• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.65-70
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• 2017

Cytomegalovirus (CMV) infection is one of the most common congenital infections. The first case of discordant congenital CMV infection in twins occurred in Korea. A 31-year-old woman became pregnant with twins (dichorionic-diamniotic). An elective caesarean section was performed at 37 weeks. The first baby was male, weighing 2,410 g with an Apgar score of 8/9. The second baby was female, weighing 1,380 g with an Apgar score of 5/8. She had experienced intrauterine growth retardation, and presented with microcephaly, micrognathia, and joint stiffness. During the work-up for discordant twins, the second baby's serum test was positive for CMV immunoglobulin M. Her urine, blood, and cerebrospinal fluid (CSF) were CMV polymerase chain reaction positive. The first baby's CMV tests were negative. Ophthalmologic exam and audiometry performed on the second baby showed CMV retinitis and bilateral sensorineural hearing loss. She was treated with intravenous ganciclovir. Currently, she is bed-ridden and has significant developmental delay. Although the causes of discordant congenital CMV infection in twins are unclear, this case shows that discordant congenital CMV infection should be considered in twins with significant differences in intrauterine growth or clinical symptoms after birth.

• The Journal of the Korean Society for Microbiology
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• v.13 no.1
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• pp.1-5
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• 1978

Listeria monocytogenes infection was considered a rather rare disease and occurs mostly either in newborn babies or in young children. However, there has been increasing reports of this infection in elderly person with various underlying disease. Recently we have experienced two cases of Listeria meningitis; one in a 4-year-old male with an acute lymphoblastic leukemia, and the other in a 43-year-old female with a breast cancer. Both were on various chemotherapeutic agents for their primary diseases when the organism, L. monocytogenes was found in their celebospinal fluid(CSF). The degree of CSF pleocytosis were quite different by cases. The former case showed a marked increase, $3,350/mm^3$, and the latter slight, $410/mm^3$, Both showed a slight decrease of CSF glucose ranging 39 to 43mg/100ml. It seems that a routine CSF analysis bears a limitted value in the diagnosis or Listeria meningitis. A direct smear of CSF with Gram's stain revealed gram-positive bacilli in one case, but none in the other. Bacterial culture of CSF yielded plenty colonies in one case, but a few in the other. It seems that isolation of L. monocytogenes must not be considered very easy, and a negative direct smear does not necessarily mean a negative culture. The two isolates we obtained showed the typical cultural and biochemical characteristics of L. monocytogenes and were found to belong to serotypes 1b and 4b. It was our experience that the identification of this organism was not very much matter because of its distinct characteristics, but the most important matter was how to think of the possibility of this organism at the begining. The two isolates were both susceptible to cephalothin, chloramphenicol, erythromycin, tetracycline and gentamicin; intermediate to ampicillin, penicillin and kanamycin; and resistant to cloxacillin.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.124-129
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• 2006

Purpose : We investigated the causative organisms of bacterial meningitis by age distribution from 1996 to 2005. Methods : Retrospective data were obtained from the medical records with diagnosis of bacterial meningitis or neonatal meningitis from 1996 through 2005. A case was defined by isolation of organism or detection of its antigen by latex agglutination from cerebrospinal fluid. Results : A total of 46 cases(27 neonates and 19 children) were identified. 15 of 27 episodes(55.6%) of neonatal meningitis had a concomitant-positive blood culture. Group B streptococci were the most common bacterial causes of neonatal meningitis(44.4%). Nine of 12 episodes(75.0%) were late-onset infections in neonatal meningitis caused by group B streptococci. 16 of 19 children(84.2%) with bacterial meningitis beyond the neonatal period were younger than 5 years of age(median age, 23 months). Of 19 cases, 8 infections were with Streptococcus pneumoniae, 8 were with Haemophilus influenzae and 3 were with Neisseria meningitidis. Since 2001 there was no case of meningococcal meningitis in this study. Conclusion : In neonates group B streptococci are the most common causative organisms of bacterial meningitis, especially late-onset infections. In infants and young children, the predominant causes of bacterial meningitis are H. influenzae and S. pneumoniae; meningitis caused by the former are likely to decrease after the introduction of the conjugate vaccine for H. influenzae type b.

• The Korean Journal of Cytopathology
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• v.18 no.1
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• pp.46-54
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• 2007

Cerebrospinal fluid (CSF) cytology is an effective tool for evaluating diseases involving the central nervous system, but this technique is usually limited by its low cellularity and poor cellular preservation. Here we compared the manual liquid-base $Liqui-PREP^{TM}$ (LP) to the cytospin (CS) with using a mononuclear cell suspension and we applied both methods to the CSFs of pediatric leukemia patients. The cytopresevability, in terms of cell yield and cell size, and the clinical efficacy were evaluated. When 2000 and 4000 mononuclear cells were applied, LP was superior to CS for the cell yield, 16.8% vs 1.7% (P=0.001) and 26.2% vs 3.5% (P=0.002), respectively. The mean size of the smeared cells was 10.60 ${\mu}m$ in the CS, 5.01 ${\mu}m$ in the LP and 6.50 ${\mu}m$ in the direct smear (DS), and the size ratio was 1.7 (CS to DS), 0.8(LP to DS) and 2.1 (CS to LP), respectively. As compared to the cells in the DS, the cells in the CS were significantly enlarged, but those in the LP were slightly shrunken. Upon application to 109 CSF samples, 4 were diagnosed as positive for leukemia (positive), 4 had atypical cells and 101 were negative by CS; 6 were positive, one had atypical cells and 102 were negative by LP. For six cases, in which 4 were positive for leukemia and 2 of 4 had atypical cells by CS, they were positive by LP and they were also confirmed as positive according to the follow-up study. Three cases diagnosed as atypical cells (two by CS and one by LP), were confirmed as negative. In conclusion, these results suggest that LP is superior to CS for the cytopresevability and for rendering a definite diagnosis of cerebrospinal fluid.

• Journal of Biomedical Engineering Research
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• v.25 no.5
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• pp.323-328
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• 2004

The development of group-specific tissue probability maps (TPM) provides a priori knowledge for better result of cerebral tissue classification with regard to the inter-ethnic differences of inter-subject variability. We present sequential procedures of group-specific TPM and evaluate the age effects in the structural differences of TPM. We investigated 100 healthy volunteers with high resolution MRI scalming. The subjects were classified into young (60, 25.92+4.58) and old groups (40, 58.83${\pm}$8.10) according to the age. To avoid any bias from random selected single subject and improve registration robustness, average atlas as target for TPM was constructed from skull-stripped whole data using linear and nonlinear registration of AIR. Each subject was segmented into binary images of gray matter, white matter, and cerebrospinal fluid using fuzzy clustering and normalized into the space of average atlas. The probability images were the means of these binary images, and contained values in the range of zero to one. A TPM of a given tissue is a spatial probability distribution representing a certain subject population. In the spatial distribution of tissue probability according to the threshold of probability, the old group exhibited enlarged ventricles and overall GM atrophy as age-specific changes, compared to the young group. Our results are generally consistent with the few published studies on age differences in the brain morphology. The more similar the morphology of the subject is to the average of the population represented by the TPM, the better the entire classification procedure should work. Therefore, we suggest that group-specific TPM should be used as a priori information for the cerebral tissue classification.

• Journal of Veterinary Clinics
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• v.26 no.6
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• pp.650-654
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• 2009

A 1-week-old, male Korean native calf with acute clinical signs of depression, mild diarrhea, ataxia, recumbency and tremor was referred to Chonbuk Veterinary Medical Center of Chonbuk National University. Vision loss and cornea edema were also observed on physical examination. The patient had been deteriorated with nystagumus, strabisumus and opisthtonus. Blood cell count test and blood biochemistry test revealed remarkable leukocytosis, and hypoalbuminemia and increased blood urea nitrogen. No remarkable findings were observed on radiography. On magnetic resonance imaging study, there were enlarge lateral, third, and forth ventricles. The cortical grey and subcortical white matter of left temporal lobe showed hypointense on T1-weighted images and hyperintense on T2-weighted images, and slightly enhanced on contrast-enhanced T1-weighted images. Escherichia coli strain was identified from cerebrospinal fluid sample. Palliative treatment was attempted but the neonatal calve was expired three days after admission. Severe multifocal fibrino-suppurative meningitis with Escherichia coli infection was confirmed histopathologically.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.618-623
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• 1995

Cryptococcosis is a systemic mycosis that most often involves the lungs and central nervous system and, less frequently, the skin, skeletal system, and prostate gland. Cryptococcus neoformans, the causative organism, is a yeastlike round or oval fungus, 4 to $6{\mu}m$ in diameter, which is surrounded by a polysaccharide capsule and reproduces by budding and found in soil and other environmental areas, especially those contaminated by pigeon droppings. Humans and animals acquire infection after inhalation of aerosolized spores. Condition or factors that predispose to cryptococcosis include corticosteroid therapy, lymphoreticular malignancies, HIV infection, and sarcoidosis etc. We discribed a case of cryptococcosis involving lung and CNS coincidently without specific underlying disease and the literature on subject were reviewed. A fifty-six year-old previously healthy female presented with headache of 3 months of duration. She had no history suggesting immunologic suppression and we could not find any abnormal laboratory findings including blood sugar, serum immunoglobulin and complement level, HIV antibody, and T cell subsets. Chest roentgenogram and CT scan showed a solitary soft tissue mass in LUL with distal pneumonitis. Brain MRI showed granulomatous lesion in cerebellum and parasagittal cortex of right frontal lobe. The diagnosis was made by bronchoscopic brushing cytology, transthoracic fine needle aspiration, and sputum KOH mount and culture. She was treated 6 weeks course of Amphotericin B and switched to oral fluconazole therapy for 3 months. Her symptoms and X-ray findings were improved gradually and she is now under regular clinical follow up.

• The Korean Journal of Nuclear Medicine
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• v.37 no.4
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• pp.229-234
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• 2003

Purpose: Since the prognosis of measles encephalitis is poor, early diagnosis and proper management are very important to improve clinical outcomes. We compared Tc-99m ECD brain SPECT (SPECT) with MR imaging (MRI) for the detection of acute measles encephalitis. Materials and Methods: Eleven patients(M : F=4 : 7, age range 18 months-14 yrs) with acute measles encephalitis were enrolled in this studies. All of them underwent both MRI and SPECT. The results of SPECT were scored from 0 (normal) to 3 (most severe defect) according to perfusion state. We compared two image modalities for the detection of brain abnormality in acute measles encephalitis. Results: Seven of 11 patients (63.6%) revealed high signal intensity in the white matter on T2WI of MRI, on the other hand all patients (100%) showed hypoperfusion on SPECT. Severe perfusion deficits above score 2 were located with decreasing frequencies in the frontal lobe (81.8%), temporal lobe (72.7%), occipital lobe (27.3%), basal ganglia (27.3%), and parietal lobe (9.1%). Conclusion: We conclude that SPECT is more useful than MRI for the detection of brain involvement in patients with acute measles encephalitis.

• Journal of Life Science
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• v.15 no.4 s.71
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• pp.664-667
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• 2005

Hydrosyringomyelia is a dilation of the spinal cord central canal. In human it may be caused by congenital malformations such as Dandy-Walker syndrome and Chiari malformations or may be acquired as a result of infection, trauma or neoplasia. Hydrocephalus is an excessive accumulation of cerebrospinal fluid within the ventricles and occipital dysplasia is the dorsal extension of the foramen magnum. Hydrosyringomyelia and hydrocephalus can be confirmed by computed tomography or magnetic resonance imaging (MRI). A 3-year-old male maltese was presented with a history of long-term seizure. Blood examination was all unremarkable. On rostrodorsal-caudoventral oblique radiograph of the skull showed severe occipital dysplasia. On brain sonography through the persistent fontanelle, severe lateral ventriculomegaly was revealed. MRI examination revealed hydrocephalus and hydrosyringomyelia. Diuretic therapy didn't reduce clinical symptoms and surgical decompression was conducted. The dog responded well with ventriculo-peritoneal shunting. MRI is the most superior modality to diagnose hydrocephalus and hydrosyringomyelia, to plan therapy and to determine the prognosis.

• Applied Microscopy
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• v.29 no.1
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• pp.11-23
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• 1999

Ultrastructure of the ependymal cells of X-irradiated rats on their head were studied. Rats weighing $200\sim250gm$ were X-irradiated on their head and neck areas. Total exposures were 3,000 rads or 6,000 rads depending on experimental groups. And irradiated rats were sacrificed on 6 hours, 2 days and 6 days following the radiation exposures. Animals were perfused through the heart with 1% glutaraldehyde-1% paraformaldehyde solution, under ether-anesthesia. The tissues from the wall of lateral ventricles were fixed in the 2% osmium tetroxide solution. The results observed with electron microscope were as follow: 1. In 6 hours group, many ependymal cells were swelled, luminal portions of cytoplasms of some cells protruded into the ventricular lumen, and many cilia were lost or irregularly altered. 2. In 2 days group, ependymal cells were swelled more severely and subependymal edema were pronounced. 3. Protruded cytoplasm contained usually basal bodies of cilia, groups of mitochondria, endoplasmic reticula , etc. 4. Following X-irradiations, some protruded masses contained neural elements including the axon terminals with dense core vesicles. Axons and axon terminals were also found in the enlarged intercellular spaces among ependymal cells. From the above results, the heavy irradiation on the head area of the rat induced alteration of the ependymal cells lining the lateral ventricle. Hence the ependymal functions of selective barrier, protective barrier, and metabolic barrier could be altered following X-irradiation on the head.