• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.1
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• pp.86-90
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• 2011

Wilson's disease is an autosomal recessive disorder of copper metabolism consequence of which leads to accumulation of copper in the liver, brain, cornea and other tissues. The manifestations are more likely to be hepatic in the early childhood and neurological in the adolescents. In addition, the abnormalities that develop during disease progression may result in other manifestations such as hematologic, endocrine, or renal findings. We report a thirteen year-old girl who manifested tetany shortly after the initial diagnosis of Wilson's disease. Despite aggressive calcium, magnesium and vitamin D replacement, the hypocalcemia and hypomagnesemia did not respond to the therapy promptly. It took more than three weeks for blood levels of the minerals to be normal. We concluded that tetany occurred in our patient because of hypoparathyroidism as a rare complication of Wilson disease, vitamin D deficiency resulting from various conditions, and inconclusive hypomagnesemia.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.1
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• pp.118-122
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• 1997

We experienced a case of 51-year-old female patient who showed symptoms of persecutory delusion, auditory hallucination and hallucinatory behavior, severe insomnia, psychomotor retardation and social withdrawal, along with some clinical signs of the deficiency of various hormones those gradually progressed after massive postpartum vaginal bleeding 13 years ago. She was admitted to a psychiatric ward under the impression of psychotic depression. However careful history taking and evaluation of clinical feature gave rise to the possibility of underlying medical condition. Laboratory work-up revealed panhypopituitarism, hypoglycemia and hyponatremia. After replacement of thyroid hormone and cortisol for 1 week, her clinical symptoms including psychiatric symptoms were improved. Taken together, these findings were compatible with the diagnosis of Sheehan's syndrome. On reporting this case, we would like to emphasize again the importance of differential diagnosis of medical problems causing psychiatric symptoms those are easily neglected in the clinical approach toward psychiatric patients.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.14 no.2
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• pp.186-190
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• 2014

Citrullinemia type 2 (citrin deficiency) is an autosomal recessive inborn error metabolism, caused by the SLC25A13 gene mutation. Citrin deficiency is associated with two clinical phenotype; neonatal-onset type II citrullinemia (CTLN2), also known as neonatal intraphepatic cholestasis caused by citrin deficiency (NICCD) and adult-onset CTLN2. Clinical manifestations of NICCD include poor growth, intrahepatic cholestasis, liver dysfunction and increased plasma citrulline, methionine, threonine, arginine. The molecular diagnosis could be confirmed by SLC25A13 gene mutation analysis. A 3-month-old male infant with persistent jaundice was referred for evaluation. Newborn screening was normal at birth. Mild elevation of serum ammonia and AST/ALT were observed. Plasma amino acid analysis showed significantly elevated citrulline, methionine, threonine. DNA sequence analysis of the SLC25A13 gene revealed two compound heterozygous mutations, c.[852_855del]($p.Met285Profs^*2$) and [1180+1G>A]. We suggest that NICCD should be considered as one of the cause of in infants with cholestatic jaundice, although the newborn screening was normal.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.116-122
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• 1995

목적 : 다음과 같은 fluoxetine으로 유발된 조증 증례를 보고한다. 이와 함께 fluoxetine사용이후 보고된 조증 증례보고를 모아서 정리하고 함께 문헌고찰을 하였다. 증례요약 : 가족력상 기분장애의 병력이 없었으며, 다른 주요 정신과적 질환의 병력은 없었다. 환아는 개인력상 5세경에 주의력 결핍, 과잉행동의 양상을 보였던 병력이 있었고, 13세때에 피해 망상, 환청이 지속되어 haloperidol로 치료받기 시작하였다. 이후 피해 망상의 내용을 언급하거나 환청에 영향받는 행동은 없어졌고 간혹 우울감을 호소하였다. 이후 정신분열증의 진단 하에 haloperidol만으로 3년간 유지하였다. 1994년 환아는 18세때 고3이 되면서 대입에 대한 걱정과 신체적인 허약감을 자주 호소하며, 우울증상이 두드려져 fluoxetine 20mg를 3일간 투여하던 중 갑자기 조증의 임상적 양상을 보이기 시작하여 본원의 입원치료를 받게 되었는데, 입원당시 보인 임상양상은 앙양된 기분, 이자극성(irritability), 사고의 비약, 연상의 이완과 지리멸렬, 과대망상, 피해망상, 관계망상, 환청 등이었고 사람, 장소, 시간에 대한 지남력까지 일시적으로 상실되는 심헌 정신병적 조증상태였다. 토의 : fluoxetine 사용이후 현재까지 세계적으로 문헌상 보고된 14개의 증례보고를 모아서 정리하였다. fluoxetine-induced mania의 병태생리학적인 기전은 명확하지 않지만 가능한 기전에 대해 토론하였다. 이 약물의 중대한 부작용중의 하나인 조증을 예방하기 위해, 이 약물을 다루는 의사는 가능한 조증 발병의 위험인자들에 대하여 인식하고, 약물의 용량조절시에도 주의를 하여야 한다. 가능한 발병 위험인자들에 관해서도 검토하였다.

• Proceedings of the KSMRM Conference
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• 1999.04a
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• pp.99-108
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• 1999

선천성 대사 이상은 다양한 뇌질환으로 나타낸다. 일반적으로 이 질환들은 하나 또는 둘이상의 대사경로에 대한 생화학적 이상에 원인이 있다. 정상적 생화학적 산물의 결핍이나 비정상적 산물의 축적에 의한 뇌기능 이상에 의해 임상증상이 나타내게 되는데 그 증상은 대개 경기, 경직성, 발육지연 등으로 비특이적이고 영상소견도 마찬가지로 비특이적이다. 대사 이상에 있어서의 신경병변은 일부 뇌백질을 주로 침범하는 경우를 제외하면 대부분 뇌백질을 침범하고 따라서 일반적으로 일차성 뇌백질 질환이 대사성 뇌질환을 일컫는다고 할 수가 있다. 뇌백질 질환은 뇌백질의 구성원중 가장 큰 부분을 차지하는 수초(myelin)를 침범하는 질환을 일컫는다. 중추신경계의 백질은 수초로 싸여있는 축삭(axon)과 선경교세포 (neuroglial cell) 및 혈관 등으로 구성되어 있으며, 이중 대부분을 수초가 차지하고 이 수초로 인하여 정상 뇌백질이 흰색을 나타낸다. 백질내의 신경교세포로는 성상세포 (astrocyte) 와 핍지세포 (oligodendrocyte)가 있으며 신 경교세포의 가장 중요한 기능은 핍지세포에 의한 축삭의 외피화 (ensheathment) 즉, 수초이다. 수초는 핍지세포의 세포질 돌기 (cytoplasmic process)의 일부이며 따라서 수초의 생존과 대사는 핍지세포와 운명을 같이한다. 일반적으로 세포의 생존, 대사와 가장 관련있는 기능은 세포질내에 함유되어 있는 구조물인 소기관(organelle)에 의하여 수행된다. 따라서, 비록 모든 소기관들이 백질 질환을 이르키는데 직접 연관되어 있지는 않더라도 수초의 생존과 대사에는 핍지세포의 소기관들이 매우 중요한 역할을 하게 된다. 세포질내 중요한 소기관으로는 세포 막, 미토콘드리아 (mitochondria), endoplasmic reticulum, Golgi 체, lysosome, peroxisome 그리고 세포질등이 있으며, 이들중에서 lysosomes, peroxisomes, 그리고 미토콘드리아가 특정한 유전성 백질질환에 중요한 역할을 하는 것이 밝혀졌다. 이러한 질환들은 최소한 각 소기관에 의한 질환군으로 분류될 수 있다.

• Korean Journal of Poultry Science
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• v.30 no.1
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• pp.55-59
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• 2003

A necrotizing skeletal myopathy was diagnosed in three flocks of 30,000 thirty-eight-week-old layer breeder chickens. The mortality attributed to the myopathy was 17.7%, 12.3% and 21.1% in flock A, B and C, respectively. Clinically, chickens were showed depression, anorexia, posterior paresis, inability to rise, incoordination, reluctance to move, and leg trembling and weakness. The most striking findings at necropsy was pale streaking in the muscles of the thighs and legs. Microscopic lesions included myofiber degeneration and necrosis with massive cellular proliferation interpreted as sarcolemmal nuclei proliferation. Plasma creatine kinase, asparte aminotransferase and akaline phosphatase were markedly elevated. In conclusion, author suggested that submitted chickens were affected by ionophores poisoning.

• Pediatric Infection and Vaccine
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• v.27 no.3
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• pp.190-197
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• 2020

Laryngotracheobronchitis (LTB) is a common disease in the pediatric population, and it is rarely caused by a fungal infection. Acute respiratory failure caused by fungal LTB mainly occurs in immunocompromised patients, and early diagnosis is closely associated with morbidity and mortality. However, an appropriate diagnosis is challenging for pediatricians because symptoms and signs of LTB caused by Aspergillus spp. are nonspecific. Here, we report a case of progressive respiratory failure caused by pseudomembranous LTB in a child with a suspicion of primary immunodeficiency and highlight the importance of an early investigation, especially in immunocompromised patients.

• Korean Journal of Soil Science and Fertilizer
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• v.17 no.4
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• pp.389-398
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• 1984

The effect of N forms ($NO_3{^-}-N$, $NH_4{^+}-N$) and concentrations (4, 8, $16meq/{\ell}$) which were changed at head formation stage on the tip-burn incidence of chinese cabbage was studied under the three levels (0, 8, 16 meq/l) of Ca. All of the plants grown on $NH_4{^+}-N$ showed the symptoms of tip-burn and low yields regardless of Ca levels. Roots of plants grown on $NH_4{^+}-N$ were severely damaged. The pH of the leachate from $NH_4{^+}-N$ pot was decreased to below pH 5. Plants which had been grown on $NH_4{^+}-N$ before the head formation stage, but changed to $NO_3{^-}-N$ were recovered from abnormal growth. But, the reverse showed the tip-burn symptoms. $NH_4{^+}-N$ treatments increased the T-N contents, but lowered K and Ca contents of inner leafblades. Icreased applications of Ca did not affect the T-N and K contents of the inner leafblades. $NH_4{^+}-N$ suppressed Ca translocation into the inner leaves from outer leaves after the head formation stage, but $NO_3{^-}-N$ accelarated it. Ca contents were much lower in leaves showing tip-burn symptoms than in healthy leaves. Internal rot which is a tip-burn symptom occuring after head formation were noted in plants applied with high concentration of $NO_3{^-}-N$ both before and after the head formation stage. Ca contents correlated well with the rates of Ca application, but there was no correlation between ca conents and internal rot incidence. Chinese cabbage tip-burn is not caused by Ca deficiency, as is commonly believed, but rather by the water stress (95% water contents in $NO_3{^-}$-fed plants, 91% in $NH_4{^+}$-fed plants) resulting from root damage caused by ammonium toxicity. Internal rot is also caused by excess applications of nitrogen, and is unaffected by calcium levels.

• Horticultural Science & Technology
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• v.28 no.5
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• pp.743-749
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• 2010

Objective of this research was to investigate the effect of various potassium concentrations in fertilizer solution on growth of and nutrient uptake by 'Chugyang' eggplant ($Solanum$ $melongena$ L.). Tissue analyses were conducted to determine the threshold levels of potassium in plants when disorders develop for potassium. The lower leaves of K deficient plants became spotted, yellowing in color, and finally necrosis occurred. The necrosis spread inward and upward. K toxic plants developed necrotic spot at the margin of old leaves and the surface of old leaves were twisted. The tissue K contents in the most recently fully expanded leaves and dry weight of full above ground plant tissue at 35 days after transplanting showed linear and quadratic response to elevated K concentrations with the equation of y=1.127+0.3147x ($R^2$=0.8916) and y=14.92+2.2743x-$0.1402x_2$ ($R^2$=0.8659). When 10% reduction in dry weight set to threshold levels, optimum tissue K contents are in the range from 2.1 to 5.1%. The yield through 150 days after transplanting and tissue K contents at 150 days after transplanting also showed quadratic and linear responses to elevated potassium concentrations in fertigation solution with the equation of y=153.24+345.5x-$18.46x^2$ ($R^2$=0.8620) and y=0.9921+0.3860x ($R^2$=0.9611), respectively. When the 10% reduction in yield is set to threshold levels, the tissue K contents for maximum yield should be around 3.4% to 5.9% in most recently fully expanded leaves.

• Journal of Aquaculture
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• v.19 no.4
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• pp.225-230
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• 2006

A long-term (26 weeks) feeding experiment was conducted to examine the essentiality and requirement of inositol in diets for olive flounder because no information is available in the species. Five casein-gelatin based semi-purified diets were formulated to contain four different levels of myo-inositol (0, 0+antibiotic, 400, 800, and 1600 mg/kg, designated as M0, M0+, M400, M800, and M1600, respectively). One (M0+) of the control diets contained tetracycline hydrochloride (0.4%, wt/wt) as an antibiotic to inhibit biosynthesis of inositol by micro-organism in intestine of fish. Olive flounder at the early juvenile stage (initial body weight 1.22 g) were randomly distributed into fifteen 35 L tanks (48 fish/tank) and fed with one of the experimental diets (3 replicates per diet). At the end of the feeding trial, the weight gain, feed intake, specific growth rate, and protein efficiency ratio of fish fed diets containing higher levels of myo-inositol (M800 & M1600) were significantly higher than those of fish fed the other diets (P<0.05). Feed conversion ratio, survival, hematocrits, and hemoglobin of fish fed experimental diets were not significantly different among all the fish groups. Whole body compositions of fish were not different except for lipid content. The lipid content was significantly different between M0 and M400 diet groups. These results indicate that juvenile olive flounder requires dietary supplementation of myo-inositol in diets for normal growth and its optimum level seems to be approximately 800 mg myo-inositol/kg diet.