Publications by authors named "Jae S Ko"

Background: Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050.

Methods: This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents.

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Purpose: This study aimed to establish and characterize patient-derived intestinal organoids (PDOs) from children with Crohn's disease (CD).

Methods: To generate PDOs, endoscopic biopsy specimens were obtained from non-inflamed duodenal bulbs of normal controls and CD patients. To verify the presence of PDOs, histological staining and quantitative reverse transcription polymerase chain reaction (RT-qPCR) analyses were performed.

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Objective: Hepatopulmonary syndrome (HPS) is a rare complication of metabolic associated fatty liver disease (MAFLD) occurring subsequent to hypopituitarism, often developing after resection of hypothalamic or pituitary tumors. The aim of this study is to report an illustrative case of an HPS patient who was successfully treated with growth hormone replacement therapy, without liver transplantation which is conventionally regarded as the only treatment option. Additionally, we conducted a comprehensive review of published case reports of HPS in the pediatric population.

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Purpose: Few studies have reported the prevalence of inflammatory bowel disease unclassified (IBDU) among Korean pediatric IBD (PIBD) population. To address this gap, we used two tertiary centers and nationwide population-based healthcare administrative data to estimate the prevalence of Korean pediatric IBDU at the time of diagnosis.

Methods: We identified 136 patients aged 2-17 years with newly diagnosed IBD (94 Crohn's disease [CD] and 42 ulcerative colitis [UC]) from two tertiary centers in Korea between 2005 and 2017.

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Article Synopsis
  • Wilson disease (WD) is a rare genetic disorder that disrupts copper metabolism, requiring lifelong medication to prevent severe complications like liver failure; the study evaluated the efficacy and safety of three treatments: D-penicillamine (DPA), trientine, and zinc in children.
  • The analysis included 90 patients, excluding those who had liver transplants, and revealed that treatment ineffectiveness was most common with trientine, followed by zinc and DPA.
  • The findings indicated that while all three treatments are effective for pediatric WD, DPA and zinc have more adverse effects compared to trientine, suggesting that trientine may be the safer choice.
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Background:  Chronic enteropathy associated with SLCO2A1 gene (CEAS) is a unique type of inflammatory bowel disease. CEAS is monogenic disease and is thought to develop from childhood, but studies on pediatric CEAS are scarce. We analyzed characteristics of pediatric CEAS.

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Purpose: Recently, the prevalence of eosinophilic gastrointestinal disease (EGID) has shown an increasing trend worldwide. As the diagnosis of EGID requires invasive endoscopy with biopsy, noninvasive markers for detecting EGID in suspected patients, particularly children, are urgently needed. Therefore, this study aimed to evaluate the diagnostic accuracy of serum eosinophil cationic protein (ECP) beyond peripheral eosinophil counts in pediatric patients with EGID.

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Background And Aim: The aim of this study was to investigate the comprehensive genetic effects of exploratory variants of LYPLAL1, GCKR, HSD17B13, TRIB1, APOC3, MBOAT7, and PARVB on pediatric nonalcoholic fatty liver disease in addition to the previously reported variants of TM6SF2, PNPLA3, and SAMM50 in Korean children.

Methods: A prospective case-control study was conducted involving 309 patients diagnosed using ultrasound and 339 controls. Anthropometric measurements, liver function tests, and metabolic marker analysis were conducted, and fibrosis scores were calculated.

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Citrin deficiency is an autosomal recessive metabolic liver disease caused by mutations in the SLC25A13 gene. The disease typically presents with cholestasis, elevated liver enzymes, hyperammonemia, hypercitrullinemia, and fatty liver in young infants, resulting in a phenotype known as "neonatal intrahepatic cholestasis caused by citrin deficiency" (NICCD). The diagnosis relies on clinical manifestation, biochemical evidence of hypercitrullinemia, and identifying mutations in the SLC25A13 gene.

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Article Synopsis
  • Researchers investigated the genetic causes of neonatal cholestasis and aimed to create a diagnostic algorithm using single-gene testing and next-generation sequencing.
  • The study involved 148 patients at Seoul National University Hospital from 2010 to 2021, resulting in a confirmed genetic diagnosis for 33.1% of them, with the most common conditions being Alagille syndrome and citrin deficiency.
  • The study also identified 16 new pathogenic variants and emphasized the combined use of single-gene tests and sequencing as essential for diagnosing genetic neonatal cholestasis.
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Background: Several cases of pediatric acute hepatitis of unknown etiology related to adenoviral infections have been reported in Europe since January 2022. The aim of this study was to compare the incidence, severity, possible etiology, and prognosis of the disease with those in the past in Korea.

Methods: The surveillance group collected data between May and November 2022 using a surveillance system.

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  • Phospholipase C-γ (PLC-γ) is important for immune responses and is linked to inflammatory disorders; this study focused on its role in Graves' orbitopathy (GO) and tested a specific inhibitor, U73122.
  • The researchers found that PLCG1 and PLCG2 were expressed more in GO tissues compared to normal ones, and that U73122 effectively reduced inflammation markers in GO fibroblasts and normal fibroblasts.
  • The study concludes that inhibiting PLC-γ with U73122 may lower inflammatory responses and suggests PLC-γ as a potential therapeutic target for treating Graves' orbitopathy.
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Background: Autoimmune hepatitis (AIH) varies significantly in incidence and prevalence across countries and regions. We aimed to examine global, regional, and national trends in incidence and prevalence of AIH from 1970 to 2022.

Methods: We conducted a thorough search of the PubMed/MEDLINE, Embase, CINAHL, Google Scholar, and Cochrane databases from database inception to August 9, 2023, using the search term "autoimmune hepatitis" in combination with "incidence," "prevalence," or "trend.

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Background And Aims: Owing to 2018 expanded diagnostic criteria for eosinophilic esophagitis (EoE) and thus a possible increase in diagnosis, previous studies on the global incidence and prevalence of EoE may need to be updated. We aimed to describe global, regional, and national trends in the incidence and prevalence of EoE from 1976 to 2022 and analyze their associations with geographic, demographic, and social factors through a systematic review.

Methods: We searched the PubMed/MEDLINE, Embase, CINAHL, Google Scholar, and Cochrane databases from their inception dates to December 20, 2022, for studies that reported the incidence or prevalence of EoE in the general population.

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  • Glycogen storage disease type VI (GSD VI) is caused by mutations in the PYGL gene, affecting liver glycogen metabolism; this study reviews clinical features and long-term outcomes in Korean patients.
  • The analysis included five patients with an onset age of 18-30 months and showed common symptoms like hepatomegaly and high triglyceride levels; genetic testing revealed ten PYGL variants, with six being novel.
  • Patients followed a high-protein diet and some received corn starch, which led to improvements in liver function, triglyceride levels, and growth metrics over time, highlighting the effectiveness of genetic testing for diagnosis and treatment monitoring.
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  • Biliary atresia is a serious bile duct condition in newborns that requires quick diagnosis and surgical treatment; this study aimed to create a machine learning model to improve detection of the condition.
  • Researchers analyzed data from over 1,600 newborns with cholestasis and found that specific lab results and imaging tests were key indicators; they used the XGBoost machine learning framework to develop models with high accuracy in predicting biliary atresia.
  • The new predictive models were validated with high performance scores and were integrated into a web-based tool to assist in clinical settings, making this one of the largest studies focused on neonatal cholestasis detection.
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Objectives: Methotrexate (MTX) has been used as maintenance therapy for Crohn disease (CD) in adults and children. However, there are only a few studies on the MTX's effectiveness in thiopurine-naïve CD adult patients and children. This study aimed to evaluate the MTX's effectiveness and safety as first immunomodulator for maintenance therapy in pediatric CD.

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Pediatric acute liver failure (PALF) is a common cause of liver transplantation (LT) but showed poor post-LT outcomes. We reviewed 36 PALF patients and 120 BA patients who underwent LT in our institution. The cause of PALF was unknown in 66.

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  • * This case study presents a 10-year-old boy with APS who displayed multiple symptoms including lipodystrophy, hypertrophic cardiomyopathy, and hyperuricemia, ultimately diagnosed with focal segmental glomerulosclerosis (FSGS) after genetic testing.
  • * Over three years, the child's kidney function worsened, emphasizing the need for early screening and management of kidney-related symptoms in APS patients from a young age.
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  • * Researchers analyzed plasma samples from 165 children and adolescents, identifying 18 specific metabolic features linked to pediatric NAFLD, noting changes in lipid and amino acid metabolism.
  • * Machine learning models, including ElasticNet and random forest, were developed for NAFLD diagnosis, achieving high accuracy, indicating that these metabolomic changes could serve as a less-invasive diagnostic method for the disease in children.
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  • The study researched the causes and outcomes of neonatal cholestasis in a hospital, aiming to create a model to predict mortality in affected infants.
  • Researchers analyzed data from 4028 infants, finding that conditions like prematurity and congenital heart anomalies were leading causes, with a 9.9% mortality rate within the first year.
  • A prediction model based on simple lab tests demonstrated strong performance in predicting mortality, validated by external data from other hospitals, indicating its potential clinical utility.
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Background/aims: Chronic intestinal pseudo-obstruction (CIPO) is a clinically heterogeneous syndrome characterized by compromised peristalsis and intestinal obstruction. Variants of actin gamma 2 (), a protein crucial for correct enteric muscle contraction, have been found in CIPO patients. The aim of this study is to examine the clinical features and variants in Korean patients with CIPO.

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Background: Inflammatory bowel disease (IBD) is associated with an increased risk of Colorectal cancer (CRC), and its most important risk factors are the duration and extent of the disease. Pediatric-onset inflammatory bowel disease has a tendency for a more extensive, more severe, and longer predicted disease duration than adult-onset inflammatory bowel disease. This study aimed to identify the clinical characteristics of patients with CRC related to pediatric-onset IBD and consider the appropriateness of current surveillance endoscopy recommendations for the detection of premalignant lesions and early-stage CRC.

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Niemann-Pick disease type C (NPC) is a neurovisceral lysosomal storage disorder caused by mutations in the and genes. These mutations cause the accumulation of unesterified cholesterol and other lipids in the lysosomes. NPC has a broad spectrum of clinical manifestations, depending on the age of onset.

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Background: Although genetic variants of PNPLA3, TM6SF2 and SAMM50 have been reported to increase the risk of non-alcoholic fatty liver disease (NAFLD), no pediatric studies have evaluated the association between SAMM50 and NAFLD.

Objective: This study aimed to investigate the risk factors, including genetic variants, of pediatric NAFLD.

Methods: NAFLD was defined as the presence of hepatic steatosis on ultrasound.

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