 1명이었고, PT INR만이 비정상으로 연장된 경우가 25건(1.7%)이었고, aPTT만 연장된 경우가 132건(9%)이었고, 둘 다 연장된 경우가 5건(0.3%)이었다. aPTT 결과가 비정상이었던 경우에 혈액 응고 인자 검사를 시행한 경우가 14건이었고, 이 중 혈액 응고인자 XII 결핍증으로 진단된 경우가 7명, 폰 빌레블란드 병으로 진단된 경우가 1명, 폰 빌레블란드 병과 혈액 응고 인자 XII 결핍증이 동시에 나타난 경우가 1명, 경증의 A형 혈우병이 의심된 경우가 1명이었으며, 나머지 4명은 정상이었다. 혈액 응고 질환으로 진단된 환자를 포함하여 내시경 시술을 받은 모든 소아 환자에서 의미 있는 출혈 합병증이 나타난 경우는 없었다. 결 론: 소아 내시경 사전 검사로 시행하는 혈액 응고검사에서 일부 이상 소견이 확인되더라도 실제 혈액 응고 질환으로 진단되는 경우는 드물고, 혈액 응고 질환으로 진단된 환자에서조차 내시경 시술에 의한 출혈 합병증이 나타나지 않았다. 따라서 내시경 시술 전에 모든 환자를 대상으로 혈액 응고 검사 및 혈소판 검사를 반드시 시행할 필요는 없을 것으로 여겨지며, 출혈 경향을 나타내는 과거력과 가족력이 있는 소아와 이전에 혈액 응고 검사를 한 번도 시행 받지 않았던 영유아 환자에서 내시경 시술 전에 혈액 응고 검사를 시행하는 것이 바람직할 것이다. 【Purpose: The aim of this study was to assess the benefits of routine pre-endoscopy coagulation screening tests and platelet counts in Korean children. Methods: Between March 2004 and December 2009, children who underwent gastrointestinal endoscopy for the evaluation of various gastrointestinal symptoms were included. All of the subjects included in the study also underwent routine coagulation screening and platelet count determinations prior to endoscopy and biopsy. The clinical records and laboratory tests were retrospectively reviewed in all patients. Results: One hundred sixty-two of 1,476 (11%) patients who underwent endoscopy had abnormal results on pre-screening coagulation tests. Fourteen patients underwent coagulation factor assays due to abnormal clotting results in consecutive tests or due to clinical evidence of a bleeding tendency. Seven patients were diagnosed with factor XII deficiency, one patient was diagnosed with von Willebrand disease, one patient had von Willebrand disease and factor XII deficiency, and one patient was presumed to have mild hemophilia. The remaining 4 patients had normal results with the factor assays. The results of platelet counts were normal with the exception of 1 patient. No patient had significant bleeding during the endoscopic procedures, despite abnormal pre-endoscopic coagulation tests. Conclusion: Routine coagulation screening tests and platelet counts revealed abnormal results in some patients. Most of the patients with abnormal clotting were shown to have a factor XII deficiency, which had no significant associated bleeding tendencies; the other patients were diagnosed with hemophilia or von Willebrand disease. Therefore, although abnormal pre-endoscopic coagulation is not always related to significant bleeding complications, pre-endoscopic coagulation screening may be useful in some children in predicting the risk of bleeding tendency during endoscopic procedures.】
目的:本研究是通过预测小儿内窥镜手术前出血危险性的检查来评价血小板和血液凝固检查的临床意义。方法:对2004年3月至2009年12月盆唐首尔大学医院少儿青少年科外来及住院患者中进行胃肠道内视镜检查的少儿青少年患者义务记录和血小板数值及血液凝结检查结果进行后向分析。结科:共1476件检查结果显示，血小板数值低于正常的有1人，只有PT INR异常延长的有25件(1.7%)，只有aPTT延长的有132件(9%)，两个都延长的有5件(0.3%)。aptt结果不正常的情况下,血液凝固因子检查施行情况14件,其中确诊为金焕基血液凝固因子缺乏症的7名,冯·比尔莱布兰特因病诊断的情况1名,手机比尔莱布兰特并处金焕基血液凝固因子缺乏症如果同时出现,1人,轻微的a型血友病的最后怀疑,这是一名,其余4人情节了。包括被诊断为血液凝固疾病的患者在内，接受内窥镜手术的所有儿童患者都没有出现有意义的出血并发症。结论:在小儿内视镜事前检查的血液凝固检查中，即使确认了部分异常，实际被诊断为血液凝固疾病的情况也很少，就连被诊断为血液凝固疾病的患者也没有出现内视镜手术引起的出血并发症。因此,内窥镜手术前所有患者为对象,血液凝固检查及血小板检查必须施行,也没有必要,被视为表示出血倾向的历史和过去有家族史,小儿和以前血液凝固检查一次也不受到施行的婴幼儿患者血液凝固在内窥镜手术前检查时,实行的是可取的。The aim of this study was to assess The benefits of routine pre-endoscopy coagulation screening tests and platelet counts in Korean children。Methods: Between March 2004 and December 2009, children who underwent gastrointestinal endoscopy for the evaluation of various gastrointestinal symptoms were included。All of the subjects included in the study also underwent routine coagulation screening and platelet count determinations prior to endoscopy and biopsy。clinical records and laboratory tests were retrospectively reviewed in all patients。patients who underwent endoscopy had abnormal Results on pre-screening coagulation tests。Fourteen patients underwent coagulation factor assays due to abnormal clotting results in consecutive tests or due to clinical evidence of a bleeding tendency1 patient was diagnosed with von Willebrand disease, one patient had von Willebrand disease and factor XII deficiency;and one patient was presumed to have mild hemophilia。The remaining 4 patients had normal results with The factor assays。platelet counts were normal with The exception of 1 patient。No patient had significant bleeding during the endoscopic procedures, despite abnormal pre-endoscopic coagulation tests。Conclusion: Routine coagulation screening tests and platelet counts revealed abnormal results in some patients。Most of the patients with abnormal clotting were shown to have a factor XII deficiency, which had no significant associated bleeding tendencies;the other patients were diagnosed with hemophilia or von Willebrand disease。Therefore, although abnormal pre-endoscopic coagulation is not always related to significant bleeding complications，pre-endoscopic coagulation screening may be useful in some children in predicting the risk of bleeding tendency during endoscopic procedures
{"title":"Clinical Significance of Coagulation Screening Tests and Platelet Counts in Children Undergoing Endoscopy","authors":"Eun Hye Lee, H. Yang, J. Ko, J. Seo","doi":"10.5223/KJPGN.2010.13.1.23","DOIUrl":"https://doi.org/10.5223/KJPGN.2010.13.1.23","url":null,"abstract":"목 적: 본 연구에서는 소아의 내시경 시술 전 출혈의 위험성을 예측하는 검사로 혈소판과 혈액 응고 검사의 임상적 의의를 평가하고자 하였다. 방 법: 2004년 3월부터 2009년 12월까지 분당서울대학교병원 소아청소년과 외래 및 입원 환자 중에서 위장관 내시경 검사를 시행 받은 소아청소년 환자의 의무기록과 혈소판 수치 및 혈액 응고 검사 결과들을 후향적으로 분석하였다. 결 과: 총 1,476건의 검사 결과, 혈소판 수치가 정상보다 낮은 경우는 1명이었고, PT INR만이 비정상으로 연장된 경우가 25건(1.7%)이었고, aPTT만 연장된 경우가 132건(9%)이었고, 둘 다 연장된 경우가 5건(0.3%)이었다. aPTT 결과가 비정상이었던 경우에 혈액 응고 인자 검사를 시행한 경우가 14건이었고, 이 중 혈액 응고인자 XII 결핍증으로 진단된 경우가 7명, 폰 빌레블란드 병으로 진단된 경우가 1명, 폰 빌레블란드 병과 혈액 응고 인자 XII 결핍증이 동시에 나타난 경우가 1명, 경증의 A형 혈우병이 의심된 경우가 1명이었으며, 나머지 4명은 정상이었다. 혈액 응고 질환으로 진단된 환자를 포함하여 내시경 시술을 받은 모든 소아 환자에서 의미 있는 출혈 합병증이 나타난 경우는 없었다. 결 론: 소아 내시경 사전 검사로 시행하는 혈액 응고검사에서 일부 이상 소견이 확인되더라도 실제 혈액 응고 질환으로 진단되는 경우는 드물고, 혈액 응고 질환으로 진단된 환자에서조차 내시경 시술에 의한 출혈 합병증이 나타나지 않았다. 따라서 내시경 시술 전에 모든 환자를 대상으로 혈액 응고 검사 및 혈소판 검사를 반드시 시행할 필요는 없을 것으로 여겨지며, 출혈 경향을 나타내는 과거력과 가족력이 있는 소아와 이전에 혈액 응고 검사를 한 번도 시행 받지 않았던 영유아 환자에서 내시경 시술 전에 혈액 응고 검사를 시행하는 것이 바람직할 것이다. 【Purpose: The aim of this study was to assess the benefits of routine pre-endoscopy coagulation screening tests and platelet counts in Korean children. Methods: Between March 2004 and December 2009, children who underwent gastrointestinal endoscopy for the evaluation of various gastrointestinal symptoms were included. All of the subjects included in the study also underwent routine coagulation screening and platelet count determinations prior to endoscopy and biopsy. The clinical records and laboratory tests were retrospectively reviewed in all patients. Results: One hundred sixty-two of 1,476 (11%) patients who underwent endoscopy had abnormal results on pre-screening coagulation tests. Fourteen patients underwent coagulation factor assays due to abnormal clotting results in consecutive tests or due to clinical evidence of a bleeding tendency. Seven patients were diagnosed with factor XII deficiency, one patient was diagnosed with von Willebrand disease, one patient had von Willebrand disease and factor XII deficiency, and one patient was presumed to have mild hemophilia. The remaining 4 patients had normal results with the factor assays. The results of platelet counts were normal with the exception of 1 patient. No patient had significant bleeding during the endoscopic procedures, despite abnormal pre-endoscopic coagulation tests. Conclusion: Routine coagulation screening tests and platelet counts revealed abnormal results in some patients. Most of the patients with abnormal clotting were shown to have a factor XII deficiency, which had no significant associated bleeding tendencies; the other patients were diagnosed with hemophilia or von Willebrand disease. Therefore, although abnormal pre-endoscopic coagulation is not always related to significant bleeding complications, pre-endoscopic coagulation screening may be useful in some children in predicting the risk of bleeding tendency during endoscopic procedures.】","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132326910","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 : 2010-03-01DOI: 10.5223/KJPGN.2010.13.1.58
J. Seo, Seong Heon Kim, Sang Geon Jeong, J. Park
목 적: 소아에서 급성 췌장염은 췌장을 침범하는 가장 흔한 질환으로 최근 발생 빈도가 증가하고 있다. 이 질환에 대한 보고가 많지 않아 임상적 특징을 알아보고자 본 연구를 시행하였다. 방 법: 1996년 1월부터 2007년 6월까지 부산대학교병원 소아청소년과에서급성 췌장염을 진단받았던 41명을 대상으로 의무 기록을 후향적으로 분석하였다. 급성 췌장염의 진단은 임상 소견, 혈청 amylase 및 lipase치의 상승 및 방사선 소견이 합당한 경우로 하였으며, 이 질환의 원인, 임상 소견 및 경과, 중증도 판정, 치료등을 분석하였다. 결 과: 남자가 20명, 여자가 21명이었고, 진단 시 평균 나이는 8.7 ${pm}$ 4.5세였다. 증상 발현에서 진단까지의 기간은 7.0 ${pm}$ 7.4일이었고, 내원 당시 주증상은 복통 37예(90.2%), 구토 24예(58.5%), 발열과 경구 섭취 불량이 각각 6예(14.6%)였다. 췌장염의 원인으로는 원인불명 22예(53.7%), 총담관낭 9예(22.0%), 췌담관 합류 이상 3예(7.3%), Henoch-schonlein 자반병과 유행성 이하선염이 각각 2예(4.9%)였고 그 외 분할췌장, 용혈 요독 증후군, 외상, 바이러스성 간염, 약물(L-asparaginase)이 각각 1예였다. 간질성 췌장염이 36예(87.8%), 괴사성 췌장염이 5예(12.2%)였고 재발성 췌장염이 4예(9.8%)였다. 방사선학적 소견은 췌종대 18예(43.9%), 췌장 주위 액체저류 12예(29.3%), 복수 10예(24.4%), 췌장 주위 지방괴사 5예(12.2%)였다. 진단 당시 혈청 amylase치는 535.3 ${pm}$ 553.2 U/L, lipase치는 766.2 ${pm}$ 723.6 U/L였고, 혈청 amylase 및 lipase치가 1주 내에 정상으로 회복한 경우가 각각 22예(59.5%), 14예(42.4%)였고, lipase치가 4주 이후에 정상화된 경우가 11예(26.8%)였다. 중증도 판정기준인 APACHE II, Ranson 기준, Balthazar 점수에서 대부분 경증에 해당하였다. 금식과 총정맥 영양이 전례에서 시행되었고, 금식 기간은 평균 13.1 ${pm}$ 17.0일, 총정맥 영양 기간은 평균 8.2 ${pm}$ 13.7일이었다. Octreotide는 8명(19.5%), Gabexate mesilate는 4명(9.8%)에서 투여되었고, 4명에서 조임근절개술이 시행되었다. 합병증으로는 복수(32.3%), 패혈증(16.1%), 거짓낭(12.9%), 신장장애(12.9%), 흉수, 십이지장 궤양, 혈성복막(6.5%) 등이 있었다. 34명이 완전 회복되었고, 2명(4.9%)이 췌장염의 합병증으로 사망하였다. 결 론: 소아 급성 췌장염은 드문 질환이 아니며 성인과는 다른 원인, 증상 및 경과를 보였다. 대부분 환자들이 수 일 이내 완전 회복되지만 아직 사망률이 높으므로 조기 진단과 발병 초기에 중증도를 평가하여 적절한 치료 및 합병증 관리가 중요하다. 【Purpose: Since there are few studies involving acute pancreatitis in children, we reviewed our experience with this medical condition to describe the clinical features. Methods: A retrospective analysis was conducted by reviewing the medical records of 41 patients with AP who were admitted to the Department of Pediatrics of Pusan National University Hospital between January 1996 and June 2007. Results: Twenty males and 21 females (mean age, 8.7 ${pm}$ 4.5 years) were included. In 22 patients (53.7%), no definitive causes were found. The most common etiologies were choledochal cysts (22.0%). Necrotizing pancreatitis was diagnosed in 5 patients (12.2%), and recurrent acute pancreatitis in 4 patients (9.8%). CT findings included pancreatic swelling (43.9%), peripancreatic fluid collection (29.3%), ascites (24.4%), and peripancreatic fat necrosis (12.2%). Serum amylase and lipase levels at diagnosis were 535.3 ${pm}$ 553.2 and 766.2 ${pm}$ 723.6 U/L, respectively, and were normalized within 1 week in 22 and 14 patients, respectively. On the basis of the Balthazar scale, 2 patients were diagnosed with severe AP. In 4 patients (9.8%), a surgical procedure was indicated. Major complications included ascites (32.3%), sepsis (16.1%), and pseudocyst and renal impairments (12.9%). Two patients died from multi-organ failure. Conclusion: The etiologies of AP in children are varied. Most children have a single episode and a self-limited course. However, AP of childhood still carries significant morbidity and mor
目积:在小儿急性胰腺炎是侵犯胰腺最常见的疾病，最近发生频率增加。由于对该疾病的报告不多，为了了解临床特征，进行了本研究。方法:以1996年1月至2007年6月在釜山大学医院少儿青少年科被诊断为急性胰腺炎的41人为对象，对义务记录进行了后向分析。急性胰腺炎的诊断是临床诊断、血清amylase及lipase值上升及放射线诊断适当的情况，并对该疾病的原因、临床诊断及经过、重症判定、治疗等进行了分析。结果:男性20名，女性21名，诊断时平均年龄为8.7美元{pm} 4.5美元。从症状表现到诊断的时间为7.0美元(pm) 7.4天，来院时的主要症状为腹痛37例(90.2%)、呕吐24例(58.5%)、发烧和口服不良6例(14.6%)。胰腺炎的原因不明有22例(53.7%)、总胆管囊9例(22.0%)、胰胆管汇合以上3例(7.3%)、Henoch-schonlein子病和流行性腮腺炎2例(4.9%)，此外还有胰腺分割、溶血尿毒症候群、外伤、病毒性肝炎、药物(L-asparaginase) 1例。间质性胰腺炎36例(87.8%)，坏死性胰腺炎5例(12.2%)，再发性胰腺炎4例(9.8%)。放射线学诊断为胰腺瘤18例(43.9%)、胰腺周围液体底流12例(29.3%)、腹水10例(24.4%)、胰腺周围脂肪坏死5例(12.2%)。诊断当时血清amylase值为535.3美元{pm}$ 553.2 U/L, lipase值为776.2美元{pm}$ 723.6 U/L，血清amylase和lipase值在1周内恢复正常的情况分别为22例(59.5%)和14例(42.4%)，lipase值在4周后恢复正常的情况为11例(26.8%)。在重症判定标准APACHE II、Ranson标准和Balthazar分数中，大部分属于轻微症状。禁食和静脉营养在前例中实行，禁食时间平均为13.1美元{pm} 17.0美元，静脉营养时间平均为8.2美元{pm} 13.7美元。Octreotide有8人(19.5%)使用，Gabexate mesilate有4人(9.8%)使用，4人使用了松紧术。并发症是复仇”(32.3%),败血症(16.1%)、假囊(12.9%)、新疆障碍(12.9%)、休谟、十二指肠溃疡、血城濮刚(6.5%)等。34人完全康复，2人(4.9%)死于胰腺炎并发症。结论:小儿急性胰腺炎并不是罕见的疾病，有与成人不同的原因，症状及经过。大部分患者虽然在数天内完全恢复，但死亡率仍然很高，因此早期诊断和发病初期评价重症程度，适当的治疗及并发症管理非常重要。【Purpose: Since there are few studies involving acute pancreatitis in children, we reviewed our experience with this medical condition to describe the clinical features】methods:A retrospective analysis was conducted by reviewing the medical records of 41 patients with AP who were admitted to the Department of Pediatrics of Pusan National University Hospital between January1996 and june 2007。Results: Twenty males and 21 females (mean age, 8.7 ${pm} 4.5 years) were included。In 22 patients (53.7%)， no definitive causes were found。The most common etiologies were choledochal cysts(22.0%)。Necrotizing pancreatitis was diagnosed in 5 patients (12.2%)， and recurrent acute pancreatitis in 4 patients(9.8%)。CT findings included pancreatic swelling (43.9%)， peripancreatic fluid collection (29.3%)， ascites (24.4%)， and peripancreatic fat necrosis(12.2%)。Serum amylase and lipase levels at diagnosis were 535.3 ${pm} 553.2 and 766.2 ${pm} 723.6 U/L, respectively, and were normalized within 1 week in 22 and 14 patients, respectively。On the basis of the Balthazar scale, 2 patients were diagnosed with severe AP. In 4 patients (9.8%)， a surgical procedure was indicated。Major complications included ascites (32.3%)， sepsis (16.1%)， and pseudocyst and renal impairments(12.9%)。Two patients died from multi-organ failure。Conclusion: The etiologies of AP in children are varied。Most children have a single episode and a self-limited course。However, AP of childhood still carries significant morbidity and mortality。Early diagnosis, appropriate treatment according to disease severity, and management of complications are important;
{"title":"Clinical Features of Acute Pancreatitis in Children","authors":"J. Seo, Seong Heon Kim, Sang Geon Jeong, J. Park","doi":"10.5223/KJPGN.2010.13.1.58","DOIUrl":"https://doi.org/10.5223/KJPGN.2010.13.1.58","url":null,"abstract":"목 적: 소아에서 급성 췌장염은 췌장을 침범하는 가장 흔한 질환으로 최근 발생 빈도가 증가하고 있다. 이 질환에 대한 보고가 많지 않아 임상적 특징을 알아보고자 본 연구를 시행하였다. 방 법: 1996년 1월부터 2007년 6월까지 부산대학교병원 소아청소년과에서급성 췌장염을 진단받았던 41명을 대상으로 의무 기록을 후향적으로 분석하였다. 급성 췌장염의 진단은 임상 소견, 혈청 amylase 및 lipase치의 상승 및 방사선 소견이 합당한 경우로 하였으며, 이 질환의 원인, 임상 소견 및 경과, 중증도 판정, 치료등을 분석하였다. 결 과: 남자가 20명, 여자가 21명이었고, 진단 시 평균 나이는 8.7 ${pm}$ 4.5세였다. 증상 발현에서 진단까지의 기간은 7.0 ${pm}$ 7.4일이었고, 내원 당시 주증상은 복통 37예(90.2%), 구토 24예(58.5%), 발열과 경구 섭취 불량이 각각 6예(14.6%)였다. 췌장염의 원인으로는 원인불명 22예(53.7%), 총담관낭 9예(22.0%), 췌담관 합류 이상 3예(7.3%), Henoch-schonlein 자반병과 유행성 이하선염이 각각 2예(4.9%)였고 그 외 분할췌장, 용혈 요독 증후군, 외상, 바이러스성 간염, 약물(L-asparaginase)이 각각 1예였다. 간질성 췌장염이 36예(87.8%), 괴사성 췌장염이 5예(12.2%)였고 재발성 췌장염이 4예(9.8%)였다. 방사선학적 소견은 췌종대 18예(43.9%), 췌장 주위 액체저류 12예(29.3%), 복수 10예(24.4%), 췌장 주위 지방괴사 5예(12.2%)였다. 진단 당시 혈청 amylase치는 535.3 ${pm}$ 553.2 U/L, lipase치는 766.2 ${pm}$ 723.6 U/L였고, 혈청 amylase 및 lipase치가 1주 내에 정상으로 회복한 경우가 각각 22예(59.5%), 14예(42.4%)였고, lipase치가 4주 이후에 정상화된 경우가 11예(26.8%)였다. 중증도 판정기준인 APACHE II, Ranson 기준, Balthazar 점수에서 대부분 경증에 해당하였다. 금식과 총정맥 영양이 전례에서 시행되었고, 금식 기간은 평균 13.1 ${pm}$ 17.0일, 총정맥 영양 기간은 평균 8.2 ${pm}$ 13.7일이었다. Octreotide는 8명(19.5%), Gabexate mesilate는 4명(9.8%)에서 투여되었고, 4명에서 조임근절개술이 시행되었다. 합병증으로는 복수(32.3%), 패혈증(16.1%), 거짓낭(12.9%), 신장장애(12.9%), 흉수, 십이지장 궤양, 혈성복막(6.5%) 등이 있었다. 34명이 완전 회복되었고, 2명(4.9%)이 췌장염의 합병증으로 사망하였다. 결 론: 소아 급성 췌장염은 드문 질환이 아니며 성인과는 다른 원인, 증상 및 경과를 보였다. 대부분 환자들이 수 일 이내 완전 회복되지만 아직 사망률이 높으므로 조기 진단과 발병 초기에 중증도를 평가하여 적절한 치료 및 합병증 관리가 중요하다. 【Purpose: Since there are few studies involving acute pancreatitis in children, we reviewed our experience with this medical condition to describe the clinical features. Methods: A retrospective analysis was conducted by reviewing the medical records of 41 patients with AP who were admitted to the Department of Pediatrics of Pusan National University Hospital between January 1996 and June 2007. Results: Twenty males and 21 females (mean age, 8.7 ${pm}$ 4.5 years) were included. In 22 patients (53.7%), no definitive causes were found. The most common etiologies were choledochal cysts (22.0%). Necrotizing pancreatitis was diagnosed in 5 patients (12.2%), and recurrent acute pancreatitis in 4 patients (9.8%). CT findings included pancreatic swelling (43.9%), peripancreatic fluid collection (29.3%), ascites (24.4%), and peripancreatic fat necrosis (12.2%). Serum amylase and lipase levels at diagnosis were 535.3 ${pm}$ 553.2 and 766.2 ${pm}$ 723.6 U/L, respectively, and were normalized within 1 week in 22 and 14 patients, respectively. On the basis of the Balthazar scale, 2 patients were diagnosed with severe AP. In 4 patients (9.8%), a surgical procedure was indicated. Major complications included ascites (32.3%), sepsis (16.1%), and pseudocyst and renal impairments (12.9%). Two patients died from multi-organ failure. Conclusion: The etiologies of AP in children are varied. Most children have a single episode and a self-limited course. However, AP of childhood still carries significant morbidity and mor","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128497700","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 : 2010-03-01DOI: 10.5223/KJPGN.2010.13.1.36
H. S. Kim, Y. Hong, J. We, J. Park
목 적: 소아에서 기능성 변비는 흔히 볼 수 있는 질환이지만 임상적 경과 및 치료 반응에 대한 대단위 연구가 없는 실정이다. 이 질환의 임상적 특징과 치료에 영향을 미치는 인자들을 알아보고자 본 연구를 시행하였다. 방 법: 1998년 1월부터 2007년 12월까지 부산대학교 병원 소아과에서 변비로 치료를 받았던 500명 중 ...
{"title":"Factors Contributing to Treatment Outcome of Functional Constipation in Children","authors":"H. S. Kim, Y. Hong, J. We, J. Park","doi":"10.5223/KJPGN.2010.13.1.36","DOIUrl":"https://doi.org/10.5223/KJPGN.2010.13.1.36","url":null,"abstract":"목 적: 소아에서 기능성 변비는 흔히 볼 수 있는 질환이지만 임상적 경과 및 치료 반응에 대한 대단위 연구가 없는 실정이다. 이 질환의 임상적 특징과 치료에 영향을 미치는 인자들을 알아보고자 본 연구를 시행하였다. 방 법: 1998년 1월부터 2007년 12월까지 부산대학교 병원 소아과에서 변비로 치료를 받았던 500명 중 ...","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128908152","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 : 2010-03-01DOI: 10.5223/KJPGN.2010.13.1.30
T. Lee, Yoo Rha Hong, G. Yeon, J. W. Lee, J. Park
Purpose: Infectious ileocecitis is an infection confined to the ileocecal area and one of the most common causes of pediatric abdominal pai n. This study was performed to demonstrate the clinical features of infectious ileocecitis in children. Methods: The medical records and radiologic findings of 37 patients with ileocecitis diagnosed by ultrasonography and/or computed tomography, who were admitted to Pusan National University Hospital from January 2004 and July 2008, were reviewed retrospectively. Viral gastroenteritis and secondary ileocecitis were excluded. Results: The mean age of the patients was 4.8±3.4 years. One-half of the patients were preschool children. The chief complaint was abdominal pain (75.7%), diarrhea (10.8%), and vomiting (8.1%). Accompanying symptoms were fever (56.8%), vomiting (21.6%), and diarrhea (16.2%). The mean duration of abdominal pain, fever, diarrhea, and vomiting was 3.8±2.1, 3.0±1.9, 3.4±1.9, and 2.4±2.3 days, respectively. The frequency of diarrhea and vomiting was 5.8±2.2 and 4.0±2.8 per day, respectively. Diagnosis was made by abdominal ultrasonography in 22 patients (59.5%), abdominal CT in 2 patients (5.4%), and both modalities in 13 patients (35.1%). Besides the radiologic finding of thickening of the bowel wall, mesenteric lymphadenitis (59.5%), ascites (5.4%), and both mesenteric lymphadenitis and ascites (16.2%) were revealed. The mean duration of illness was 7.5±5.0 days. There were no specific laboratory findings, and culture studies with stool or blood were negative. All of the patients recovered completely without specific treatment. Conclusion: Infectious ileocecitis has acute appendicitis-mimicking symptoms, but is self-limited within a few days, thus unnecessary treatment and work-up is avoided. However, distinguishing infectious ileocecitis from appendicitis, inflammatory bowel disease, and mesenteric lymphadenitis is important. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 30∼35)
{"title":"Clinical Features of Infectious Ileocecitis in Children","authors":"T. Lee, Yoo Rha Hong, G. Yeon, J. W. Lee, J. Park","doi":"10.5223/KJPGN.2010.13.1.30","DOIUrl":"https://doi.org/10.5223/KJPGN.2010.13.1.30","url":null,"abstract":"Purpose: Infectious ileocecitis is an infection confined to the ileocecal area and one of the most common causes of pediatric abdominal pai n. This study was performed to demonstrate the clinical features of infectious ileocecitis in children. Methods: The medical records and radiologic findings of 37 patients with ileocecitis diagnosed by ultrasonography and/or computed tomography, who were admitted to Pusan National University Hospital from January 2004 and July 2008, were reviewed retrospectively. Viral gastroenteritis and secondary ileocecitis were excluded. Results: The mean age of the patients was 4.8±3.4 years. One-half of the patients were preschool children. The chief complaint was abdominal pain (75.7%), diarrhea (10.8%), and vomiting (8.1%). Accompanying symptoms were fever (56.8%), vomiting (21.6%), and diarrhea (16.2%). The mean duration of abdominal pain, fever, diarrhea, and vomiting was 3.8±2.1, 3.0±1.9, 3.4±1.9, and 2.4±2.3 days, respectively. The frequency of diarrhea and vomiting was 5.8±2.2 and 4.0±2.8 per day, respectively. Diagnosis was made by abdominal ultrasonography in 22 patients (59.5%), abdominal CT in 2 patients (5.4%), and both modalities in 13 patients (35.1%). Besides the radiologic finding of thickening of the bowel wall, mesenteric lymphadenitis (59.5%), ascites (5.4%), and both mesenteric lymphadenitis and ascites (16.2%) were revealed. The mean duration of illness was 7.5±5.0 days. There were no specific laboratory findings, and culture studies with stool or blood were negative. All of the patients recovered completely without specific treatment. Conclusion: Infectious ileocecitis has acute appendicitis-mimicking symptoms, but is self-limited within a few days, thus unnecessary treatment and work-up is avoided. However, distinguishing infectious ileocecitis from appendicitis, inflammatory bowel disease, and mesenteric lymphadenitis is important. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 30∼35)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115709611","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 : 2010-03-01DOI: 10.5223/KJPGN.2010.13.1.75
Kun-Song Lee, Ji Yun Park, Jong Seok Oh, I. Seong, K. Han, Young Seok Lee
Intestinal duplication cysts are characterized by the attachment to some part of the gastrointestinal tract with which a blood supply is shared, and have an epithelial lining resembling some part of the alimentary tract. A 15-month-old female was admitted to our hospital with cyclic irritability, vomiting, and blood-tinged stool. The results of an ultrasound showed an ileocolic intussusception and a 1.3 cm cystic mass had double-wall sign and a Y-configuration with an adjacent ileal loop. She had a past history of two ileocolic intussusceptions. The cystic mass was considered to be a pathologic lead point, so resection and end-to-end anastomosis was performed. The gross and histologic evaluation of the specimen demonstrated a 2.4×2.4 cm cystic mass containing yellow mucoid fluid and the cyst wall was lined with intestinal and gastric mucosa and enclosed by a layer of muscle, which was shared with the adjacent ileum. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 75∼80)
{"title":"A Case of Intestinal Duplication Cyst Identified as Pathological Lead Point in a Child with Recurrent Intussusception","authors":"Kun-Song Lee, Ji Yun Park, Jong Seok Oh, I. Seong, K. Han, Young Seok Lee","doi":"10.5223/KJPGN.2010.13.1.75","DOIUrl":"https://doi.org/10.5223/KJPGN.2010.13.1.75","url":null,"abstract":"Intestinal duplication cysts are characterized by the attachment to some part of the gastrointestinal tract with which a blood supply is shared, and have an epithelial lining resembling some part of the alimentary tract. A 15-month-old female was admitted to our hospital with cyclic irritability, vomiting, and blood-tinged stool. The results of an ultrasound showed an ileocolic intussusception and a 1.3 cm cystic mass had double-wall sign and a Y-configuration with an adjacent ileal loop. She had a past history of two ileocolic intussusceptions. The cystic mass was considered to be a pathologic lead point, so resection and end-to-end anastomosis was performed. The gross and histologic evaluation of the specimen demonstrated a 2.4×2.4 cm cystic mass containing yellow mucoid fluid and the cyst wall was lined with intestinal and gastric mucosa and enclosed by a layer of muscle, which was shared with the adjacent ileum. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 75∼80)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123368798","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 : 2009-11-01DOI: 10.5223/KJPGN.2009.12.SUPPL1.S1
J. Moon
2007 Korean National Growth Charts were published by The Korean Pediatric Society and Korea Centers for Disease Control and Prevention in October, 2007. These Growth Charts are composed of Growth Curves and Tables, which are based on the principles such as pooling data of the different generations and application of LMS method. In this review, several tips of application using these new charts are summarized with points of view both in clinical and research fields. [Korean J Pediatr Gastroenterol Nutr 2009; 12(Suppl 1): 1∼5]
{"title":"Application of 2007 Korean National Growth Charts: Growth Curves and Tables","authors":"J. Moon","doi":"10.5223/KJPGN.2009.12.SUPPL1.S1","DOIUrl":"https://doi.org/10.5223/KJPGN.2009.12.SUPPL1.S1","url":null,"abstract":"2007 Korean National Growth Charts were published by The Korean Pediatric Society and Korea Centers for Disease Control and Prevention in October, 2007. These Growth Charts are composed of Growth Curves and Tables, which are based on the principles such as pooling data of the different generations and application of LMS method. In this review, several tips of application using these new charts are summarized with points of view both in clinical and research fields. [Korean J Pediatr Gastroenterol Nutr 2009; 12(Suppl 1): 1∼5]","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126267236","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 : 2009-11-01DOI: 10.5223/KJPGN.2009.12.SUPPL1.S111
S. Bae
Constipation is one of the most common symptoms that a child visits pediatrician. The general approach to the child with functional constipation includes the following steps; disimpaction, maintenance and withdrawal of medication. There are many drugs which can be applied to children; osmotic agents (lactulose, sorbitol, magnesium hydroxide/citrate, polyethylene glycol with/without electrolytes, sodium phosphate, glycerin), stimulants (senna, bisacodyl, caster oil), lubricant (mineral oil), bulking agent (psyllium, cellulose, glucomannan). At each stage of treatment, one or some of these drug can be applied to the purpose. The author tries to summarize recent studies on drugs for constipation in child, and finally introduces new dugs for constipation which is under investigation. [Korean J Pediatr Gastroenterol Nutr 2009; 12(Suppl 1): 111∼117]
{"title":"Medications for Child with Chronic Constipation","authors":"S. Bae","doi":"10.5223/KJPGN.2009.12.SUPPL1.S111","DOIUrl":"https://doi.org/10.5223/KJPGN.2009.12.SUPPL1.S111","url":null,"abstract":"Constipation is one of the most common symptoms that a child visits pediatrician. The general approach to the child with functional constipation includes the following steps; disimpaction, maintenance and withdrawal of medication. There are many drugs which can be applied to children; osmotic agents (lactulose, sorbitol, magnesium hydroxide/citrate, polyethylene glycol with/without electrolytes, sodium phosphate, glycerin), stimulants (senna, bisacodyl, caster oil), lubricant (mineral oil), bulking agent (psyllium, cellulose, glucomannan). At each stage of treatment, one or some of these drug can be applied to the purpose. The author tries to summarize recent studies on drugs for constipation in child, and finally introduces new dugs for constipation which is under investigation. [Korean J Pediatr Gastroenterol Nutr 2009; 12(Suppl 1): 111∼117]","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130675517","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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