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Clinical Study on Hemolytic Uremic Syndrome in Children: Review of 23 Cases (소아 용혈성 요독 증후군 23예에 대한 임상적 고찰)

  • Oh Seungjin;Yook Jinwon;Kim Ji Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.4 no.2
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    • pp.136-143
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    • 2000
  • Purpose : The hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia thrombocytopenia, and acute renal failure. It is ole of tile most common cause of acute renal failure in children but few reports are available in Korea. Thus we investigated the 23 patients diagnosed as HUS during last 14 years. Method : We retrospectively investigated the etiologic factor, clinical manifestations laboratory findings, treatment modalities, and final outcomes of the patients. Then patients were divided into two groups according to outcome, md comparison was performed. Group A(8) comprised patients who progressed to end-stage renal disease or expired. Group B(15) comprised patients who completely recovered after dialysis treatment. Result The number of patients aged less than 4 years were 17; between 5 and 10 were 4 and more than 10 were 2. The gende ratio was M:F=2 : 1. The etiologic factors were as follows: acute gastroenteritis in 14 patients including 4 bloody diarrhea, upper respiratory tract infection in 7 patients, and 1 patient with herbal mediation. The overall mortality rate was 22$\%$: 2 patients died of US complications, 2 patients died of sepsis, and 1 patient died of pulmonary hemorrhage. Group A (Hb 4.8${\pm}$1.2 g/dL) showed lower value in hemoglobin than group B (Hb 6.3${\pm}$1.7 g/dL) during hospital stay (P< 0.05), And the time interval between tile disease onset and dialysis treatment was significantly longer in group A ($11.9{\pm}9.1\;days\;vs\;2.8{\pm}2.1\;days$) (P< 0.05). Conclusion : Overall mortality rate was 22$\%$. Low hemoglobin value and the prolonged time interval between the disease onset and dialysis treatment were related with poor prognosis. So early diagnosis and appropriate intensive care including dialysis treatment is essential to achieve better outcome in children.

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Cystic Diseases of the Kidney in Children (소아의 낭포성 신질환)

  • Lee Ji-Suk;Rho Kwang-Sik;Kim Ji-Hong;Lee Jae-Seung;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.144-150
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    • 1997
  • Purpose : The kidney is one of the most common sites of cyst formation. Cystic diseases of the kidney are a diverse group of clinicopathologic entities and variable prognosis. They span a wide range of both age of presentation and severity of the renal disease. And many of them are systemic disorders, sharing similar process of cyst formation in other organs. Recently, development of imaging studies has been contributing widely to the diagnosis of the diseases. Treatment, however, is not established satisfactorily. We performed this study to evaluate the occurrence and treatment of cystic diseases of the kidney. Methods : We reviewed retrospectively the medical records of 44 patients with cystic diseases of the kidney in the Department of Pediatrics, during last 11 years. Results : In the 44 patients with cystic diseases of the kidney, 31 patients(71%) had multicystic dysplastic kidney and 11(35%) of them received nephrectomy due to differentiation from neoplasms or severe abdominal distension. Seven patients(16%) had polycystic kidney disease, and all of them were infantile type. Five patients(11%) were diagnosed as having a simple renal cysts. Progression to renal failure was noted in none of the cases. In 14(32%) out of total 44 patients, the diagnosis was made in neonatal or infantile pelted. Conclusion : The incidence of cystic diseases of the kidney appeared very low, but further investigation on their pathogenesis, classification, and indication of treatment is needed.

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Should Voiding Cystourethrography be Performed for Infants with Urinary Tract Infection? (요로감염 영아에서 배뇨성방광요도조영술이 필요한가?)

  • Woo, Mi-Kyeong;Kim, Mun-Sub;Koo, Ja-Wook
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.54-61
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    • 2008
  • Purpose: This study was performed to assess necessity of voiding cystourethrography (VCUG) for infants with urinary tract infection (UTI) who had both normal renal sonography and normal DMSA renal scans. Methods: We reviewed 117 infants hospitalized for UTI between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture(n=57), catheterization(n=58), or collection bag method (n=2, twice positive culture of the same organism). All patients had undergone renal sonography, DMSA renal scan and VCUG. Children with both normal renal sonography and normal DMSA renal scans were evaluated for the presence or severity of vesicoureteral reflux (VUR). Results: Of the 117 patients, 96 were boys and 21 were girls. 28 patients(23.9%) had VUR. 59(50.4%) showed both normal renal sonography and normal DMSA renal scans. Among these 59 patients, 7(11.9%) showed VUR. Three of them had grade I-II reflux, two grade III reflux, and the other two grade IV reflux. One of them showed bilateral VUR, grade IV reflux on the right and grade III on the left. Conclusion: Although the negative predictive value of both normal renal sonography and normal DMSA renal scan for VUR was 88.1%, 7 patients had VUR and two of them had high grade reflux(grade IV). So, we suggest that VCUG should be performed in infants with UTI despite both normal renal sonography and normal DMSA renal scans.

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A STUDY ON NEWCASTLE DISEASE VACCINATION: The Immunological Response to Inactivated and Attenuated Virus Vaccines (Newcastle병(病)의 예방접종(豫防接種)에 관한 연구(硏究); 사독(死毒)백신 및 감독(減毒)된 생독(生毒)백신에 대한 면역학적(免疫學的) 반응(反應))

  • Chung, Gill Taik
    • Korean Journal of Veterinary Research
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    • v.2 no.1
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    • pp.27-36
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    • 1962
  • Immune response to two methods of Newcastle disease virus vaccine, one inactivated and the other attenuated was observed and the data presented. (1) Administration of inactivated virus vaccine in an amount of 1.0 ml. by intramuscular route gave an appreciable immunity to Newcastle disease for a period of at least three-and-half months. (2) The chickens given attenuated virus vaccine in the drinking water produced satisfactory immunity as manifested by the fact that immunized birds showed resistance when challenged 105 days after the vaccination and maintained high degree of HI titer for a period of 75 days. (3) Vaccination with the attenuated virus vaccine in drinking water is very simple and time saving in procedure, although the duration of immunity seems to be slightly shorter than that proced by inactivated virus vaccine. The author wishes to express his appreciation, to Drs. Kyu Myung Lee, Chang Koo Lee, and Ryong Sook Kee of their suggestions and help. The author is also indebted to Dr. Chang Hi Lee, Director of Anyang Veterinary Laboratory, who allowed the use of the facilities of the laboratory, whitout which this experiment could not have been undertaken.

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Development of Auto-aging System for the Kimchi Refrigerator for Optimal Fermentation and Storage of Dongchimi (동치미 최적발효 및 저장을 위한 김치냉장고의 자동숙성 시스템 개발)

  • Noh, Jeong-Sook;Kim, Jong-Hyun;Lee, Myung-Ju;Kim, Myung-Hee;Song, Yeong-Ok
    • Korean Journal of Food Science and Technology
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    • v.40 no.6
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    • pp.661-668
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    • 2008
  • This study was investigated to determine the conditions for an auto-aging system placed within a kimchi refrigerator for optimal fermentation, as well as the optimal conditions for the prolongation of dongchimi storage time. Various fermentation characteristics of dongchimi stored at different temperatures ($5-23^{\circ}C$) were compared. The pH and acidity of dongchimi associated with the highest levels of overall acceptability were $3.9{\pm}0.1$ and $0.25{\pm}0.05%$, respectively. In order to establish the time point for the conversion of fermentation to storage, dongchimi was fermented at $10^{\circ}C$ or $15^{\circ}C$ until the acidity reached the designated points (0.1, 0.2, and 0.3%), and was then stored at $-1^{\circ}C$ for 1 week. According to the sensory evaluation, the dongchimi acidity of 0.2% fermented at $10^{\circ}C$ evidenced the highest levels of overall acceptability after 1 week of storage among the samples. In conclusion, we suggest conditions of $10^{\circ}C$ and $-2.5{\pm}0.5^{\circ}C$ for the fermentation and storage temperature, respectively, and a dongchimi acidity of 0.2% as an index for the time point for the conversion of fermentation to storage in the kimchi refrigerator.

Extending the Shelf-life of Yukwa Using Secondary Packaging (이차포장을 통한 유과의 저장성 연장)

  • Jung, Jun-Jae;Lee, Keun-Taik
    • Korean Journal of Food Science and Technology
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    • v.42 no.4
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    • pp.452-458
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    • 2010
  • This study aimed at improving the packaging technology of Yukwa to improve the quality and extend the shelflife using secondary packaging. After packaging the Yukwa using an OPP film, P2, P3, and P4 packaging materials were applied secondarily. Various films including (1) P1: OPP (oriented polypropylene), (2) P2: P1+OPP/LLDPE (linear low density polyethylene), (3) P3: P1+PET (polyethylene terephthalate)/NY (nylon)/CPP (cast polypropylene) and (4) P4: P1+PET/AL (aluminum)/NY/CPP (P4) were used for packaging Yukwa. The experiment was conducted at $25^{\circ}C$ for 12 weeks. P1 showed the highest acid value score (1.26 mg KOH/g), and P3 had the highest peroxide value score (32.91 meq/kg) among all packaging groups. Nevertheless, these values did not exceed the guideline values of 2.0 g KOH/g and 40 meq/kg specified in the Korean food code. The overall color difference showed a tendency for decreasing Hunter 'L' values and increasing 'a' and 'b' values; however, no noticeable difference in the outer appearance was observed in any of the packaging treatments except in the P1 for greater than 10 weeks of storage. Some texture defects were observed in the Yukwa when the moisture contents dropped below 5%. The P4 packaging treatment had the lowest moisture permeability and showed the least rheological deterioration change, followed by P3 and P2. In conclusion, the use of a secondary packaging with less gas and moisture permeability was more effective for maintaining the quality and extending the shelf-life of Yukwa than other types of packaging material.

Differences in T Serotypes and emm Genotypes of Group A Streptococci Obtained from Invasive and Non-invasive Streptococcal Infections (침습적 및 비침습적 감염 환자에서 분리된 A군 연구균의 T 혈청형과 emm 유전자형의 비교 연구)

  • Hahn, Wonho;Kim, Sejin;Ko, Hansoek;Jung, Sajun;Cha, Sungho;Lee, Heejoo;Lee, Kyungwon
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.106-114
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    • 2006
  • Purpose : Studying the serotypes and emm genotype of group A streptococci(GAS) hold a key role in the investigation of epidemiology, pathogenesis, and resistance to antibiotics. We planed to find out the possible differences in serotypes and genotypes between the invasive and the non-invasive GAS infection. Methods : We obtained 39 isolates from the patients hospitalized in 2004 with the diagnosis of invasive GAS infectious diseases in the Severance Hospital, Yonsei University. We sent the isolates to the WHO Collaboratory Center in University of Minnesota and analyzed T serotypes and emm genotypes. These results were compared with non-invasive GAS infections in our hospital. Results : Compared this data with the results of 2003 to 2004, T2/28, T3, T5/27/44, T9 and NT were more prevalent. The NT showed statistically significant difference(P=0.019). The emm 3, emm 9, emm 18, emm 44 and emm provision type STG485 were more frequent genotypes compared with the study in 2003~2004, relatively. The emm provision type STG485 had statistically significant difference(P=0.000). The incidence of T12 plus T4, known as erythromycin(EM) resistant serotypes, was as low as 17.9% in this study, compared with those of non-invasive strains. Conclusion : The incidence of EM-resistant strains is supposed not to be higher in invasive GAS infection. We could find out possible higher incidence of rheumatogenic strains in the invasive GAS infections. It seems to be important to have an effort on studying of serotyping and genotyping for the monitoring of strains and to know the epidemiologic characteristics.

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The Risk Factors for the Development of Hypertension in a Rural Area - An 1-Year Prospective Cohort Study - (농촌 지역 주민들의 고혈압 발생 위험요인 - 1년간 전향성 추적 조사 -)

  • Oh, Hee-Sook;Kam, Sin;Yeh, Min-Hae;Kang, Yun-Sik;Kim, Keon-Yeop;Lee, Young-Sook;Park, Ki-Soo;Son, Jae-Hee;Lee, Sang-Won;Ahn, Moon-Young;Chun, Byung-Yeol
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.2
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    • pp.199-207
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    • 2000
  • Objectives : This study was peformed to identify the risk factors related to the development of hypertension in a rural area. Method : Total of 3,573 subjects in Chung-Song County were interviewed and examined in 1996. The study cohort comprised 2,580 hypertension-free subjects aged above 20. One-year follow up was completed for 1,781 subjects(69.0%) in 1997. General characteristics(age, gender, education level, economic status, marital status), the family history of hypertension, diet, alcohol, smoking, coffee, stress, past history of oral contraceptive and menopausal status in female, height, weight, waist and hip circumference, baseline blood pressure, and serum total cholesterol were considered as risk factors. Results : Multivariate analysis using logistic regression model indicated that age(RH=1.50, 95% CI; 1.15-1.96), the family history of hypertension(RR=2.11, 95% CI; 1.04-4.26), waist-hip ratio(WHR) (RR=2.09, 95%, CI; 1.15-3.79), and baseline systolic blood pressure(130-139/<120mmHg)(RR=3.34, 95% CI; 1.47-7.60) were significant risk factors associated with the development of hypertension above the borderline level in male. In female, age(RR=1.06, 95% CI; 1.03-1.09), change in menopausal status$(no{\rightarrow}yes/no{\rightarrow}no)$ (RR=3.32, 95% CI; 1.01-10.87), baseline systolic blood pressure(120-129/<120mmHg: RR=2.00, 95% CI; 1.02-3.90)(130-139/<120mmHg: RR=2.64, 95% CI; 1.34-5.20) and baseline diastolic blood pressure(85-89/<80mmHg)(RR=4.09, 95% CI; 1.86-8.96) were identified as risk factors. Conclusions : Age and high normal blood pressure were significant risk factors for the development of hypertension above the borderline level. In addition, the family history of hypertension and WHR in men, and the change of menopausal status in women might be significant risk factors in Korea.

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The National Survey of Breast Cancer Treatment Pattern in Korea (1998): The Use of Breast-Conserving Treatment (1998년도 우리나라 유방암 치료 현황 조사: 유방보존술 적용 실태를 중심으로)

  • Shin Hyun Soo;Lee Hyung Sik;Chang Sei Kyung;Chung Eun JE;Kim Jin Hee;Oh Yoon Kyung;Chun Mi Sun;Huh Seung Jae;Loh Jun Kyu;Suh Chang-Ok
    • Radiation Oncology Journal
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    • v.22 no.3
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    • pp.184-191
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    • 2004
  • Purpose: In order to improve the proper use of radiotherapy and breast-conserving treatment (BCT) in the management of breast cancer, current status of breast cancer treatment in Korea was surveyed nationwide and the use of BCT were evaluated. Materials and Methods: Patients characteristics and treatment pattern of 1048 breast cancer patients from 27 institutions diagnosed between January, 1998 and June, 1998 were analyzed. The incidence of receiving BCT was analyzed according to the stage, age, geography, type of hospital, and the availability of radiotherapy facility. Results: Radical mastectomy was peformed in 64.8$\%$ of total patients and 26$\%$ of patients received breast- conserving surgery (BCS). The proportions of patients receiving BCT were 47.5$\%$ in stage 0, 54.4$\%$ in stage I, and 20.3$\%$ in stage II, Some of the patients (6.6$\%$ of stage I, 10.1$\%$ of stage II and 66.7$\%$ of stage III) not received radiotherapy after BCS. Only 45$\%$ of stage III patients received post-operative radiotherapy after radical mastectomy. The proportion of patients receiving BCT was different according to the geography and availability of radiotherapy facilities. Conclusion: Radiotherapy was not fully used in the management of breast cancer, even in the patients received breast-conserving surgery. The proportion of the patients who received BCT was lower than the report of western countries. To improve the application of proper management of breast cancer, every efforts such as a training of physicians, public education, and improving accessibility of radiotherapy facilities should be done. The factors predicting receipt of BCT were accessibility of radiotherapy facility and geography. Also, periodic survey like current research is warranted.

Surgical Treatment for Carotid Artery Stenosis (경동맥 협착증의 수술적 치료)

  • Kim, Dae-Hyun;Yi, In-Ho;Youn, Hyo-Chul;Kim, Bum-Shik;Cho, Kyu-Seok;Kim, Soo-Cheol;Hwang, Eun-Gu;Park, Joo-Chul
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.815-821
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    • 2006
  • Background: Carotid endarterectomy is an effective treatment modality in patients with severe carotid artery stenosis, but it may result in serious postoperative complications, We analyzed the results of the carotid endarterectomy performed in our institution to reduce the complications related to the card endarterectomy. Material and Method: We analyzed retrospectively the medical records of 74 patients(76 cases) who underwent carotid endarterectomy for carotid artery stenosis by a single surgeon from February 1996 to July 2004. Result: There were 64 men and 10 women. The mean age of the patients was 63.6 years old. Carotid endarterectomy only was performed in 63 cases, carotid endarterectomy with patch angioplasty in 8 cases, and carotid endarterectomy with segmental resection of internal carotid artery and end to end anastomosis in 5 cases. Intra-arterial shunt was used in 29 cases. The mean back pressures of internal carotid arteries checked after clamping common carotid arteries and external carotid arteries were $23.48{\pm}10.04$ mmHg in 25 cases with changes in electroencephalography(group A) and $47.16{\pm}16.04$ mmHg in 51 cases without changes in electroencephalography(group B). There was no statistical difference in the mean back pressure of internal carotid arteries between two groups(p=0.095), but the back pressures of internal carotid arteries of all patients with changes in electroencephalography were under 40 mmHg. When there was no ischemic change of electroencephalography after clamping common carotid artery and external carotid artery, we did not make use of intra-arterial shunt regardless of the back pressure of internal carotid artery. Operative complications were transient hypoglossal nerve palsy in four cases, cerebral hemorrhage occurred at previous cerebral infarction site in two cases, mild cerebral infarction in one case, hematoma due to anastomosis site bleeding in one case, and upper airway obstruction due to laryngeal edema probably caused by excessive retraction during operation in two cases. One patient expired due to cerebral hemorrhage occurring at previous cerebral infarction site. Conclusion: Carotid endarterectomy is a safe operative procedure showing low operative mortality. We suggest that intra-arterial shunt usage should be decided according to the ischemic change of electroercephalography regardless of the back pressure of internal carotid artery. Excessive retraction during operation should be avoided to prevent upper alway obstruction due to laryngeal edema and if upper airway obstruction is suspected, prompt management is essential.