• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1086-1092
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• 2006

Purpose : Refractory status epilepticus(RSE) is a serious neurological emergency in children. The mortality is high and the neurological outcome is not good. This study aimed to evaluate the clinical significance of cerebrospinal fluid(CSF) pleocytosis in refractory status epilepticus in children. Methods : From January 1999 to January 2006, 25 out of 37 children with refractory status epilepticus had spinal tapping. We retrospectively analyzed the data from these children's medical records. We compared the results between groups with and without CSF pleocytosis, and between a group with first seizure and a group with epilepsy. Result : Six out of 25 children had CSF pleocytosis. The group without CSF pleocytosis had a higher mortality rate and required higher doses of antiepileptic drugs as compared with the group with CSF pleocytosis. The group with CSF pleocytosis had much worse neurologic segualae. However, except for the children with CNS infection, the overall prognosis between the group with and without CSF pleocytosis was not significantly different. All children with CSF pleocytosis came in with first seizures. Conclusion : In children with RSE, a CSF study must be perfomed as soon as possible to exclude the possibility of CNS infection. A CSF study is even more important in cases of first seizure or CNS infection suspected. Mild CSF pleocytosis without evidence of infection does not seem to affect the prognosis, so physicians should therefore be more cautious in selecting antibacterial or antiviral agents for it.

• Clinical and Experimental Pediatrics
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• v.46 no.3
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• pp.271-276
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• 2003

Purpose : Granulocyte-colony stimulating factor(G-CSF) and granulocyte macrophage-colony stimulating factor(GM-CSF) are principal cytokines in granulopoiesis and their physiologic effects are mediated through binding to specific cell surface receptors. Although it is known that the level of serum G-CSF and GM-CSF, and presentation of the receptors are increased in infectious diseases, there have been no studies to find the correlation between the granulopoiesis and leukocytosis. This study was designed to measure G-CSF and GM-CSF in leukocytosis and in control and to demonstrate the possible pathogenesis of granulopoiesis in leukocytosis using quantitative analysis of G-CSF, GM-CSF and their CSFr. Methods : The plasma levels of G-CSF, GM-CSF of 13 children without leukocytosis and 14 children with leukocytosis were measured. Counts of cell surface G-CSFr and GM-CSFr were measured by combining anti G-CSFr and anti GM-CSFr monoclonal antibodies to their respective receptors by using quantitative flow cytometric assay. Results : There was no significant difference betweeen the plasma concentration of G-CSF and GM-CSF in acute leukocytosis and in the control group. However, levels of G-CSFr in acute leukocytosis decreased significantly compared to the control(P=0.012) and the levels of GM-CSFr in both groups revealed no significant difference. Conclusion : Increase in the number of leukocyte in leukocytosis was mediated by increasing the number of neutrophil, and increased plasma concentration of G-CSF may be the cause of neutrophilia. But GM-CSF did not have any influence on leukocytosis.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.54-59
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• 2017

Purpose: Urinary tract infection (UTI) is the most common serious bacterial infection in infants younger than 3 months of age. Lumbar puncture is routinely performed to evaluate febrile young infants for sepsis. However, there is no clear consensus on the use of routine lumbar puncture to diagnose concomitant meningitis in infants with UTI. We evaluated the prevalence of coexisting bacterial meningitis and sterile cerebrospinal fluid (CSF) pleocytosis in young infants with UTI. Methods: We retrospectively reviewed the medical records of 85 infants with UTI, aged from 29 to 99 days, who were admitted to Daegu Catholic University Medical Center from January 2013 to May 2016. We included 80 patients who had undergone lumbar puncture. Demographic features, clinical features, and laboratory findings were analyzed. Patients were divided into two groups based on the presence of sterile CSF pleocytosis and we compared these groups and assessed the differences between them. Results: Of the 80 UTI patients enrolled, 34 (43%) had sterile CSF pleocytosis. None had bacterial meningitis, and CSF polymerase chain reaction for enterovirus was positive in two patients without CSF pleocytosis. There were no significant differences between the two groups with regards to age, body temperature, peripheral white blood cell count, urinalysis, and duration of hospital stay. Conclusions: Though sterile CSF pleocytosis is common in young UTI patients, coexisting bacterial or viral meningitis is very rare. Indications for lumbar puncture in these patients depend on clinical condition.

• Radiation Oncology Journal
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• v.19 no.2
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• pp.142-145
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• 2001

Purpose : Acute leukemia with hyperleukocytosis (more than $10^5/mm^3$) is at high risk of early sudden death, usually from intracerebral hemorrhage. Emergency cranial irradiation is a relatively simple approach to solve this the problem. We summarized our experience of cranial irradiation in 24 leukemic children who presented with hyperleukocytosis. Methods and Materials : Between 1990 and 1998, 40 children with acute leukemia presenting with hyperleukocytosis were referred for emergency cranial irradiation. Among these patients, 24 children were evaluable. There were 16 boys and eight girls, their ages ranged from 2 to 13 years (median 9.5 years). The initial leukocyte counts ranged $109,910/mm^3\;to\;501,000/mm^3$. Peripheral blood smear was peformed in all patients and noted the morphology of the blast. Introduction of emergency cranial irradiation was determined by the leukocyte counts (more than 100,000/mm) and the existence of the blast in peripheral blood smear. All patients were treated with intravenous hydration with alkaline fluid and oral allopurinol. Cranial irradiation started on the day of diagnosis. With 2 Gy in one fraction in 4 patients, 4 Gy in two fractions in 20 patients. Results : The WBC count had fallen in 19 patients (83%) and no intracerebral hemorrhage occurred after irradiation. There were five cases of early deaths. Four patients died of metabolic complications, and one patient with intracerebral hemorrhage. He died 5 hours after cranial irradiation. No patient had any immediate side effect from cranial irradiation. Conclusion : Our data suggest, that emergency cranial irradiation can be safely chosen and effective in childhood leukemic patients presenting with high leukocyte counts.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.4
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• pp.586-590
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• 2009

Leukocyte adhesion deficiency is rare inherited defect on phagocytic function resulting lack of leukocyte cell surface expression of $\beta2$ integrin molecule that are essential for leukocyte adhesion to endothelial cells and chemotaxis. Clinical features of patients with leukocyte adhesion deficiency type I include recurrent necrotic infection of the skin mucous membranes, and intestinal tract with septicemia, and omphalitis arising from delayed umbilical cord separation. Oral manifestations are severe progressive periodontitis with alveolar bone loss, periodontal pockets, and partial and total premature loss of the deciduous and permanent dentitions. We report a case of leukocyte adhesion deficiency type I in a 5-year-old child with severe periodontitis. In order to prevent local and systemic infection, we controlled periodontal disease with periodic oral prophylaxis. Oral swabs and blood cultures were perfomed for suspected infection, so that optimal measures were taken through the use of appropriate antibiotics.

• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.654-659
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• 1995

Background: Tuberculosis has commonly been associated with various hematologic changes. A difference between the changes found in pulmonary tuberculosis and those found in miliary tuberculosis has been discussed. Up to now some worker were investigated hematological changes associated with pulmonary tuberculosis but was not investigated those associated with miliary tuberculosis in korea. Therefore we examimed the peripheral blood and bone marrow findings in miliary tuberculosis patients to determine hematologic changes. Methods: We performed blood sample at admission and bone marrow biopsy within 7days after admission. For evaluation of the hematologic findings, full blood counts and marrow differential counts were defined by the criteria outlined by Dacie and Lewis. Results: 1) Peripheral blood findings: Pancytopenia in 10% of patients, anemia in all patients, leukocytosis in 10% of patients, leukopenia in 20% of patients, thrombocytopenia in 30% of patients, lymphocytopenia in 90% of patients, monocytosis in 40% of patients and neutrophilia in 10% of patients were found at peripheral blood. 2) Bone marrow findings: Lymphocytopenia in 30% of patients, lymphocytosis in 20% of patients, plasmacytosis in 40% of patients, monocytosis in 100% of patients, and hypocellularity in 30% of patients were found at bone marrow. Erythropoiesis was decreased in 30% of patients. Granulopoiesis was decreased in 20% of patients and increased in 20% of patients. Bone morrow granuloma occured in 25% of patients. Conclusion: Hematologic changes of miliary tuberculosis were seen tendency of cytopenic pattern but monocyte was increased at peripheral blood and bone morrow. This findings would provide additional information for the differential diagnosis of miliary tuberculosis.

• The Monthly Diabetes
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• s.216
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• pp.39-41
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• 2007

당뇨병환자에서의 감염증은 인슐린과 항균제의 사용으로 그 이환율과 사망률이 현저히 감소하였으나, 현재까지 당뇨병환자의 진료에 있어서 해결해야 할 중요한 문제로 남아있다. 당뇨병환자에서 감염증의 발생빈도는 대부분 일반인과 차이가 없다고 보고되고 있으나 일부 특정 감염증의 빈도는 현저하게 증가하고 감염증의 정도가 훨씬 심하며, 임상양상도 정상인과 다른 것으로 알려져 있다. 특히 인플루엔자, 세균뇨, 악성 외이도염, 비뇌모균증, 기종성 담낭염, 기종성 신우신염 또는 방광염, 급성 신유두괴사, 신주위 농양, 진균성 요로 감염증, 그람 음성균에 의한 폐렴, 괴사성 연조직 감염과 족부 궤양 관련 감염증 등은 당뇨병과의 관련성이 이미 입증된 감염질환들이다. 당뇨병 환자에서 감염증의 발생빈도는 약 14.4%에서 39.5%까지 보고되고 있으며, 국내에서는 폐결핵 20%, 요로 감염 20%, 폐렴 16%, 진균감염 7.6%, 균혈증 6.2%, 족부 궤양 관련 감염증 5.5%의 순으로 보고되고 있다. 당뇨병환자가 감염증에 대한 원인에 대해서는 확실히 밝혀지지는 않았지만 탈수, 영양실조, 다형 백혈구의 기능 장애, 혈액 순환장애 및 신경병증 등으로 설명되고 있다. 특히 당뇨병환자에서는 미세 혈관병증과 죽상경화증이 흔히 발생하기 때문에 각 조직으로의 혈액 공급이 감소되어 각 장기 조직에서는 정상적인 영양 및 산소 공급과 적절한 면역 반응을 유지하는 것이 어려워 결과적으로 감염증에 걸리기 쉽다. 이 글에서는 여러 가지 감염증 중 족부 궤양 감염증, 기종성 신우신염, 비대뇌모균증, 간농양에 대해 사례를 중심으로 알아보겠다.

• Journal of the korean veterinary medical association
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• v.24 no.1
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• pp.19-24
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• 1988

A lactating Holstein cow which did not have had responded to drug therapy during 2 months was clinically examined. Right atrial vegetative endocarditis was determined dy ultrasonographic diagnosis, and later it was confirmed at necropsy. An early systolic

• Clinical and Experimental Pediatrics
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• v.50 no.11
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• pp.1129-1133
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• 2007

Osteopetrosis, a rare osteosclerotic bone disease characterized by a defect in osteoclast function and the reduced generation of superoxide by leukocytes, can be classified into several types based on their mode of inheritance, age of onset, severity, and associated clinical symptoms. Stem cell transplantation is the only curative therapy for the infantile malignant type, although alternative treatments, such as corticosteroids, calcitriol, and interferon (IFN)-${\gamma}$ have been attempted in patients with milder clinical types. In addition, IFN-${\gamma}$ therapy has been reported to increase bone resorption and hematopoiesis and to improve leukocyte function. Here, we present the cases of two patients with osteopetrosis who benefited from either 3 or 6 years of INF-${\gamma}$ therapy that resulted in improved blood counts and no further pathological fractures.

• Journal of Veterinary Clinics
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• v.32 no.4
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• pp.338-342
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• 2015

A 12-year-old castrated male miniature Schnauzer had anorexia, vomiting, lethargy, and fever for four days. The dog had leukocytosis, thrombocytopenia, hypoglycemia, hypoalbuminemia, hyperbilirubinemia, increased hepatic enzymes on hematologic and biochemical examinations. On abdominal ultrasonographs, there was an enlarged gallbladder with hyperechoic irregular wall thickening. Echocardiography showed vegetative change and regurgitation of aortic and mitral valves. E.coli was identified through ultrasound guided percutaneous cholecystocentesis and bile culture. Bacterial cholecystitis and concurrent endocarditis were diagnosed. The dog was recovered from sepsis with antibacterial and aggressive supportive therapy.