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Modified Blalock-Taussig Shunt for the Patients with Complex Congenital Heart Defects in Early Infancy (조기 영아기에 시행된 복합 심기형 환자들에서의 변형 Blalock-Taussig 단락술)

  • Lim Hong Gook;Kim Woong-Han;Hwang Seong Wook;Lee Cheul;Kim Chong Whan;Lee Chang-Ha
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.335-348
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    • 2005
  • Background: This retrospective review examines the preoperative condition, postoperative course, mortality and cause of death for the patients who underwent modified Blalock-Taussig shunt for complex congenital heart defects in early infancy. Material and Method: Fifty eight patients underwent modified Blalock-Taussig shunts from January 2000 to November 2003. The mean age at operation was $23.1\pm16.2$ days ($5\~81\;days$), and the mean body weight was $3.4\pm0.7\;kg\;(2.1\~4.3\;kg)$. Indications for surgery were pulmonary atresia with ventricular septal defect in 12 cases, pulmonary atresia with intact ventricular septum in 17, single ventricle (SV) in 18, and hypoplastic left heart syndrome (HLHS) in 11. Total anomalous pulmonary venous return (TAPVR) was associated with SV in 4 cases. Result: There were 11 ($19.0\%$) early, and 5 ($10.6\%$) late deaths. Causes of early death included low cardiac output in 9, arrhythmia in 1, and multiorgan failure in 1. Late deaths resulted from pneumonia in 2, hypoxia in 1, and sepsis in 1. Risk factors influencing mortality were preoperative pulmonary hypertension, metabolic acidosis, use of cardiopulmonary bypass, HLHS and TAPVR. Twenty four patients ($41.4\%$) had hemodynamic instability during the 48 postoperative-hours. Six patients underwent shunt revision for occlusion, and 1 shunt division for pulmonary overflow. Conclusion: Modified Blalock-Taussig shunt for complex congenital heart defects in early infancy had satisfactory results except in high risk groups. Many patients had early postoperative hemodynamic instability, which means that continuous close observation and management are mandatory in this period. Aggressive management may appear warranted based on understanding of hemodynamic changes for high risk groups.

Effect of Irradiation, Packaging and Storage on the Oxidation of Cholesterol and Lipid in Pork Longissimus Meat (돈육 등심의 콜레스테롤 및 지질 산화에 전자선 조사, 포장 및 저장기간이 미치는 영향)

  • 신택순;이정일
    • Food Science of Animal Resources
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    • v.22 no.2
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    • pp.137-144
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    • 2002
  • Pork loins that retailed in market were used as experimental samples. Some pork samples in raw state were packaged with PVDC in either aerobic or vacuum condition. The other pork samples were cooked until core temperature reached at 70$\^{C}$ and then packaged immediately in the same way with the raw samples. After these samples were irradiated by electron beam 6 kGy, the samples were stored in a refrigerator (2∼4$\^{C}$). Identification and quantification of cholesterol oxides were performed at 0 and 7 days. The results were following. During the early stage of storage, cholesterol oxides were not produced from the raw meat samples, but with the passage of storage time,7 $\alpha$-hydroxycholesterol, 7$\beta$-hydroxycholesterol, 7-ketocholesterol, 20 $\alpha$-hydroxycholesterol, $\beta$-epoxide and $\alpha$-epoxide, which were not produced during the early stage of storage, were produced. The production of cholesterol and lipid oxidation products were significantly higher (P<0.05) in the meats with aerobic packaging than those with vacuum packaging, Cooked meat after irradiation showed 7 $\alpha$-hydroxycholesterol, 7 $\beta$-hydroxycholesterol, $\alpha$-epoxide and cholestanetriol on the 7th day of storage, although those chemicals were not produced during the early stage of storage. Production of cholesterol oxides was significantly increased (P<0.05) with the passage of storage time for all treatments, and showed significantly lower value (P<0.05) with the vacuum packaging than these for aerobic packaging. Species of cholesterol oxides from irradiated meat after cooking were similar to those from cooked meat after irradiation. Collectively, it was found that the production of cholesterol oxides was more easily affected by packaging condition than irradiation.

Clinical Course of IgA Nephropathy in Children (소아 IgA 신병증의 추적 관찰)

  • Hong In-Hee;Lee Jun-Hwa;Go Cheol-Woo;Kwak Jung-Sik;Koo Ja-Hoon
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.153-160
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    • 1999
  • Purpose : Present study was undertaken to find out significance of clinical presentation, initial laboratory data and renal biopsy findings on subsequent clinical course of IgA nephropathy in children. Methods : Clinical and laboratory data were analysed retrospectively from 60 children who have been admitted to the Pediatric Department of Kyungpook National University Hospital for the past 11 years and diagnosed as IgA nephropathy. Renal biopsy findings were graded according to the pathologic subclass proposed by Haas. Results : Pathologic grading according to Haas subclassification showed 10 cases in subclass I, 36 in II, 12 in IV and 2 in V and none in subclass II. Sex distribution showed male predominance (male to female ratio = 3 : 1) and mean age at onset of disease was $10.4{\pm}2.8$ years. Episodes of gross hematuria was seen in 71.7% and IgA level increased in 28.3% of children and these were not associated with pathologic grading nor clinical outcomes. With increasing subclass grading, serum protein and albumin decreased and 24 hours urinary protein excretion increased. Normalization of urinalysis (disappearance of hematuria) was seen in 14% at 1-2 years and 37.1% at 3-4 years of follow up period. In 3 cases, renal function deteriorated progressively and they belonged one each to the Haas subclass III, IV and V. Conclusion : In children with IgA nephropathy, progression to chronic renal failure appears to be quite high and pathologic grading according to Haas' subclassification seems to predict patient's outcome faily well. However, firm conclusion cannot be drawn from present study due to the small numbers of patients and short follow-up period. Therefore further multicenter study involving larger numbers of patients and longer periods of follow-up over 10 years was to be undertaken.

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Clinical Evaluation of Tissue Biopsy for Children with Neck Mass; A Single Center Study (조직검사를 시행한 소아 경부 종류의 임상적 고찰 : 단일 기관 연구)

  • Youn, You Sook;Yun, Hye Won;Kim, Sun Young;Sul, Ji Yeong;Song, Chang Jun;Kim, Jin Man;Park, Kyung Duk
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.839-845
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    • 2005
  • Purpose : Neck masses, in pediatric population, derive from a multitude of congenital, inflammatory, or neoplastic diseases. The majority of these masses represent benign conditions. However, thorough clinical evaluation is required to rule out malignant diseases. We evaluated the causes, clinical characteristics and outcomes of children with neck masses who underwent tissue biopsy. Methods : A total of 28 medical records of children with neck mass who underwent tissue biopsy at Chungnam National University Hospital, from January 2000 to March 2004 were retrospectively analyzed. The methods of biopsy were ultrasonography guided core biopsy(CB), fine needle aspiration biopsy(FNAB) and excisional biopsy. Results : Out of 28 patients, half were boys. The most common location of the mass was the posterior cervical area(N=19, 67.9%). Laboratory findings of peripheral blood and serologic studies were nonspecific. In 25(89.3%) cases, CB or FNAB was initially performed for neck masses. Among them 10 cases(40%) were reactive hyperplasia, 8(32%) inflammatory granulation tissues, 4(16%) necrotizing lymphadenitis, and 3(12%) acute suppurative inflammations. Initially, excisional biopsy was performed for diagnosis in 3(10.7%) cases. Diagnosis of these cases was thyroglossal duct cyst, dermoid cyst and lymphoblastic lymphoma, respectively. Conclusion : Most neck masses in children were benign. CB and FNAB were safe methods for tissue sampling, without need for general anesthesia.

Clinical aspects of chronic urticaria in children (소아 만성 두드러기의 임상 양상 및 경과)

  • Kang, Hye Seon;Shin, Mee Yong
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.205-212
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    • 2009
  • Purpose : Chronic urticaria is a disorder characterized by the appearance of wheals for more than 6 weeks; in most cases, the etiology is unknown. This study was aimed to discover the clinical aspects, the etiologic factors, and the course of chronic urticaria. Methods : 51 children who were diagnosed with chronic urticaria in the past 4 years, and who had had follow-ups more than 6 months after diagnosis in the pediatric department of Soonchunhyang University Hospital in Bucheon, were enrolled in the study. The laboratory findings, clinical aspects, and courses were retrospectively investigated by medical record review and telephone interview. Results : The median age of children with chronic urticaria was 4 years (8 months to 16 years) and the ratio of male to female was 1.4:1. Of the total, 39.2% of patients had a history of atopy. Angioedema occurred concurrently with urticaria in 11.8% of patients, and dermographism was seen in 41.2%. Results of thyroid function tests were normal and thyroid autoantibodies were absent in all cases. Regarding etiology, most cases (74.5%) were forms of idiopathic urticaria. Urticaria was induced by physical factors in 19.6% of patients. Open challenge tests revealed that 3 patients were allergic to food additives (glutamate 2, glutamate, and sulfite 1). In this study, most of the patients reported good response after medication of 1st- or 2nd-generation antihistamines alone. Follow-up at 6 months revealed that 70.6% of patients had experienced remission, and 84.8% of children who had follow-up at 1 year presented remission. Conclusion : Chronic urticaria in most patients was idiopathic. Remission occurred within 1 year of diagnosis, in most cases so chronic urticaria in children seems to have good prognosis.

The Clinical Features of Chronic Neonatal Hepatitis: Non-familial, Non-metabolic and Non-A, B, C Viral Hepatitis (만성 신생아 간염의 임상적 고찰: 비-가족형, 비-대사성, 비-A, B, C형 바이러스성 신생아 간염)

  • Park, Ji Ae;Lee, Chang Hun;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.242-248
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    • 2006
  • Purpose: Neonatal hepatitis is the major cause of neonatal cholestasis and may be divided into infectious, metabolic, genetic, and idiopathic neonatal hepatitis. Non-familial, non-metabolic, and non-A, B, C viral neonatal hepatitis is known to have made satisfactory progress, but little is known about its chronic clinical features. Methods: Clinical and histological assessments were carried out in 34 cases with chronic neonatal hepatitis [elevated serum alanine aminotrasferase (ALT) level for more than 6 months] except for A, B, C viral hepatitis, metabolic, or genetic neonatal hepatitis, who were admitted to the Department of Pediatrics, Pusan National University Hospital, from January 1998 to January 2004. Results: Males were more common (70%). Jaundice (100%) and hepatomegaly (44%) were frequent manifestations. Peak serum ALT levels were most commonly below 300 IU/L in 41.2% of patients and peak serum direct bilirubin levels were most commonly between 1.0~5.0 mg/dL in 50% of patients. Ten cases (34%) of 29 patients had positive serum cytomegalovirus (CMV) IgM or urine CMV polymerase chain reaction. Serum ALT level was normalized within 1 year in 11 (37.9%) of 29 cases, and within 2 years in 9 (69.2%) of 13 cases. Serum ALT level was elevated persistently over 2 years in four (30.7%) of 13 cases. Histologic findings such as portal or periportal activity, lobular necrosis, portal or periportal fibrosis were more severe in patients with persistent ALT elevation over 2 years than in those showing normalization of ALT within 2 years (p>0.05). Conclusion: When the elevation of ALT level sustains over 1 year in non-familiar, non-metabolic, non-A, B, C viral neonatal hepatitis, an assessment of the severity of liver injury and a careful monitoring about chronic liver disease may be required.

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Expressions of Laminin-1 in Lung Alveolar Septa after CS gas Exposure in Rats (CS 가스 흡입이 흰쥐의 폐포막내 Laminin-1에 미치는 영향)

  • Chon, Soon-Ho;Paik, Doo-Jin;Lee, Chul Burm;Kim, Hyuck;Chung, Won Sang;Kim, Young Hak;Kang, Jung Ho;Jee, Heng Ok
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.397-405
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    • 2005
  • Background : Laminin-1 is known to have regular functions in the development and course of differentiation of the lungs. The morphogenesis and distribution of laminin-1 still remains as a mystery and its distribution and changes in the molecular structure of laminin-1 in the pathogenesis of the lung still is a subject of great controversy. In this study, experiments were done to delineate the distribution and changes in the amount of laminin-1 after inducing inflammation of the lungs by exposing experimental animals to CS gas and especially, to find compositions of laminin-1 within type II pneumocytes. Materials and Methods : The experimental subjects of study were newborn rats and the extracted tissue from the experimental rats were viewed under light microscope and electron microscope after the sections were treated with immunohistochemical methods and immunogold reaction methods using bounded gold particles. Results : 1) Lymphocytes and mononuclear phagocytes invaded the alveolar septa in the 2 day group rats after CS gas exposure and intense interstitial inflammation was seen in the 3 day group. 2) Laminin immunoreactions decreased to a moderate degree in the 2 and 3 day group rats after CS gas exposure and strong laminin immunoreactions were seen again in the 5 and 7 day group rats. 3) Gold particles in basal lamina of the lung blood-air barrier decreased and in the type I pneumocytes decreased in the 2 and 3 day group rats after CS gas exposure. 4) Gold particles were seen only on the surface of the cell membranes of type II pneumocytes of the 1 and 2 day group rats after CS gas exposure. 5) Few gold particles around the lamellar bodies and cytoplasm of type II pneumocytes in the control rat group and at 12 hours after CS gas exposure. Gold particles are seen only on the surface of type II pneumocytes of the 1 and 2 day group rats after CS gas exposure and are evenly distributed in small amounts in the cells of the 3 day group after CS gas exposure. Conclusion : CS gas exposure in the rats caused inflammation of lung alveolar septa and also induced a decrease in laminin-1 in basal lamina and loss of laminin-1 in the cytoplasm of type II pneumonocytes. As the inflammatory cells disappeared, an increase in the distribution of laminin-1 occurred. This reflects tissue regeneration functions of laminin-1 in the pneumocytes of rats and the distribution of laminin-1 in type II pneumocytes can be seen through the electron microscope using immunogold methods.

Effects of Supplementation of Spent Mushroom(Flammulina velutipes) Substrates on the in vitro Ruminal Fermentation Characteristics and Dry Matter Digestibility of Rye Silage (호밀 사일리지 제조 시 팽이버섯 수확 후 배지 첨가수준이 in vitro 반추위 발효특성 및 건물소화율에 미치는 영향)

  • Kang, Han-Byeol;Cho, Woong-Ki;Cho, Soo-Jeong;Lee, Shin-Ja;Lee, Sung-Sill;Moon, Yea-Hwang
    • Journal of agriculture & life science
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    • v.51 no.5
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    • pp.91-101
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    • 2017
  • The in vitro experiment was conducted to ensure the supplemental level of spent Flammulina velutipes mushroom substrates(SMS) as an energy source in manufacturing of rye silage. Rye harvested at heading stage was ensiled with spent mushroom substrates of 0%(Control), 20%(R-20), 40%(R-40) and 60%(R-60) as fresh matter basis for 6week. The rumen fluid for preparation of in vitro solution was collected from two cannulated Holstein bulls fed a 40:60 concentrate:timothy diet. The experiment was conducted by 3, 6, 9, 12, 24, and 48 hrs of ncubation time with 3 replications. The silages were evaluated fermentation characteristics and dry matter digestibility(DMD) in vitro. The pH of in vitro solution was inclined to decrease with elapsing the incubation time, and that of the R-60 was significantly(p<0.05) lower than the other treatment at 48 hr of incubation. The microbial growth in vitro was inclined to increase with elapsing the incubation time, and that of the R-20 was significantly(p<0.05) greater than the Control at 48 hr of incubation. Gas production was greater(p<0.05) in the Control than the other treatments at 48 hr of incubation. In vitro dry matter digestibility(IVDMD) was higher with increasing the supplemental level of SMS, and was significantly(p<0.05) lower in the Control compared with other treatments throughout whole incubation time. The IVDMD for R-60 was the highest(p<0.05) among treatments at 24 hr and 48 hr of incubation. Considering of above results and the availability of SMS, SMS could be supplemented by 60% in fresh matter basis for rye silage fermentation.

Analysis of Ruminal Dry Matter and Crude Protein Digestibility on Major Roughage, Wormwood and Green Tea (주요 조사료원과 쑥, 녹차의 반추위 건물 및 조단백질 소화율에 대한 분석)

  • Lee, Shin Ja;Lee, Su Kyoung;No, Jin Gu;Kim, Do Hyung;Lim, Jung Hwa;Moon, Yea Hwang;Lee, Sung Sill
    • Journal of agriculture & life science
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    • v.50 no.5
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    • pp.139-152
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    • 2016
  • The comparative in vitro and in situ analysis were conducted to evaluate the rumen degradability and physical structure of domestic roughage as rice straw, timothy, alfalfa, wormwood and green tea. The feedstuffs incubated with rumen fluid and was used to determine gas production, microbial growth rate and pH changes in an in vitro experiment. The gas production was increased during incubation times and was significantly(p<0.05) lower in green tea than other feedstuffs. The microbial growth rate in the feedstuffs was increased during incubation times. However, microbial growth rate was significantly(p<0.05) lower in wormwood and green tea than other feedstuffs. Ruminal pH was decreased during incubation times, and timothy was the lowest, and rice straw was the highest among feedstuffs. The disappearance rate of dry matter(DM) and crude protein(CP) in all feedstuffs were increased during incubation times and green tea was the highest(p<0.05) compared with other feedstuffs. In effective degradability, when rumen out-flow rate was assigned to 4%, wormwood showed the highest in DM, and alfalfa was the highest in CP. Whereas, green tea was the highest in both in situ DM and CP degradability. Many cilia on the surface and stoma of wormwood and stoma in green tea were observed by scanning electron microscopy. Microbes breaked down the cilia at the beginning and then degraded the surface in wormwood. In case of green tea, microbes attached to stoma. Therefore, wormwood and green tea have a potential value as ruminal feed stuffs.

Clinical Characteristics of Childhood Henoch-Sch$\"{o}$nlein Purpura with Duodenal Involvement by Upper Gastrointestinal Endoscopy (내시경상 십이지장을 침범한 Henoch-Sch$\"{o}$nlein Purpura 환아의 임상적 특징)

  • Park, Sun-Hee;Nam, Yoo-Nee;Park, Sang-Hui;Sim, So-Yeon;Eun, Byung-Wook;Choi, Deok-Young;Sun, Yong-Han;Cho, Kang-Ho;Ryoo, Eell;Son, Dong-Woo;Jeon, In-Sang;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.156-162
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    • 2009
  • Purpose: The aim of this study was to investigate the clinical usefulness of upper gastrointestinal (GI) endoscopy in children with Henoch-Sch$\"{o}$nlein purpura (HSP). Methods: We retrospectively analyzed the clinical, endoscopic, and histopathologic records of children with HSP who had been admitted to the Department of Pediatrics of Gil Hospital and underwent upper GI endoscopy between January 2002 and June 2009. Patients were classified into the following two groups for statistical analysis: duodenal involvement (+) and duodenal involvement (-). Results: Fifty-one children with HSP underwent upper GI endoscopy; the mean age was 7.2${\pm}$2.9 years. The upper GI endoscopy showed abnormalities of the duodenum in 38 cases (74.5%), 22 of which had duodenal ulcers. Among the biopsy specimens obtained from the duodenum of 37 cases, 13 cases (35.1%) had leukocytoclastic vasculitis, neutrophil debri, and/or extravasation of RBCs. Steroid use was more frequent in the duodenal involvement (+) group (86.8%) than the duodenal involvement (-) group (53.8%; p=0.02). The mean length of hospitalization was 13.9${\pm}$8.43 days in the duodenal involvement (+) group and 8.1${\pm}$4.62 days in the duodenal involvement (-) group (p=0.003). The recurrence rate was significantly higher in the duodenal involvement (-) group than the duodenal involvement (+) group (p=0.027), whereas none of the other study parameters, such as the age of onset, renal involvement, and steroid use, led to significantly higher or lower recurrence rates. Conclusion: These results suggest that duodenal involvement can influence the clinical course and prognosis of HSP in children.

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