97 results on '"Jung Ok Shim"'
Search Results
2. Comparison of endoscopic healing and durability between infliximab originator and CT-P13 in pediatric patients with inflammatory bowel disease
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Eun Sil Kim, Sujin Choi, Byung-Ho Choe, Sowon Park, Yeoun Joo Lee, Sang Jun Sohn, Soon Chul Kim, Ki Soo Kang, Kunsong Lee, Jung Ok Shim, Yu Bin Kim, Suk Jin Hong, Yoo Min Lee, Hyun Jin Kim, So Yoon Choi, Ju Young Kim, Yoon Lee, Ji-Sook Park, Jae Young Kim, Dae Yong Yi, Ji Hyuk Lee, Kwang-Hae Choi, Hyo-Jeong Jang, In Sook Jeong, and Ben Kang
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children ,inflammatory bowel disease ,CT-P13 ,endoscopic healing ,durability ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Background and aimsFavourable clinical data were published on the efficacy of CT-P13, the first biosimilar of infliximab (IFX), in pediatric inflammatory bowel disease (IBD); however, few studies have compared the effect on endoscopic healing (EH) and drug retention rate between the IFX originator and CT-P13. Therefore, we aimed to compare EH and the drug retention rate between the IFX originator and CT-P13.MethodsChildren with Crohn’s disease (CD) and ulcerative colitis (UC)/IBD-unclassified (IBD-U) at 22 medical centers were enrolled, with a retrospective review conducted at 1-year and last follow-up. Clinical remission, EH and drug retention rate were evaluated.ResultsWe studied 416 pediatric patients with IBD: 77.4% had CD and 22.6% had UC/IBD-U. Among them, 255 (61.3%) received the IFX originator and 161 (38.7%) received CT-P13. No statistically significant differences were found between the IFX originator and CT-P13 in terms of corticosteroid-free remission and adverse events. At 1-year follow-up, EH rates were comparable between them (CD: P=0.902, UC: P=0.860). The estimated cumulative cessation rates were not significantly different between the two groups. In patients with CD, the drug retention rates were 66.1% in the IFX originator and 71.6% in the CT-P13 group at the maximum follow-up period (P >0.05). In patients with UC, the drug retention rates were 49.8% in the IFX originator and 56.3% in the CT-P13 group at the maximum follow-up period (P >0.05).ConclusionsThe IFX originator and CT-P13 demonstrated comparable therapeutic response including EH, clinical remission, drug retention rate and safety in pediatric IBD.
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- 2024
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3. Development and Validation of a Machine Learning–Based Prediction Model for Detection of Biliary Atresia
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Ho Jung Choi, Yeong Eun Kim, Jung-Man Namgoong, Inki Kim, Jun Sung Park, Woo Im Baek, Byong Sop Lee, Hee Mang Yoon, Young Ah Cho, Jin Seong Lee, Jung Ok Shim, Seak Hee Oh, Jin Soo Moon, Jae Sung Ko, Dae Yeon Kim, and Kyung Mo Kim
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Biliary Atresia ,Neonatal Cholestasis ,Prediction ,Machine Learning ,XGBoost ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background and Aims: Biliary atresia is a rare and devastating bile duct disease that occurs during the neonatal period. Timely identification and prompt surgical intervention is critical for improving the outcome. The aim of the study was to develop a new machine learning–based prediction model for the detection of biliary atresia. Methods: Neonates aged
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- 2023
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4. Gut Bacterial Dysbiosis in Irritable Bowel Syndrome: a Case-Control Study and a Cross-Cohort Analysis Using Publicly Available Data Sets
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Gun-Ha Kim, Kihyun Lee, and Jung Ok Shim
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gastrointestinal ,microbiota ,16S rRNA ,diversity ,microbiota-gut-brain axis ,dysbiosis ,Microbiology ,QR1-502 - Abstract
ABSTRACT Research on the gut microbiota in irritable bowel syndrome (IBS) shows discordant results due to inconsistent study designs or small sample sizes. This study aimed to characterize how gut microbiota in IBS patients differs from that in healthy controls by performing a case-control study and cross- and mega-cohort analysis. Multiple publicly shared data sets were examined by using a unified analytical approach. We performed 16S rRNA gene (V3-4) sequencing and taxonomic profiling of the gut bacterial communities. Fecal samples from children with IBS (n = 19) and age-matched healthy controls (n = 24) were used. Next, we analyzed 10 separate data sets using a unified data-processing and analytical approach. In total, 567 IBS patients and 487 healthy controls were examined. In our data sets, no significant differences existed in stool α-diversity between IBS patients and healthy controls. After combining all the data sets using a unified data-processing method, we found significantly lower α-diversity in IBS patients than in healthy controls. In addition, the relative abundance of 21 bacterial species differed between the IBS patients and healthy participants. Although the causal relationship is uncertain, gut bacterial dysbiosis is associated with IBS. Further functional studies are needed to assess whether the change in gut microorganisms contributes to the development of IBS. IMPORTANCE Research on the gut bacteria in irritable bowel syndrome (IBS) shows discordant results due to inconsistent study designs or small sample sizes. To overcome these issues, we analyzed microbiota of 567 IBS patients and 487 healthy people from 10 shared data sets using a unified method. We demonstrated that gut bacteria are less diverse in IBS patients than in healthy people. In addition, the abundance of 21 bacterial species is different between the two groups. Altered bacterial balance, called dysbiosis, has been reported in several disease states. Although the causal relationship is uncertain, gut bacterial dysbiosis also seems to be associated with IBS.
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- 2023
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5. Clinical characteristics of neonatal cholestasis in a tertiary hospital and the development of a novel prediction model for mortality
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Ho Jung Choi, Inki Kim, Hye-Jin Lee, Hyun Ju Oh, Mi Kyoung Ahn, Woo Im Baek, Yeong Eun Kim, Seak Hee Oh, Byong Sop Lee, Jung-Man Namgoong, Dae Yeon Kim, Eun Joo Lee, Jung Ok Shim, Jae Sung Ko, and Kyung Mo Kim
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Neonatal cholestasis ,Aetiology ,Mortality ,Prediction model ,Medicine ,Medicine (General) ,R5-920 - Abstract
Summary: Background: Few studies have described the aetiologies of neonatal cholestasis, and the overall neonatal cholestasis-related mortality (NCM) rate is unclear. We investigated the aetiology and outcome of neonatal cholestasis in a tertiary hospital and developed an NCM prediction model for these patients. Methods: Patients aged 1.0 mg/dL were retrospectively screened. Diagnostic and laboratory data during the 8-week follow-up period after enrolment between 2005 and 2020 were extracted digitally, and medical charts were reviewed manually by clinicians. Logistic regression was used to derive a prediction model for the 1-year mortality outcome of neonatal cholestasis, and performance evaluation and external validation were conducted for the NCM prediction model. Findings: We enrolled 4028 neonates with DB of >1.0 mg/dL at least once. Prematurity and birth injury (35.4%), complex heart anomalies (18.6%), liver diseases (11.4%), and gastrointestinal anomalies (9.2%) were the most common aetiologies; 398 (9.9%) patients died before one year of age. The peak value of DB was positively correlated to the 1-year mortality rate. In the multivariate analysis, simple laboratory indices, including platelet, prothrombin time, aspartate aminotransferase, albumin, direct bilirubin, creatinine, and C-reactive protein, were independent predictors of 1-year mortality outcome of complete-case subjects. Using these laboratory indices, a logistic regression-based NCM prediction model was constructed. It showed acceptable performances on discrimination (area under the curve, 0.916), calibration (slope, 1.04) and Brier scoring (0.072). The external validation of the sample (n = 920) from two other centres also revealed similar performance profiles of the NCM model. Interpretation: Various aetiologies of neonatal cholestasis were identified in a tertiary hospital, resulting in unfavourable outcomes of a large proportion. The NCM prediction model may have the potential to help clinicians to be aware of high-risk neonatal cholestasis.
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- 2022
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6. Human milk oligosaccharides as immunonutrition key in early life
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Jung Ok Shim
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Pediatrics ,RJ1-570 - Published
- 2022
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7. Recent advance in very early-onset inflammatory bowel disease
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Jung Ok Shim
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Very early-onset inflammatory bowel disease ,Child ,Infant ,Mutation ,Medicine ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Recent studies on pediatric inflammatory bowel disease (IBD) have revealed that early-onset IBD has distinct phenotypic differences compared with adult-onset IBD. In particular, very early-onset IBD (VEO-IBD) differs in many aspects, including the disease type, location of the lesions, disease behavior, and genetically attributable risks. Neonatal or infantile-onset IBD develops in less than 1% of pediatric patients. Children with infantile-onset IBD have high rates of affected first-degree relatives and severe disease course. The suspicion of a monogenic cause of VEO-IBD was first confirmed by the discovery of mutations in the genes encoding the interleukin 10 (IL-10) receptors that cause impaired IL-10 signaling. Patients with such mutations typically presented with perianal fistulae, shows a poor response to medical management, and require early surgical interventions in the first year of life. To date, 60 monogenic defects have been identified in children with IBD-like phenotypes. The majority of monogenic defects presents before 6 years of age, and many present before 1 year of age. Next generation sequencing could become an important diagnostic tool in children with suspected genetic defects especially in children with VEO-IBD with severe disease phenotypes. VEO-IBD is a phenotypically and genetically distinct disease entity from adult-onset or older pediatric IBD.
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- 2019
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8. Clinical practice guideline for the diagnosis and treatment of pediatric obesity: recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition
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Dae Yong Yi, Soon Chul Kim, Ji Hyuk Lee, Eun Hye Lee, Jae Young Kim, Yong Joo Kim, Ki Soo Kang, Jeana Hong, Jung Ok Shim, Yoon Lee, Ben Kang, Yeoun Joo Lee, Mi Jin Kim, Jin Soo Moon, Hong Koh, JeongAe You, Young-Sook Kwak, Hyunjung Lim, and Hye Ran Yang
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guideline ,obesity ,diagnosis ,treatment ,child ,Pediatrics ,RJ1-570 - Abstract
The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery.
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- 2019
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9. The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects
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Jae Hyun Kim, Sungha Yun, Seung-sik Hwang, Jung Ok Shim, Hyun Wook Chae, Yeoun Joo Lee, Ji Hyuk Lee, Soon Chul Kim, Dohee Lim, Sei Won Yang, Kyungwon Oh, and Jin Soo Moon
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Growth ,Growth charts ,Child ,Adolescent ,Korea ,Pediatrics ,RJ1-570 - Abstract
Growth charts are curves or tables that facilitate the visualization of anthropometric parameters, and are widely used as an important indicator when evaluating the growth status of children and adolescents. The latest version of the Korean National Growth Charts released in 2007 has raised concerns regarding the inclusion of data from both breastfed and formula-fed infants, higher body mass index (BMI) values in boys, and smaller 3rd percentile values in height-for-age charts. Thus, new growth charts have been developed to improve the previous version. The 2006 World Health Organization Child Growth Standards, regarded as the standard for breastfed infants and children, were introduced for children aged 0–35 months. For children and adolescents aged 3–18 years, these new growth charts include height-for-age, weight-for-age, BMI-for-age, weight-for-height, and head circumference-for-age charts, and were developed using data obtained in 1997 and 2005. Data sets and exclusion criteria were applied differently for the development of the different growth charts. BMI-for-age charts were adjusted to decrease the 95th percentile values of BMI. Criteria for obesity were simplified and defined as a BMI of ≥95th percentile for age and sex. The 3rd percentile values for height-for-age charts were also increased. Additional percentile lines (1st and 99th) and growth charts with standard deviation lines were introduced. 2017 Korean National Growth Charts are recommended for the evaluation of body size and growth of Korean children and adolescents for use in clinics and the public health sector in Korea.
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- 2018
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10. Familial Mediterranean fever presenting as fever of unknown origin in Korea
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Jun Hee Lee, Jong Hyun Kim, Jung Ok Shim, Kwang Chul Lee, Joo Won Lee, Jung Hwa Lee, and Jae Jin Chae
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Familial Mediterranean fever ,Fever of unknown origin ,Colchicine ,Korea ,Pediatrics ,RJ1-570 - Abstract
Familial Mediterranean fever (FMF) is the most common Mendelian autoinflammatory disease, characterized by uncontrolled activation of the innate immune system that manifests as recurrent brief fever and polyserositis (e.g., peritonitis, pleuritic, and arthritis). FMF is caused by autosomal recessive mutations of the Mediterranean fever gene, MEFV which encodes the pyrin protein. Although FMF predominantly affects people from Mediterranean and Middle Eastern ethnic origins, 3 cases of FMF have been reported in Korea since 2012. We report another case of FMF in Korea in which the patient presented with a month-long fever without serositis. After treatment with colchicine was initiated, the patient’s symptoms quickly subsided. The response to colchicine was helpful for diagnosis. We compare the FMF genotypes in Korea with in other countries. Studying FMF cases in Korea will help establish the best MEFV exons to use for screening and diagnosis of Korean FMF.
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- 2016
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11. Eosinophilic gastroenteritis in an 18-year-old male with prolonged nephrotic syndrome
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Da Min Choi, Jung Eun Pyun, Hyung Eun Yim, Kee Hwan Yoo, Jung Ok Shim, Eun Jung Lee, and Nam Hee Won
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Nephrotic syndrome ,Eosinophilic enteropathy ,Eosinophilia ,Pediatrics ,RJ1-570 - Abstract
Eosinophilic gastroenteritis is a rare disease characterized by prominent eosinophilic tissue infiltration of the gastrointestinal tract. Here, we report a case of eosinophilic gastroenteritis in an 18-year-old patient with prolonged nephrotic syndrome who presented with abdominal pain and peripheral hypereosinophilia. During the previous 2 years, he had visited local Emergency Department several times because of epigastric pain and nausea. He had been treated with steroid-dependent nephrotic syndrome since 3 years of age. Tests ruled out allergic and parasitic disease etiologies. Gastroduodenoscopy with biopsy revealed marked eosinophilic infiltration in the duodenum. Renal biopsy findings indicated minimal change disease spectrum without eosinophilic infiltration. The oral deflazacort dosage was increased, and the patient was discharged after abdominal pain resolved. To our knowledge, this is the first report of eosinophilic gastroenteritis in a patient with minimal change disease.
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- 2016
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12. The Long-Term Effect of Early Anti-Tumor Necrosis Factor on Restoration of Growth in Pediatric Crohn’s Disease
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Jung Ok Shim and Yoon Tae Jeen
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2018
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13. Clinical Characteristics and Genotypes of Rotaviruses in a Neonatal Intensive Care Unit
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Jung Ok Shim, Dong Woo Son, So-Yeon Shim, Eell Ryoo, Wonyong Kim, and Yeon-Chang Jung
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clinical symptom ,genotype ,nosocomial ,preterm infants ,rotavirus ,Pediatrics ,RJ1-570 - Abstract
There are few reports on the symptoms of rotavirus infections in neonates. This study aims to describe clinical signs of rotavirus infections among neonates, with a particular focus on preterm infants, and to show the distribution of genotypes in a neonatal intensive care unit (NICU). Methods: A prospective observational study was conducted at a regional NICU for 1 year. Stool specimens from every infant in the NICU were collected on admission, at weekly intervals, and from infants showing symptoms. Rotavirus antigens were detected by enzyme-linked immunosorbent assay (ELISA), and genotypes were confirmed by Reverse transcription-Polymerase chain reaction (RT-PCR). The infants were divided into three groups: symptomatic preterm infants with and without rotavirus-positive stools [Preterm(rota+) and Preterm(rota–), respectively] and symptomatic full- or near-term infants with rotavirus-positive stools [FT/NT(rota+)]. Demographic and outcome data were compared among these groups. Results: A total of 702 infants were evaluated for rotaviruses and 131 infants were included in this study. The prevalence of rotavirus infections was 25.2%. Preterm(rota+) differed from Preterm(rota–) and FT/NT(rota+) with respect to frequent feeding difficulty (p = 0.047 and 0.034, respectively) and higher percentage of neutropenia (p = 0.008 and 0.011, respectively). G4P[6] was the exclusive strain in both the Preterm(rota+) (97.7%) and FT/NT(rota+) (90.2%), and it was the same for nosocomial, institutional infections, and infections acquired at home. Conclusion: Systemic illness signs such as feeding difficulty and neutropenia are specific for preterm infants with rotavirus infections. G4P[6] was exclusive, regardless of preterm birth or locations of infections. This study might be helpful in developing policies for management and prevention of rotavirus infections in NICUs.
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- 2012
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14. Saccharomyces boulardii and Lactulose for Childhood Functional Constipation: A Multicenter Randomized Controlled Trial
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Kyung Jae Lee, Eell Ryoo, Yoo Min Lee, Jung Min Yoon, Hyo-Jeong Jang, So Yoon Choi, You Jin Choi, Hyun Jin Kim, Ju Young Chung, and Jung Ok Shim
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Gastroenterology ,Neurology (clinical) - Published
- 2022
15. Treatment patterns of anti‐tumour necrosis factor‐alpha and prognosis of paediatric and adult‐onset inflammatory bowel disease in Korea: a nationwide population‐based study
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Young June Choe, Kyoungdo Han, and Jung Ok Shim
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Adult ,Hepatology ,Incidence ,Gastroenterology ,Inflammatory Bowel Diseases ,Prognosis ,Necrosis ,Crohn Disease ,Chronic Disease ,Humans ,Colitis, Ulcerative ,Tumor Necrosis Factor Inhibitors ,Pharmacology (medical) ,Child - Abstract
The global prevalence of inflammatory bowel disease (IBD) is increasing. However, population-level data are scarce for Asian populations.To outline and compare paediatric and adult IBD incidence and prevalence data in Korea, describe prescription patterns, and analyse outcomes of anti-tumour necrosis factor (anti-TNF) use in a nationally representative cohort METHODS: IBD was identified based on the presence of Rare and Intractable Disease diagnosis codes for Crohn's disease (CD) and ulcerative colitis (UC). We calculated age-based prevalence and incidence, and examined prescription patterns. We used a Cox proportional hazard model to calculate the hazard ratio (HR) for undergoing surgery.The prevalence of CD increased between 2006 and 2015, particularly among those aged 10-19 years (12.7-35.5 patients per 100,000 people). The use of anti-TNF agents increased from 3.2% to 22.9% in paediatric CD patients. Early use of an anti-TNF agent increased 25-fold in CD patients. Further, CD patients aged 0-14 years were most likely to undergo fistulectomy (HR, 2.63; 95% confidence interval [CI], 1.73-3.97). Children with UC had a higher risk of undergoing surgery (HR, 3.01; 95% CI, 1.33-6.83) than adults. Early use of an anti-TNF agent in CD patients was associated with lower odds of surgery than late-stage use.The prevalence of IBD has increased over time, especially among paediatric patients. Given the magnitude of paediatric IBD disease burden, a multi-faceted approach is needed for early detection and vigilant monitoring to aim for better prognosis.
- Published
- 2022
16. Gut Bacterial Dysbiosis in Irritable Bowel Syndrome: a Case-Control Study and a Cross-Cohort Analysis Using Publicly Available Data Sets
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Kihyun Lee, Gun-Ha Kim, and Jung Ok Shim
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Microbiology (medical) ,Infectious Diseases ,General Immunology and Microbiology ,Ecology ,Physiology ,Genetics ,Cell Biology - Abstract
Research on the gut bacteria in irritable bowel syndrome (IBS) shows discordant results due to inconsistent study designs or small sample sizes. To overcome these issues, we analyzed microbiota of 567 IBS patients and 487 healthy people from 10 shared data sets using a unified method.
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- 2023
17. Gut microbiota affects brain development and behavior
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Gun-Ha, Kim and Jung-Ok, Shim
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Pediatrics, Perinatology and Child Health ,Pediatrics - Abstract
The gut covers a large surface area of the body and faces various external factors. The brain works in concert with commensal microbes in the gut to efficiently process the enormous amount of chemical signals that enter the gut every day. This review discusses: 1) evidence that gut bacteria can alter brain development and behavior, 2) mechanisms by which gut bacteria communicate with the brain, 3) preclinical and clinical studies demonstrating the impact of gut microbiota on autism spectrum disorder, and 4) variables worth consideration by future research on gut bacteria.
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- 2022
18. Gut microbiota affects brain development and behavior.
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Gun-Ha Kim and Jung-Ok Shim
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GUT microbiome , *NEURAL development , *AUTISM spectrum disorders , *BODY surface area - Abstract
The gut covers a large surface area of the body and faces various external factors. The brain works in concert with commensal microbes in the gut to efficiently process the enormous amount of chemical signals that enter the gut every day. This review discusses: (1) evidence that gut bacteria can alter brain development and behavior, (2) mechanisms by which gut bacteria communicate with the brain, (3) preclinical and clinical studies demonstrating the impact of gut microbiota on autism spectrum disorder, and (4) variables worth consideration by future research on gut bacteria. [ABSTRACT FROM AUTHOR]
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- 2023
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19. Editorial: trends in the epidemiology of inflammatory bowel disease in Korea – author's reply
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Jung Ok Shim
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Hepatology ,Chronic Disease ,Republic of Korea ,Gastroenterology ,Humans ,Pharmacology (medical) ,Inflammatory Bowel Diseases - Published
- 2022
20. Impact of Social Distancing on Intussusception Incidence in Children
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Young June Choe, Yoon Lee, and Jung Ok Shim
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Male ,Physical Distancing ,Infant, Newborn ,Infant ,COVID-19 ,General Medicine ,Brief Communication ,Communicable Diseases ,Pediatrics ,Social Distancing ,humanities ,Primary Prevention ,Coronavirus ,Child, Preschool ,Republic of Korea ,Humans ,Female ,Intussusception ,Non-pharmaceutical Intervention - Abstract
Following nonpharmaceutical intervention (NPI) to mitigate coronavirus disease 2019 has led to drastic reduction in incidence of communicable disease. Intussusception is commonly preceded by infectious pathogens. Indirect effect from NPI implementation on incidence of intussusception has not been understood fully. We conducted a cohort study to estimate the impact of NPI on incidence of intussusception in Korean children. The net risk ratio of intussusception incidence for 2020 compared to 2010–2019 was 0.53 (95% confidence interval [CI], 0.43–0.64) for boys and 0.56 (95% CI, 0.44–0.71) for girls (P for difference = 0.017). Our study showed an association between NPI implementation and reduction of intussusception incidence, with more profound reduction in boys compared to girls.
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- 2022
21. A Novel VPS33B Variant Identified by Exome Sequencing in a Patient with Arthrogryposis-Renal Dysfunction-Cholestasis Syndrome
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Jee Hyun Lee, Min J.U. Lee, Kee Hwan Yoo, Baik Lin Eun, Jung Ok Shim, Yoon Lee, Jeong Hee Shin, and Chae R.I. Suh
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education.field_of_study ,Pathology ,medicine.medical_specialty ,Mutation ,Arc (protein) ,Hepatology ,business.industry ,Population ,Gastroenterology ,Case Report ,VIPAR ,medicine.disease ,Compound heterozygosity ,medicine.disease_cause ,Arthrogryposis–renal dysfunction–cholestasis syndrome ,Neonatal cholestasis ,Pediatrics, Perinatology and Child Health ,medicine ,VPS33B ,Differential diagnosis ,education ,business ,Exome sequencing - Abstract
Arthrogryposis-renal dysfunction-cholestasis (ARC) syndrome is a rare autosomal recessive multisystemic disease that is associated with the liver, kidney, skin, and central nervous and musculoskeletal systems. ARC occurs as a result of mutations in the VPS33B (Vacuolar protein sorting 33 homolog B) or VIPAR (VPS33B interacting protein, apical-basolateral polarity regulator) genes. A female infant presented with neonatal cholestasis with a severe clinical outcome. She was diagnosed with ARC syndrome using targeted exome sequencing (TES). Exome sequencing revealed compound heterozygous mutations, c.707A>T and c.239+5G>A, in VPS33B, where c.707A>T was a novel variant; the resultant functional protein defects were predicted via in silico analysis. c.239+5G>A, a pathogenic mutation that affects splicing, is found in less than 0.1% of the general population. Invasive techniques, such as liver biopsies, did not contribute to a differential diagnosis of ARC syndrome; thus, early TES together with clinical presentations constituted an apparently accurate diagnostic procedure.
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- 2019
22. Clinical characteristics of neonatal cholestasis in a tertiary hospital and the development of a novel prediction model for mortality
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Ho Jung Choi, Inki Kim, Hye-Jin Lee, Hyun Ju Oh, Mi Kyoung Ahn, Woo Im Baek, Yeong Eun Kim, Seak Hee Oh, Byong Sop Lee, Jung-Man Namgoong, Dae Yeon Kim, Eun Joo Lee, Jung Ok Shim, Jae Sung Ko, and Kyung Mo Kim
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Tertiary Care Centers ,Cholestasis ,Liver Diseases ,Infant, Newborn ,Humans ,General Medicine ,Infant, Low Birth Weight ,General Biochemistry, Genetics and Molecular Biology ,Aged ,Retrospective Studies - Abstract
Few studies have described the aetiologies of neonatal cholestasis, and the overall neonatal cholestasis-related mortality (NCM) rate is unclear. We investigated the aetiology and outcome of neonatal cholestasis in a tertiary hospital and developed an NCM prediction model for these patients.Patients aged100 days with serum direct bilirubin (DB) levels of1.0 mg/dL were retrospectively screened. Diagnostic and laboratory data during the 8-week follow-up period after enrolment between 2005 and 2020 were extracted digitally, and medical charts were reviewed manually by clinicians. Logistic regression was used to derive a prediction model for the 1-year mortality outcome of neonatal cholestasis, and performance evaluation and external validation were conducted for the NCM prediction model.We enrolled 4028 neonates with DB of1.0 mg/dL at least once. Prematurity and birth injury (35.4%), complex heart anomalies (18.6%), liver diseases (11.4%), and gastrointestinal anomalies (9.2%) were the most common aetiologies; 398 (9.9%) patients died before one year of age. The peak value of DB was positively correlated to the 1-year mortality rate. In the multivariate analysis, simple laboratory indices, including platelet, prothrombin time, aspartate aminotransferase, albumin, direct bilirubin, creatinine, and C-reactive protein, were independent predictors of 1-year mortality outcome of complete-case subjects. Using these laboratory indices, a logistic regression-based NCM prediction model was constructed. It showed acceptable performances on discrimination (area under the curve, 0.916), calibration (slope, 1.04) and Brier scoring (0.072). The external validation of the sample (n = 920) from two other centres also revealed similar performance profiles of the NCM model.Various aetiologies of neonatal cholestasis were identified in a tertiary hospital, resulting in unfavourable outcomes of a large proportion. The NCM prediction model may have the potential to help clinicians to be aware of high-risk neonatal cholestasis.Ministry of HealthWelfare, Republic of Korea.
- Published
- 2021
23. Association Between Vitamin D Deficiency and Suspected Nonalcoholic Fatty Liver Disease in an Adolescent Population
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Young-Hoon Cho, Ju Young Chang, Jae Sung Ko, Hye Ran Yang, Jung Ok Shim, Jin Soo Moon, and Ju Whi Kim
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medicine.medical_specialty ,Adolescent ,Population ,Gastroenterology ,vitamin D deficiency ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Internal medicine ,Nonalcoholic fatty liver disease ,medicine ,Vitamin D and neurology ,Obesity ,education ,Alanine transaminase ,Children ,education.field_of_study ,Vitamin D deficiency ,Hepatology ,business.industry ,nutritional and metabolic diseases ,Odds ratio ,medicine.disease ,digestive system diseases ,Pediatrics, Perinatology and Child Health ,030211 gastroenterology & hepatology ,Original Article ,Metabolic syndrome ,business ,Body mass index - Abstract
Purpose Vitamin D deficiency is a condition widespread throughout the world. Recent studies have suggested that vitamin D deficiency was associated with obesity and metabolic syndrome. The purpose of the study was to examine the relationship between vitamin D deficiency and nonalcoholic fatty liver disease (NAFLD) in adolescents. Methods The data were obtained from the Korean National Health and Nutrition Examination Survey from 2008–2014. A total of 3,878 adolescents were included in the study. Vitamin D deficiency was defined as a 25-hydroxyvitamin D concentration 30 U/L. Results Vitamin D deficiency was noted in 78.9% of the studied population. Age, body mass index, waist circumference, and blood pressure, glucose, cholesterol, and triglyceride levels were significantly higher in adolescents with suspected NAFLD than in adolescents without suspected NAFLD, while the mean vitamin D level was significantly lower in adolescents with suspected NAFLD. The multivariate-adjusted odds of suspected NAFLD were higher with increased age, male gender, obesity, and metabolic syndrome. Individuals with vitamin D deficiency were at higher risk of suspected NAFLD (odds ratio, 1.77; 95% confidence interval, 1.07–2.95) after adjusting for age, gender, obesity, and metabolic syndrome. Conclusion Vitamin D deficiency was associated with suspected NAFLD, independent of obesity and metabolic syndrome, in adolescents.
- Published
- 2019
24. Gut Bacterial Dysbiosis in Children with Intractable Epilepsy
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Namil Kim, Kihyun Lee, Gun Ha Kim, and Jung Ok Shim
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medicine.medical_specialty ,Bifidobacterium longum ,medicine.medical_treatment ,lcsh:Medicine ,microbiome ,Gut flora ,Gastroenterology ,digestive system ,Article ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Internal medicine ,medicine ,microbiota ,Microbiome ,stool ,030304 developmental biology ,0303 health sciences ,biology ,business.industry ,digestive, oral, and skin physiology ,lcsh:R ,General Medicine ,biology.organism_classification ,medicine.disease ,ketogenic diet ,Cohort ,Biomarker (medicine) ,epilepsy ,business ,Dysbiosis ,030217 neurology & neurosurgery ,intestinal flora ,Ketogenic diet - Abstract
A few published clinical studies have evaluated the association between gut microbiota in intractable epilepsy, but with inconsistent results. We hypothesized that the factors associated with the gut bacterial composition, such as age and geography, contributed to the discrepancies. Therefore, we used a cohort that was designed to minimize the effects of possible confounding factors and compared the gut microbiota between children with intractable epilepsy and healthy controls. Eight children with intractable epilepsy aged 1 to 7 years and 32 age-matched healthy participants were included. We collected stool samples and questionnaires on their diet and bowel habits at two time points and analyzed the gut microbiota compositions. In the epilepsy group, the amount of Bacteroidetes was lower (Mann&ndash, Whitney test, false discovery rate (FDR) <, 0.01) and the amount of Actinobacteria was higher (FDR <, 0.01) than in the healthy group. The epilepsy subjects were 1.6- to 1.7-fold lower in microbiota richness indices (FDR <, 0.01) and harbored a distinct species composition (p <, 0.01) compared to the healthy controls. Species biomarkers for intractable epilepsy included the Enterococcus faecium group, Bifidobacterium longum group, and Eggerthella lenta, while the strongest functional biomarker was the ATP-binding cassette (ABC) transporter. Our study identified gut bacterial dysbiosis associated with intractable epilepsy within the cohort that was controlled for the factors that could affect the gut microbiota.
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- 2020
25. Percutaneous Endoscopic Gastrostomy and Nutritional Interventions by the Pediatric Nutritional Support Team Improve the Nutritional Status of Neurologically Impaired Children
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Baik-Lin Eun, Wonkyung Kim, Chae-Ri Suh, and Jung Ok Shim
- Subjects
Pediatrics ,medicine.medical_specialty ,medicine.medical_treatment ,growth ,nutritional support ,lcsh:Medicine ,malnutrition ,Article ,03 medical and health sciences ,Muscle tone ,0302 clinical medicine ,030225 pediatrics ,Percutaneous endoscopic gastrostomy ,PEG ratio ,medicine ,Neurologically impaired ,child ,business.industry ,lcsh:R ,General Medicine ,Anthropometry ,medicine.disease ,Gastrostomy ,Malnutrition ,medicine.anatomical_structure ,gastrostomy ,030211 gastroenterology & hepatology ,business ,Body mass index - Abstract
Aim: To evaluate the long-term effects of nutritional improvement following percutaneous endoscopic gastrostomy (PEG) tube feeding stratified by previous feeding method and to assess the impact of underlying muscle tone on the outcomes of the nutritional intervention. Methods: Neurologically impaired children who underwent PEG tube insertion and nutritional intervention provided by a pediatric nutritional support team were enrolled. We measured anthropometric variables, laboratory parameters, and nutritional intake at baseline, 6 months after PEG insertion, and the last visit. We evaluated the percent ideal body weight (PIBW), body mass index (BMI)-for-age z-score, and percentiles and calculated the ratios of calorie intake compared to required requirement (CIR) and protein intake compared to recommended requirement (PIR). Results: The PIBW and BMI-for-age z-score improved during the first 6 months (p = 0.003 and p = 0.005, respectively). The CIR (p = 0.015) and PIR (p = 0.004) increased during the study period. The baseline BMI and PIBW of the previous nasogastric tube feeding group were better than those of the oral feeding group (p = 0.02 and p = 0.03, respectively). The BMI-for-age z-score, PIBW, CIR, and PIR improved in the hypertonic group (p = 0.03, 0.02, 0.03, and 0.01, respectively). Conclusion: PEG tube feeding and active nutritional intervention improved the nutritional status of neurologically impaired children immediately after PEG insertion. The nutritional requirements might vary by the muscle tonicity.
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- 2020
26. Nationwide Survey for Application of ROME IV Criteria and Clinical Practice for Functional Constipation in Children
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Hyo Jeong Jang, Ju Young Chung, Jung Ok Shim, Byung-Ho Choe, Jin Soo Moon, and Ji Hyun Seo
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Male ,medicine.medical_specialty ,Constipation ,Colonic Diseases, Functional ,Nationwide survey ,Pediatrics ,Colonic Diseases ,03 medical and health sciences ,Lactulose ,0302 clinical medicine ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Pediatricians ,030212 general & internal medicine ,Practice Patterns, Physicians' ,Medical prescription ,Child ,medicine.diagnostic_test ,Questionnaire ,business.industry ,Probiotics ,Infant ,General Medicine ,Rectal examination ,medicine.disease ,Health Surveys ,Management ,Clinical Practice ,Laxatives ,Child, Preschool ,Defecation ,Functional constipation ,Female ,Original Article ,medicine.symptom ,business ,medicine.drug - Abstract
Background This study aimed to investigate the awareness and application of ROME IV criteria for functional constipation (FC) in real-world practices and assessed differences between pediatric gastroenterologists (PGs) and general pediatricians. Methods A total of 239 (47.8%) out of 500 nationwide pediatricians answered a questionnaire for diagnosis and management of pediatric FC; 60 were PGs (75% of total PGs in Korea). Results A total of 16.6% of pediatricians were aware of the exact ROME IV criteria. Perianal examination and digital rectal examination were practiced less, with a higher tendency among PGs (P < 0.001). Treatment duration was longer among PGs for > 6 months (63.8%) than < 3 months among general pediatricians (59.2%, P < 0.001). Fecal disimpaction and rectal enema were practiced among 78.8% and 58.5% of pediatricians, respectively. High dose medication for initial treatment phase was prescribed by 70.7% of pediatricians, primarily within the first 2 weeks (48.3%). The most commonly prescribed medications in children aged > 1-year were lactulose (59.1%), followed by polyethylene glycol (PEG) 4000 (17.7%), and probiotics (11.8%). Prescription priority significantly differed between PGs and general pediatricians; lactulose or PEG 4000 were most commonly prescribed by PGs (89.7%), and lactulose or probiotics (75.7%) were prescribed by general pediatricians (P < 0.001). For patients aged < 1-year, lactulose (41.6%) and changing formula (31.7%) were commonly prescribed. Most participants recommended diet modification, and PGs more frequently used defecation diary (P = 0.002). Conclusion Discrepancies between actual practice and Rome IV criteria and between PGs and general pediatricians were observed. This survey may help construct practice guidelines and educational programs for pediatric FC., Graphical Abstract
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- 2019
27. Clinical Practice Guideline for the Diagnosis and Treatment of Pediatric Obesity: Recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition
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Yong Joo Kim, Young Sook Kwak, Soon Chul Kim, Jeong Ae You, Hyunjung Lim, Jeana Hong, Ji Hyuk Lee, Jung Ok Shim, Eun Hye Lee, Hye Ran Yang, Ki Soo Kang, Jin Soo Moon, Ben Kang, Jae Young Kim, Hong Koh, Dae Yong Yi, Yeoun Joo Lee, Mi Jin Kim, and Yoon Suk Lee
- Subjects
medicine.medical_specialty ,Overweight ,Guideline ,Pediatrics ,Childhood obesity ,Internal medicine ,Diagnosis ,medicine ,Obesity ,Child ,Pediatric gastroenterology ,Nutrition ,Hepatology ,business.industry ,lcsh:RJ1-570 ,Gastroenterology ,lcsh:Pediatrics ,Evidence-based medicine ,medicine.disease ,Mental health ,Treatment ,Family medicine ,Pediatrics, Perinatology and Child Health ,medicine.symptom ,business - Abstract
The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery.
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- 2018
28. Foreign Body Ingestion in Children: Should Button Batteries in the Stomach Be Urgently Removed?
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Jun Hee Lee, Jung Hwa Lee, Jee Hoo Lee, Baik Lin Eun, Kee Hwan Yoo, and Jung Ok Shim
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medicine.medical_specialty ,Pediatrics ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,medicine ,Ingestion ,Foreign Bodies ,Foreign Body Ingestion ,Button battery ,Foreign bodies ,Hepatology ,business.industry ,Stomach ,digestive, oral, and skin physiology ,Gastroenterology ,Endoscopy ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,030211 gastroenterology & hepatology ,Original Article ,Foreign body ,business - Abstract
Purpose Foreign body (FB) ingestion is common in children, and button battery (BB) ingestion has been increasing in recent years. This study was to identify factors related to outcomes of FB ingestion, particularly BBs in the stomach. We evaluated whether the current recommendations are appropriate and aimed to suggest indications for endoscopic removal of BB in the stomach in young children. Methods We investigated patient age, shape, size, location of FBs, spontaneous passage time and resulting complications among 76 children. We observed types, size, location of BB and outcomes, and analyzed their associations with complications. Results Coins and BB were the two most common FBs. Their shapes and sizes were not associated with the spontaneous passage time. Size, spontaneous passage time, and age were also not associated with any specific complications. For BB ingestion, all 5 cases with lithium batteries (≥1.5 cm, 3 V) presented moderate to major complications in the esophagus and stomach without any symptoms, even when the batteries were in the stomach and beyond the duodenum, while no complications were noted in 7 cases with alkaline batteries (
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- 2016
29. Can We Estimate Quality of Life in Pediatric Inflammatory Bowel Disease Patients? An Asian Multicenter Study
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Yunkoo Kang, Jae Hong Park, Yeoun Joo Lee, Jung Ok Shim, Byung-Ho Choe, Hong Koh, Hann Tchah, Kyung Mo Kim, Hye Ran Yang, Jung-Eun Kim, Seung Kim, Sowon Park, Sung-Hee Lee, Ben Kang, and Eell Ryoo
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Male ,medicine.medical_specialty ,Adolescent ,MEDLINE ,Standard score ,Inflammatory bowel disease ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Asian People ,Crohn Disease ,030225 pediatrics ,Internal medicine ,Surveys and Questionnaires ,Severity of illness ,Medicine ,Humans ,Child ,business.industry ,Crohn disease ,Gastroenterology ,medicine.disease ,Ulcerative colitis ,digestive system diseases ,humanities ,Multicenter study ,Pediatrics, Perinatology and Child Health ,Quality of Life ,030211 gastroenterology & hepatology ,Colitis, Ulcerative ,Female ,business - Abstract
Objectives Inflammatory bowel disease (IBD) is a chronic lifelong condition and is related to poor quality of life (QoL). The aim of this study was to evaluate the QoL of Asian pediatric patients with IBD and to determine the clinical factors that can influence QoL. Methods Children and adolescents aged 9 to 18 years diagnosed with IBD were enrolled from 7 hospitals. The patients completed the IMPACT-III questionnaire, and clinical data were collected. The results of the questionnaire and the correlation with clinical data were analyzed. Results A total of 208 patients (Crohn disease: n = 166; ulcerative colitis: n = 42) were enrolled. There was no definite QoL difference according to the Paris classification. Female sex (-5.92 ± 2.97, P = 0.0347) and active disease status (-10.79 ± 3.11, P = 0.0006) were significantly associated with poor QoL. Extreme body weight z score and older age at diagnosis were also associated with worse QoL. Conclusions Various clinical factors may affect the QoL in patients with IBD, but determining the overall QoL of patients using only these clinical factors is difficult. Therefore, regular direct measurements of QoL are necessary to better understand patients with IBD.
- Published
- 2018
30. Ten-year Nationwide Population-based Survey on the Characteristics of Children with Henoch-Schӧnlein Purpura in Korea
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Jae Sung Ko, Sang Hyun Park, Kyoungdo Han, Ju Young Chung, Jung Ok Shim, and Gun Ha Kim
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Male ,Pediatrics ,medicine.medical_specialty ,Henoch-Schonlein purpura ,Adolescent ,Databases, Factual ,IgA Vasculitis ,medicine.medical_treatment ,Population ,Psychological intervention ,Arthritis ,03 medical and health sciences ,0302 clinical medicine ,Sex Factors ,Risk Factors ,Laparotomy ,Surveys and Questionnaires ,Epidemiology ,Republic of Korea ,medicine ,Humans ,030212 general & internal medicine ,education ,Child ,030203 arthritis & rheumatology ,education.field_of_study ,Nephritis ,business.industry ,Incidence ,Age Factors ,Infant, Newborn ,Infant ,General Medicine ,medicine.disease ,Purpura ,Child, Preschool ,Female ,Steroids ,Seasons ,medicine.symptom ,business ,Vasculitis ,Intussusception - Abstract
Background Henoch-Schӧnlein purpura (HSP) is a common vasculitis of childhood. Though HSP is usually self-limiting, severe complications can occur. The management for this condition has not been established yet. Thus, this nationwide study aimed at investigating epidemiological characteristics of children with HSP in Korea. The patterns of clinical practice with regard to the complications of the condition were also investigated. Methods This is a national population-based study that used the National Health Insurance Database. Children below 18 years who were diagnosed with HSP in Korea between 2006 and 2015 were enrolled. Data, such as age, sex, yearly and monthly distribution of HSP, hospitalization, re-hospitalization, comorbidities, and interventions were obtained. The use of steroids was also analyzed. Results A total of 56,841 children were enrolled. The annual incidence of HSP was 55.9 per 100,000 children. The peak age was 5 years. Spring was the most prevalent season. Sex (male) and young age (< 9 years) were risk factors of hospitalization. Younger children were more likely to be re-hospitalized and suspected with intussusception, arthritis, and nephritis. Only 4 children received laparotomy. In total, 57% were managed with steroids, and mean durations of medication were 4-5 days. Children who were hospitalized and those with comorbidities used steroids more frequently (P < 0.001). Conclusion The annual incidence of HSP is 55.9 per 100,000 children which is higher in Korea than that in other countries. Younger children can have a more severe clinical course. This nationwide survey provides valuable information to understand HSP in children and to inspire further research on HSP.
- Published
- 2018
31. Multiplex Ligation-dependent Probe Amplification Analysis Subsequent to Direct DNA Full Sequencing for IdentifyingATP7BMutations and Phenotype Correlations in Children with Wilson Disease
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Jeong Kee Seo, Hye Ran Yang, Jung Ok Shim, Jae Sung Ko, Jin Soo Moon, Sung Sup Park, and Ju Young Chang
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0301 basic medicine ,Wilson Disease ,DNA Mutational Analysis ,Mutant ,Multiplex Ligation-dependent Probe Amplification ,Biology ,medicine.disease_cause ,Pediatrics ,DNA sequencing ,Frameshift mutation ,03 medical and health sciences ,Hepatolenticular Degeneration ,Gene duplication ,medicine ,Humans ,Multiplex ligation-dependent probe amplification ,Allele ,Child ,Allele frequency ,Genetics ,Mutation ,DNA ,Exons ,General Medicine ,Phenotype ,030104 developmental biology ,Original Article ,Sequence Analysis ,Multiplex Polymerase Chain Reaction - Abstract
Background Mutations in ATP7B cause Wilson disease (WD). However, direct DNA full sequencing cannot detect all mutations in patients with WD. Multiplex ligation-dependent probe amplification (MLPA) analysis is reportedly useful in increasing the diagnostic yield in other genetic disorders with large deletions or insertions. The aim of this study was to evaluate whether the detection rate of ATP7B mutations can be increased by using MLPA. Methods We enrolled 114 children with WD from 104 unrelated families based on biochemical tests and direct DNA full sequencing. The patients with one or zero mutant allele were investigated using MLPA. We analyzed phenotypic correlations. Results Total allele frequency by full sequencing was 87.5%. Full sequencing revealed two mutant alleles in 80 of 104 unrelated children. One mutant allele was detected in 22 children, and no mutations were found in two children. Novel mutations including small deletions with frameshift mutations were identified by DNA sequencing. MLPA revealed no gross deletion or duplication in 24 children with one or zero mutant alleles. The number of detected mutations was not associated with hepatic manifestation, age of onset, Kayser-Fleischer ring, ceruloplasmin, and urinary Cu concentrations. Conclusion MLPA showed a limited role to increase the mutation detection rate in children who do not receive a definite genetic diagnosis of WD through DNA full sequencing. This finding suggests that large deletions or duplications might be extremely rare in WD. Further development is needed to improve the genetic diagnosis of WD., Graphical Abstract
- Published
- 2018
32. Management of Acute Gastroenteritis in Children: A Survey among Members of the Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition
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Ju Young Chung, Jin Su Moon, Jung Ok Shim, Byung-Ho Choe, Ji Hyun Seo, and Ki Soo Kang
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medicine.medical_specialty ,medicine.drug_class ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Internal medicine ,Disease management ,medicine ,Antiemetic ,Pediatricians ,Disease management (health) ,Medical prescription ,Child ,Pediatric gastroenterology ,Hepatology ,business.industry ,Gastroenterology ,Gastroenteritis ,Diarrhea ,Pediatrics, Perinatology and Child Health ,Vomiting ,Etiology ,Original Article ,030211 gastroenterology & hepatology ,medicine.symptom ,Surveys and questionnaires ,business - Abstract
Purpose No national survey has yet described the guidelines followed by Korean pediatricians to treat acute gastroenteritis (AGE). An online survey was performed to investigate the management of AGE followed by members of The Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition, and the results were compared between pediatric gastroenterologists (PG) and general pediatricians (GP). Methods Questionnaires were sent to pediatricians between June 2 and 4, 2018 regarding the type of hospital, indications for admission, antiemetic and antidiarrheal drugs and antibiotics prescribed, and dietary changes advised. Results Among the 400 pediatricians approached, 141 pediatricians (35.3%) responded to the survey. PG comprised 39% of the respondents and 72.7% worked at a tertiary hospital. Both PG and GP considered diarrhea or vomiting to be the primary symptom. The most common indication for hospitalization was severe dehydration (98.8%). Most pediatricians managed dehydration with intravenous fluid infusions (PG 98.2%, GP 92.9%). Antiemetics were prescribed by 87.3% of PG and 96.6% of GP. Probiotics to manage diarrhea were prescribed by 89.1% of PG and 100.0% of GP. Antibiotics were used in children with blood in diarrheal stool or high fever. Dietary changes were more commonly recommended by GP (59.3%) than by PG (27.3%) (p
- Published
- 2019
33. Nationwide Multicenter Study of Eosinophilic Esophagitis in Korean Children.
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Kunsong Lee, Byung-Ho Choe, Ben Kang, Seung Kim, Jae Young Kim, Jung Ok Shim, Yoo Min Lee, Eun Hye Lee, Hyo-Jeong Jang, Eell Ryoo, and Hye Ran Yang
- Subjects
EOSINOPHILIC esophagitis ,GASTROENTERITIS ,WESTERN countries ,ALLERGIES ,EOSINOPHILS - Abstract
Purpose: In East Asian countries, there are only a few epidemiologic studies of eosinophilic esophagitis (EoE) and no studies in children. We investigated the incidence and compared the clinical characteristics of EoE and eosinophilic gastroenteritis involving the esophagus (EGEIE) in Korean children. Methods: A total of 910 children, who had symptoms of esophageal dysfunction, from 10 hospitals in Korea were included. EoE was diagnosed according to diagnostic guidelines and EGEIE was diagnosed when there were >15 eosinophils in the esophagus per high power field (HPF) and >20 eosinophils per HPF deposited in the stomach and duodenum with abnormal endoscopic findings. Results: Of the 910 subjects, 14 (1.5%) were diagnosed with EoE and 12 (1.3%) were diagnosed with EGEIE. Vomiting was the most common symptom in 57.1% and 66.7% of patients with EoE and EGEIE, respectively. Only diarrhea was significantly different between EoE and EGEIE (p=0.033). In total, 61.5% of patients had allergic diseases. Exudates were the most common endoscopic findings in EoE and there were no esophageal strictures in both groups. The median age of patients with normal endoscopic findings was significantly younger at 3.2 years, compared to the median age of 11.1 years in those with abnormal endoscopic findings (p=0.004). Conclusion: The incidence of EoE in Korean children was lower than that of Western countries, while the incidence of EGEIE was similar to EoE. There were no clinical differences except for diarrhea and no differences in endoscopic findings between EoE and EGEIE. [ABSTRACT FROM AUTHOR]
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- 2020
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34. A Novel VPS33B Variant Identified by Exome Sequencing in a Patient with Arthrogryposis-Renal Dysfunction-Cholestasis Syndrome.
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Min Ju Lee, Chae Ri Suh, Jeong Hee Shin, Jee Hyun Lee, Yoon Lee, Baik-Lin Eun, Kee Hwan Yoo, and Jung Ok Shim
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ARTHROGRYPOSIS ,CENTRAL nervous system ,SYNDROMES ,LIVER biopsy - Abstract
Arthrogryposis-renal dysfunction-cholestasis (ARC) syndrome is a rare autosomal recessive multisystemic disease that is associated with the liver, kidney, skin, and central nervous and musculoskeletal systems. ARC occurs as a result of mutations in the VPS33B (Vacuolar protein sorting 33 homolog B) or VIPAR (VPS33B interacting protein, apical-basolateral polarity regulator) genes. A female infant presented with neonatal cholestasis with a severe clinical outcome. She was diagnosed with ARC syndrome using targeted exome sequencing (TES). Exome sequencing revealed compound heterozygous mutations, c.707A>T and c.239+5G>A, in VPS33B, where c.707A>T was a novel variant; the resultant functional protein defects were predicted via in silico analysis. c.239+5G>A, a pathogenic mutation that affects splicing, is found in less than 0.1% of the general population. Invasive techniques, such as liver biopsies, did not contribute to a differential diagnosis of ARC syndrome; thus, early TES together with clinical presentations constituted an apparently accurate diagnostic procedure. [ABSTRACT FROM AUTHOR]
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- 2019
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35. Distribution of rotavirus G and P genotypes approximately two years following the introduction of rotavirus vaccines in South Korea
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Jung Ok Shim, Sang In Chung, Inseok Lim, Wonyong Kim, Kijeong Kim, Yoosik Yoon, Eell Ryoo, and Van Thai Than
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Rotavirus G ,Acute diarrhea ,Infectious Diseases ,Virology ,Rotavirus ,Genotype ,medicine ,Biology ,medicine.disease_cause ,Genotyping - Abstract
Genotyping of human rotaviruses was performed on 299 (40.1%) rotavirus-positive samples obtained from 745 children with acute diarrhea in three provinces in South Korea between March 2008 and February 2010, approximately 2 years following the introduction of the RotaTeq (September 2007) and Rotarix (July 2008). The most prevalent G genotypes were G1 (51.5%), followed by G3 (24.0%), G4 (15.4%), G9 (6.4%), and G2 (4.7%). The predominant types of P genotypes were P[8] (72.6%), followed by P[6] (19.1%) and P[4] (6.0%). The phylogenetic analyses of the VP7 genes of G9 strains revealed they were highly identical and belonged in lineage III. This study highlights the consistency of the predominant G1 genotype and slightly higher predominance of the identical G9 strains over the G2 genotype.
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- 2013
36. Clinical Characteristics and Genotypes of Rotaviruses in a Neonatal Intensive Care Unit
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So Yeon Shim, Eell Ryoo, Dong Woo Son, Yeon Chang Jung, Jung Ok Shim, and Wonyong Kim
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Pediatrics ,medicine.medical_specialty ,Neonatal intensive care unit ,genotype ,Rotavirus Infections ,Enzyme-Linked Immunosorbent Assay ,Infant, Premature, Diseases ,Neutropenia ,medicine.disease_cause ,Feeding difficulty ,Feces ,Intensive Care Units, Neonatal ,Rotavirus ,Genotype ,medicine ,Humans ,Pediatrics, Perinatology, and Child Health ,preterm infants ,Antigens, Viral ,Cross Infection ,business.industry ,Infant, Newborn ,lcsh:RJ1-570 ,nosocomial ,lcsh:Pediatrics ,medicine.disease ,Gastroenteritis ,rotavirus ,clinical symptom ,Pediatrics, Perinatology and Child Health ,Outcome data ,business ,Infant, Premature - Abstract
Background There are few reports on the symptoms of rotavirus infections in neonates. This study aims to describe clinical signs of rotavirus infections among neonates, with a particular focus on preterm infants, and to show the distribution of genotypes in a neonatal intensive care unit (NICU). Methods A prospective observational study was conducted at a regional NICU for 1 year. Stool specimens from every infant in the NICU were collected on admission, at weekly intervals, and from infants showing symptoms. Rotavirus antigens were detected by enzyme-linked immunosorbent assay (ELISA), and genotypes were confirmed by Reverse transcription-Polymerase chain reaction (RT-PCR). The infants were divided into three groups: symptomatic preterm infants with and without rotavirus-positive stools [Preterm(rota+) and Preterm(rota–), respectively] and symptomatic full- or near-term infants with rotavirus-positive stools [FT/NT(rota+)]. Demographic and outcome data were compared among these groups. Results A total of 702 infants were evaluated for rotaviruses and 131 infants were included in this study. The prevalence of rotavirus infections was 25.2%. Preterm(rota+) differed from Preterm(rota–) and FT/NT(rota+) with respect to frequent feeding difficulty ( p = 0.047 and 0.034, respectively) and higher percentage of neutropenia ( p = 0.008 and 0.011, respectively). G4P[6] was the exclusive strain in both the Preterm(rota+) (97.7%) and FT/NT(rota+) (90.2%), and it was the same for nosocomial, institutional infections, and infections acquired at home. Conclusion Systemic illness signs such as feeding difficulty and neutropenia are specific for preterm infants with rotavirus infections. G4P[6] was exclusive, regardless of preterm birth or locations of infections. This study might be helpful in developing policies for management and prevention of rotavirus infections in NICUs.
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- 2012
37. Molecular characterization of rotavirus diarrhea among children in South Korea: detection of an unusual G11 strain
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Jung Ok Shim, Van Phan Le, Hyeon Soo Lee, In Hyuk Baek, Wonyong Kim, Eell Ryoo, Ja Kyoung Kim, So Yeon Shim, Young Uh, Sung Yeon Ahn, Wonkeun Song, Inseok Lim, Eun Mi Ko, and Won Seok Seok
- Subjects
Diarrhea ,Rotavirus ,Genotype ,Molecular Sequence Data ,Reoviridae ,medicine.disease_cause ,Rotavirus Infections ,Virology ,Republic of Korea ,medicine ,Cluster Analysis ,Humans ,Phylogeny ,Molecular Epidemiology ,biology ,Infant, Newborn ,Infant ,Sequence Analysis, DNA ,General Medicine ,biology.organism_classification ,Child, Preschool ,RNA, Viral ,medicine.symptom - Abstract
Among 312 rotavirus-positive samples collected from eight hospitals across South Korea during 2008 and 2009, the most prevalent circulating G genotype was G1 (35.9%), followed by G3 (24.7%), G2 (17.0%), G4 (7.7%), and G9 (2.6%). Notably, one unusual G11 lineage III strain-the first hypoendemic infection case in the world-was found. Of the P genotypes, P[8] (43.9%) was the most common, followed by P[6] (29.5%), P[4] (9.3%) and P[9] (0.6%). Determining G- and P-type combinations showed that G1P[8] was the most prevalent (20.5%), followed by G2P[6] (12.8%) and G3P[8] (12.8%). These findings provide new information concerning the current prevalence and spread of the rare G11 rotavirus.
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- 2011
38. Genetic variation of G4P[6] rotaviruses: Evidence for novel strains circulating between the hospital and community
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So Yeon Shim, Dong Woo Son, Inseok Lim, Van Phan Le, Wonyong Kim, Eell Ryoo, Jung Ok Shim, and Yeon Chang Jung
- Subjects
biology ,Molecular epidemiology ,Reoviridae ,biology.organism_classification ,medicine.disease_cause ,Group A ,Virology ,Virus ,Microbiology ,Diarrhea ,Infectious Diseases ,Rotavirus ,Genotype ,medicine ,medicine.symptom ,Feces - Abstract
One hundred forty-six fecal specimens collected between 2007 and 2008 from infants with acute gastroenteritis were screened for rotavirus by ELISA with VP6-specific antibody. One hundred twenty-three of the samples (84.2%) were confirmed to be positive for group A rotavirus (community-acquired, n = 90 [73.2%] and nosocomial, n = 33 [26.8%]), and were typed subsequently using RT-PCR and sequence analysis methods. Determination of G- and P-type combinations showed that G4P[6] (78.9%) was the most common strain, followed by G3P[8] (7.3%), G1P[8] (6.5%), G2P[4] (0.8%), G2P[6] (0.8%), G1P[6] (0.8%), and G9P[8] (0.8%) strains. Of the 97 G4P[6] strains, 62 (63.8%) were responsible for community-acquired cases and 35 (36.1%) were hospital-acquired cases. Phylogenetic analysis of the VP7 gene from the G4P[6] strains revealed that both the community-acquired and nosocomial strains were segregated to the human rotaviruses circulating world-wide, including the prototype vaccinal strain, ST3, which constituted a novel sublineage in lineage 1. Owing to the recent emergence of G4P[6] rotaviruses within the hospital, as well as in the community, the findings from this study are important since they provide new information concerning the community and nosocomial spread of rotaviruses. J. Med. Virol. 82:700–706, 2010. © 2010 Wiley-Liss, Inc.
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- 2010
39. The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects
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Dohee Lim, Kyungwon Oh, Hyun Wook Chae, Yeoun Joo Lee, Sei Won Yang, Jung Ok Shim, Ji Hyuk Lee, Soon Chul Kim, Jin Soo Moon, Jae Hyun Kim, Seung Sik Hwang, and Sungha Yun
- Subjects
medicine.medical_specialty ,Percentile ,Adolescent ,030209 endocrinology & metabolism ,Review Article ,Growth ,Age and sex ,Pediatrics ,World health ,Anthropometric parameters ,03 medical and health sciences ,0302 clinical medicine ,medicine ,030212 general & internal medicine ,Child growth ,Growth charts ,Child ,Korea ,business.industry ,Public health ,lcsh:RJ1-570 ,lcsh:Pediatrics ,medicine.disease ,Obesity ,Pediatrics, Perinatology and Child Health ,business ,Body mass index ,Demography - Abstract
Growth charts are curves or tables that facilitate the visualization of anthropometric parameters, and are widely used as an important indicator when evaluating the growth status of children and adolescents. The latest version of the Korean National Growth Charts released in 2007 has raised concerns regarding the inclusion of data from both breastfed and formula-fed infants, higher body mass index (BMI) values in boys, and smaller 3rd percentile values in height-for-age charts. Thus, new growth charts have been developed to improve the previous version. The 2006 World Health Organization Child Growth Standards, regarded as the standard for breastfed infants and children, were introduced for children aged 0–35 months. For children and adolescents aged 3–18 years, these new growth charts include height-for-age, weight-for-age, BMI-for-age, weight-for-height, and head circumference-for-age charts, and were developed using data obtained in 1997 and 2005. Data sets and exclusion criteria were applied differently for the development of the different growth charts. BMI-for-age charts were adjusted to decrease the 95th percentile values of BMI. Criteria for obesity were simplified and defined as a BMI of ≥95th percentile for age and sex. The 3rd percentile values for height-for-age charts were also increased. Additional percentile lines (1st and 99th) and growth charts with standard deviation lines were introduced. 2017 Korean National Growth Charts are recommended for the evaluation of body size and growth of Korean children and adolescents for use in clinics and the public health sector in Korea.
- Published
- 2018
40. Management of Acute Gastroenteritis in Children: A Survey among Members of the Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition.
- Author
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Ji-Hyun Seo, Jung Ok Shim, Byung-Ho Choe, Jin Su Moon, Ki-Soo Kang, and Ju-Young Chung
- Subjects
- *
PEDIATRIC gastroenterology , *GASTROENTERITIS , *HOSPITAL care of children , *CHILDREN , *DRUG prescribing - Abstract
Purpose: No national survey has yet described the guidelines followed by Korean pediatricians to treat acute gastroenteritis (AGE). An online survey was performed to investigate the management of AGE followed by members of The Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition, and the results were compared between pediatric gastroenterologists (PG) and general pediatricians (GP). Methods: Questionnaires were sent to pediatricians between June 2 and 4, 2018 regarding the type of hospital, indications for admission, antiemetic and antidiarrheal drugs and antibiotics prescribed, and dietary changes advised. Results: Among the 400 pediatricians approached, 141 pediatricians (35.3%) responded to the survey. PG comprised 39% of the respondents and 72.7% worked at a tertiary hospital. Both PG and GP considered diarrhea or vomiting to be the primary symptom. The most common indication for hospitalization was severe dehydration (98.8%). Most pediatricians managed dehydration with intravenous fluid infusions (PG 98.2%, GP 92.9%). Antiemetics were prescribed by 87.3% of PG and 96.6% of GP. Probiotics to manage diarrhea were prescribed by 89.1% of PG and 100.0% of GP. Antibiotics were used in children with blood in diarrheal stool or high fever. Dietary changes were more commonly recommended by GP (59.3%) than by PG (27.3%) (p<0.05). Tests to identify etiological agents were performed primarily in hospitalized children. Conclusion: This survey assessing the management of pediatric AGE showed that the indications for admission and rehydration were similar between GP and PG. Drug prescriptions for diarrhea and dietary changes were slightly commonly recommended by GP than by PG. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
41. Different Age Distribution between Campylobacteriosis and Nontyphoidal Salmonellosis in Hospitalized Korean Children with Acute Inflammatory Diarrhea
- Author
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Sue Shin, Ahlee Kim, Ju Young Chang, and Jung Ok Shim
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Salmonella ,030106 microbiology ,Campylobacteriosis ,Brief Communication ,medicine.disease_cause ,Pediatrics ,Gastroenterology ,Microbiology ,Foodborne Diseases ,Feces ,03 medical and health sciences ,Age Distribution ,Age ,0302 clinical medicine ,Interquartile range ,Nontyphoidal Salmonella ,Internal medicine ,Campylobacter Infections ,Republic of Korea ,Multiplex polymerase chain reaction ,medicine ,Humans ,030212 general & internal medicine ,Child ,Children ,Pathogen ,Enterocolitis ,business.industry ,Campylobacter ,Infant ,General Medicine ,medicine.disease ,Gastroenteritis ,Child, Preschool ,Salmonella Infections ,medicine.symptom ,business ,Child, Hospitalized ,Multiplex Polymerase Chain Reaction - Abstract
We investigated recent epidemiologic trends regarding campylobacteriosis vs. nontyphoidal salmonellosis (NTS), a previously known leading cause of bacterial enterocolitis in Korean children. Among 363 hospitalized children with acute inflammatory diarrhea, Campylobacter (18.7%) was the most frequently detected pathogen using multiplex polymerase chain reaction tests followed by Salmonella (15.4%). Children with campylobacteriosis were older than children with NTS (112.6 months [interquartile range (IQR) 66.0–160.1] vs. 53 months [IQR 31.0–124.0], P < 0.001) and had higher prevalences of abdominal cramping and stool hemoglobin. Campylobacteriosis may be suspected as a primary cause of acute inflammatory diarrhea in hospitalized school-aged Korean children and adolescents., Graphical Abstract
- Published
- 2017
42. Familial Mediterranean fever presenting as fever of unknown origin in Korea
- Author
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Jong Hyun Kim, Jun Hee Lee, Kwang Chul Lee, Jung Ok Shim, Jae Jin Chae, Jung Hwa Lee, and Joo Won Lee
- Subjects
medicine.medical_specialty ,Peritonitis ,Arthritis ,Familial Mediterranean fever ,Case Report ,Pediatrics ,Pyrin domain ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine ,Colchicine ,030212 general & internal medicine ,Fever of unknown origin ,030203 arthritis & rheumatology ,Korea ,business.industry ,lcsh:RJ1-570 ,lcsh:Pediatrics ,medicine.disease ,MEFV ,Dermatology ,chemistry ,Pediatrics, Perinatology and Child Health ,business ,Serositis - Abstract
Familial Mediterranean fever (FMF) is the most common Mendelian autoinflammatory disease, characterized by uncontrolled activation of the innate immune system that manifests as recurrent brief fever and polyserositis (e.g., peritonitis, pleuritic, and arthritis). FMF is caused by autosomal recessive mutations of the Mediterranean fever gene, MEFV which encodes the pyrin protein. Although FMF predominantly affects people from Mediterranean and Middle Eastern ethnic origins, 3 cases of FMF have been reported in Korea since 2012. We report another case of FMF in Korea in which the patient presented with a month-long fever without serositis. After treatment with colchicine was initiated, the patient’s symptoms quickly subsided. The response to colchicine was helpful for diagnosis. We compare the FMF genotypes in Korea with in other countries. Studying FMF cases in Korea will help establish the best MEFV exons to use for screening and diagnosis of Korean FMF.
- Published
- 2016
43. Novel CFTR mutations in a Korean infant with cystic fibrosis and pancreatic insufficiency
- Author
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Jung Ho Kim, Jong-Won Kim, Ran Lee, Young Yull Koh, Chang-Seok Ki, Jung Ok Shim, Jae Jun Han, Jeong Kee Seo, Young June Choe, and Jae Sung Ko
- Subjects
medicine.medical_specialty ,Cystic Fibrosis ,Cystic Fibrosis Transmembrane Conductance Regulator ,Case Report ,Cystic fibrosis ,Pediatrics ,Frameshift mutation ,Diagnosis, Differential ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Exocrine pancreatic insufficiency ,Frameshift Mutation ,Splice site mutation ,biology ,Base Sequence ,business.industry ,Infant ,General Medicine ,medicine.disease ,Cystic fibrosis transmembrane conductance regulator ,Steatorrhea ,Alternative Splicing ,Endocrinology ,Failure to thrive ,Cystic Fibrosis Conductance Regulator ,Mutation ,biology.protein ,Exocrine Pancreatic Insufficiency ,Female ,medicine.symptom ,Differential diagnosis ,business - Abstract
Cystic fibrosis (CF) is an autosomal recessive disease that is very rare in Asians: only a few cases have been reported in Korea. We treated a female infant with CF who had steatorrhea and failure to thrive. Her sweat chloride concentration was 102.0 mM/L. Genetic analysis identified two novel mutations including a splice site mutation (c.1766+2T>C) and a frameshift mutation (c.3908dupA; Asn1303LysfsX6). Pancreatic enzyme replacement and fat-soluble vitamin supplementation enabled the patient to get a catch-up growth. This is the first report of a Korean patient with CF demonstrating pancreatic insufficiency. CF should therefore be considered in the differential diagnosis of infants with steatorrhea and failure to thrive.
- Published
- 2008
44. Achalasia Previously Diagnosed as Gastroesophageal Reflux Disease by Relying on Esophageal Impedance-pH Monitoring: Use of High-Resolution Esophageal Manometry in Children
- Author
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Jung Hwa Lee, Jung Eun Pyun, Jung Ok Shim, Da Min Choi, and Kee Hwan Yoo
- Subjects
medicine.medical_specialty ,Manometry ,Electric impedance ,Esophageal achalasia ,Achalasia ,Case Report ,Esophageal Disorder ,Gastroenterology ,Internal medicine ,otorhinolaryngologic diseases ,medicine ,Esophagus ,Child ,Esophageal pH monitoring ,Hepatology ,medicine.diagnostic_test ,business.industry ,Heartburn ,medicine.disease ,Dysphagia ,humanities ,digestive system diseases ,medicine.anatomical_structure ,Gastroesophageal reflux ,Pediatrics, Perinatology and Child Health ,Failure to thrive ,GERD ,medicine.symptom ,business - Abstract
Gastroesophageal reflux disorder (GERD) is the most common esophageal disorder in children. Achalasia occurs less commonly but has similar symptoms to GERD. A nine-year old boy presented with vomiting, heartburn, and nocturnal cough. The esophageal impedance-pH monitor revealed nonacidic GERD (all-refluxate clearance percent time of 20.9%). His symptoms persisted despite medical treatment for GERD, and he was lost to follow up. Four years later, he presented with heartburn, solid-food dysphagia, daily post-prandial vomiting, and failure to thrive. Endoscopy showed a severely dilated esophagus with candidiasis. High-resolution manometry was performed, and he was diagnosed with classic achalasia (also known as type I). His symptoms resolved after two pneumatic dilatation procedures, and his weight and height began to catch up to his peers. Clinicians might consider using high-resolution manometry in children with atypical GERD even after evaluation with an impedance-pH monitor.
- Published
- 2015
45. Clostridium difficilein Children: To Treat or Not to Treat?
- Author
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Jung Ok Shim
- Subjects
medicine.medical_specialty ,Hepatology ,medicine.drug_class ,business.industry ,Risk of infection ,Antibiotics ,Gastroenterology ,Review Article ,Clostridium difficile ,Disease ,medicine.disease ,Comorbidity ,Microbiology ,Carriage ,Anti-bacterial agents ,Internal medicine ,Pediatrics, Perinatology and Child Health ,medicine ,Child ,business - Abstract
Clostridium difficile infection has been increasing since 2000 in children and in adults. Frequent antibiotics use, comorbidity, and the development of hypervirulent strains have increased the risk of infection. Despite the high carriage rates of C. difficile, infants rarely develop clinical infection. Discontinuing antibiotics and supportive management usually leads to resolution of disease. Antibiotics use should be stratified depending on the patient's age and severity of the disease.
- Published
- 2014
46. Changing distribution of age, clinical severity, and genotypes of rotavirus gastroenteritis in hospitalized children after the introduction of vaccination: a single center study in Seoul between 2011 and 2014.
- Author
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Jung Ok Shim, Ju Young Chang, Sue Shin, Jin Soo Moon, Jae Sung Ko, Shim, Jung Ok, Chang, Ju Young, Shin, Sue, Moon, Jin Soo, and Ko, Jae Sung
- Subjects
- *
ROTAVIRUSES , *CLINICAL epidemiology , *GASTROENTERITIS , *REVERSE transcriptase polymerase chain reaction , *VACCINATION , *GENOTYPES , *GENETICS , *ROTAVIRUS vaccines , *DEMOGRAPHY , *DIARRHEA , *HOSPITAL care , *POLYMERASE chain reaction , *RETROVIRUS diseases , *RNA , *DISEASE prevalence , *SEQUENCE analysis , *PREVENTION , *THERAPEUTICS - Abstract
Background: This study aimed to explore changes in clinical epidemiology and genotype distribution and their association among hospitalized children with rotavirus gastroenteritis after the introduction of vaccines.Methods: Between November 2010 and October 2014, hospitalized children with acute gastroenteritis were enrolled. Rotavirus genotypes were confirmed through reverse transcription-polymerase chain reaction (RT-PCR), semi-nested PCR, and sequencing. Clinical information including vaccination status and the modified Vesikari scores were collected.Results: Among 179 children with rotavirus infection, nineteen (10.6 %) were completely vaccinated. During the study period, the number of children between three and 23 months of age decreased significantly compared to the number of children older than 24 months of age (P = 0.010), who showed lower diarrhea severity (duration, P = 0.042; frequency, P = 0.021) but higher vomiting severity (P = 0.007, 0.036) compared to the former. Vaccination status was also significantly associated with lower vomiting severity after adjustment for age (frequency only, P = 0.018). The predominant genotypes were G2P[4] (18.4 %), G1P[8] (14.5 %), and G1P[4]P[8] (12.8 %), and the prevalence of genotypes with uncommon and mixed combinations was more than 50 %. Children infected with G2P[4] strains tended to be older (P = 0.005) and had more severe vomiting (P = 0.018, 0.006) than those with G1P[8].Conclusions: Increase in age of infected, hospitalized children was accompanied by change in clinical severity during 2011-2014 after the introduction of vaccines in Seoul. Clinical severity was also associated with vaccination status and genotype. Long-term large scale studies are needed to document the significance of the increase in genotypes of uncommon and mixed combinations. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
47. Interleukin-10 receptor mutations in children with neonatal-onset Crohn’s disease and intractable ulcerating enterocolitis
- Author
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Sung Sup Park, Solha Hwang, Gyeong Hoon Kang, Woo Sun Kim, Ju Young Chang, Jae Sung Ko, Jung Ok Shim, Jin Soo Moon, Hye Ran Yang, and Jeong Kee Seo
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Interleukin-10 Receptor alpha Subunit ,Neonatal onset ,Gastroenterology ,Inflammatory bowel disease ,Ileostomy ,Crohn Disease ,Internal medicine ,Humans ,Medicine ,Colectomy ,Enterocolitis ,Crohn's disease ,Hepatology ,business.industry ,Infant, Newborn ,Colonoscopy ,medicine.disease ,Magnetic Resonance Imaging ,Ulcerative colitis ,digestive system diseases ,Rectovaginal fistula ,Mutation ,Colitis, Ulcerative ,Female ,medicine.symptom ,business - Abstract
Neonatal-onset inflammatory bowel disease (IBD) accounts for only 0.25% of pediatric IBD cases. The molecular pathogenesis of IBD remains unclear. Recently, rare Mendelian mutations have been identified in children with very early-onset Crohn's disease and ulcerative colitis. In this study, we report compound heterozygous mutations in the interleukin-10 receptor A (IL-10RA) gene in children with severe neonatal-onset IBD. Patient 1 had chronic diarrhea within the first month of life and had perianal fistulae. She was diagnosed with 'intractable ulcerating enterocolitis in infancy' and underwent subtotal colectomy at the age of 24 months because of poor response to immunosuppressant therapy. Compound heterozygous mutations, c.[301C>T];[350G>A](p.[R101W];[R117H]), were discovered in IL-10RA for this patient. Patient 2 presented symptoms within the first month of life and was diagnosed with Crohn's disease. Severe colitis and perianal and enteroenteric fistulae occurred repeatedly, and he underwent surgical management involving colectomy, colostomy, and ileostomy. We identified mutations in IL-10RA, c.[272A>G];[784C>T] (p.[Y91C];[R262C]). Patient 3 had chronic diarrhea and a rectovaginal fistula at 3 days of life and was diagnosed with Crohn's disease. She underwent fistulectomy and ileostomy, but experienced frequent relapses. Mutations, c.[272A>G];[301C>T] (p.[Y91C];[R101W]), were found in IL-10RA. This report confirms the genetic defect of IL-10RA in neonatal-onset IBD including 'intractable ulcerating enterocolitis in infancy'.
- Published
- 2013
48. Gut Microbiota in Inflammatory Bowel Disease
- Author
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Jung Ok Shim
- Subjects
Hepatology ,biology ,business.industry ,Microbiota ,digestive, oral, and skin physiology ,Gastroenterology ,Review Article ,Inflammatory bowel diseases ,Gut flora ,medicine.disease ,biology.organism_classification ,digestive system ,Inflammatory bowel disease ,digestive system diseases ,Pathogenesis ,Pediatrics, Perinatology and Child Health ,Immunology ,Genetic predisposition ,Medicine ,In patient ,Immune homeostasis ,Child ,business ,Dysbiosis ,Mucosal immunity - Abstract
The gut mucosal barrier plays an important role in maintaining a delicate immune homeostasis. The pathogenesis of inflammatory bowel disease (IBD) is considered to involve a defective mucosal immunity along with a genetic predisposition. Recent views have suggested an excessive response to components of the gut microbiota in IBD. A condition of "dysbiosis", with alterations of the gut microbial composition, has been observed in patients with IBD. In this article, the author review recent studies of gut microbiota in IBD, particularly the importance of the gut microbiota in the pathogenesis of pediatric IBD.
- Published
- 2013
49. Monitoring ofClostridium difficileColonization in Preterm Infants in Neonatal Intensive Care Units
- Author
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Jae Sung Ko, Jin A Lee, Jung Hwan Choi, Sue Shin, Jeong Kee Seo, Han Suk Kim, Ju Young Chang, Jung Ok Shim, and Son Moon Shin
- Subjects
Pediatrics ,medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,Clostridium difficile ,University hospital ,law.invention ,law ,Intensive care ,Pediatrics, Perinatology and Child Health ,Medicine ,Colonization ,business ,Feces ,Polymerase chain reaction ,Bacterial dna - Abstract
Fecal samples were serially collected within 72 h after birth and at 1, 2, and 4-6 weeks of age from preterm infants in the neonatal intensive care units (NICUs) of two different university hospitals. Total bacterial DNA was extracted from each fecal sample from 49 infants, and polymerase chain reaction (PCR) was performed with primers for the 16S gene of
- Published
- 2012
50. Differential diagnosis of acute diarrheal disorders in children
- Author
-
Jung Ok Shim
- Subjects
Pediatrics ,medicine.medical_specialty ,medicine.drug_class ,business.industry ,viruses ,Antibiotics ,virus diseases ,General Medicine ,medicine.disease_cause ,medicine.disease ,Bloody ,Diarrhea ,Malnutrition ,fluids and secretions ,Etiology ,medicine ,Norovirus ,Vomiting ,medicine.symptom ,Differential diagnosis ,business - Abstract
Acute diarrhea is one of the most common symptoms in children. Common causes and differential diagnosis are reviewed in this article. In children with suspicious diarrhea, one should consider whether the stool is normal variant or true diarrhea and in the case of true diarrhea, whether it is infectious or noninfectious diarrhea, particularly bacterial or viral infection; last, in the case of bacterial infection, whether antibiotics is needed or not. Rotaviruses and noroviruses are the most common causes in children with acute diarrhea. The seasonal distribution of rotavirus infection is changing. Epidemics of norovirus are increasing. The main symptom of norovirus infection in children is vomiting, unlike rotavirus infection. Bacterial infection is not a common cause. When a child shows bloody and mucoid diarrhea, the use of antibiotics should be considered if the patient is a young infant, is immunocompromised, or has toxic symptoms such as high fever, severe dehydration, or malnutrition. Clinical approaches focused on etiology can support the proper management and prediction of prognosis. Genetic epidemiology research is needed to monitor the efficacy of rotavirus vaccination and to develop a norovirus vaccine.
- Published
- 2012
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