• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.5 no.2
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• pp.158-165
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• 2002

Purpose: We designed this retrospective study to establish the incidence of diagnosic delay in children diagnosed with acute appendicitis and to identify associated factors with delayed diagnosis and its impact on the clinical course. Methods: All cases of children under 15 years of age who underwent appendectomy from 1996 to 2001 at Gangneung Asan Hospital were reviewed. We reviewed signs and symptoms, type of health professional first contacted, the advice given by the health professional and a history of appendicitis in first degree relatives. Diagnostic period is the time elapsed between first complaints and definitive diagnosis. Delay was defined as diagnostic period exceeded the 48 hours. Postoperative course and complications were also reviewed. Results: Incidence of diagnostic delay differed by whether diarrhea and fecalith on X-ray were present. Also children whose parents were advised to observe them at home were more likely to have a diagnostic delay. In almost half of the cases in delayed group, initial diagnosis was not acute appendicitis but gastroenteritis. The perforation rate in non-delayed group was 22%, whereas 87% in delayed group. The delayed group showed a higher number of postoperative complication and a longer hospitalization period. Conclusions: Diarrhea with abdominal pain and fever in children should not be dismissed as gastroenteritis, respiratory infections or other common disorders. Our study suggests that physicians have a responsibility to prevent diagnostic delay and resultant perforation of acute appendicitis in children by having a high index of suspicion about acute appendicitis.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.8
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• pp.417-421
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• 2018

Carboxytherapy is very similar to mesotherapy in terms of methods, conditions it treats, and outcomes. An important difference consider, however, is that carboxytherapy administers carbon dioxide gas into the subcutaneous layer, just underneath the skin, whereas mesotherapy administers a cocktail of vitamins, minerals, and drugs and into the mesoderm of the skin. There have been many previous case reports of complications of mesotherapy such as hematoma, granulomatous panniculitis, cellulitis, and abscesses. However, complications of carboxytherapy have rarely been reported because the carbon dioxide gas is absorbed within a week and is infused into the subcutaneous and superficial layers. A 27-year-old woman who had twice undergone carboxytherapy to reduce abdominal fat (3 days and 2 weeks ago) at an oriental medical clinic visited the emergency department due to high fever, myalgia, severe back pain, and subcutaneous emphysema from the buttocks to the lower chest wall area. A computed tomography (CT) scan was performed for diagnosis and treatment. We immediately started broad spectrum antibiotics and consulted with the department of radiology, which could not rule out acute peritonitis due to needle injury. A radiologist confirmed abdominal myositis and needle puncture induced acute pyelonephritis. Pyelonephritis can even lead to septicemia, which can have fatal consequences. Therefore, if the patient has costovertebral or back pain after undergoing needle puncture or acupuncture therapy, the emergency physcians need careful initial evaluation for diagnosis and treatment.

• Journal of Life Science
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• v.23 no.8
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• pp.1050-1056
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• 2013

Streptococcus pneumoniae is the leading cause of community-acquired pneumonia throughout the world. The bacteria invade through lung tissue and cause sepsis, shock, and serious sequelae, including rheumatic fever and acute glomerulonephritis. However, the molecular mechanism associated with pneumonia's penetration of lung tissue and invasion of the blood stream are still unclear. We attempted to investigate the host cell response at protein levels to S. pneumoniae D39 invasion using human lung cancer epithelial cells, A549. Streptococcus pneumoniae D39 began to change the morphology of A549 cells to become round with filopodia at 2 hours post-infection. A549 cell proteins obtained at each infection time point were separated by SDS-PAGE and analyzed using MALDI-TOF. We identified several endoplasmic reticulum (ER) resident proteins such as Grp94 and Grp78 and mitochondrial proteins such as ATP synthase and Hsp60 that increased after S. pneumoniae D39 infection. Cytosolic Hsc70 and Hsp90 were, however, identified to decrease. These proteins were also confirmed by Western blot analysis. The identified ER resident proteins were known to be induced during ER stress signaling. These/ data, therefore, suggest that S. pneumoniae D39 infection may induce ER stress.

• Journal of Chest Surgery
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• v.34 no.4
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• pp.338-344
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• 2001

배경: 말기 신부전 환자에서 심장병, 특히 관상 동맥 질환의 이환이 늘어나면서 관상동맥 우회수술의 대상 환자가 지속적으로 증가하고 있다. 이들 환자군은 수술후 유병률과 사망률이 매우 높고 고위험군으로 알려져 있다. 대상 및 방법: 1996년 3월부터 2000년 5우러까지 서울 중앙 병원 흉부외과에서 술전 말기 신부전증으로 진단 받은 후 관상 동맥 우회수술을 시행받은 환자 25명을 대상으로 의무 기록을 중심의 후향적 분석을 하였다. 술전 위험 인자 및 술전 신기능, 수술 결과, 술후 경과, 수술후 합병증, 사망률 및 생존률 등을 분석하였다. 결과: 술전 평균 크레아티닌 청소율은 12.7$\pm$5ml/mim였고 술전 평균 혈중 크레아티닌 치는 6.2$\pm$3mg/dl(1.7-14.4)였다. 술전 투석을 시행중인 환자는 11례(44%)였고 술전 투석을 시행하지 않았던 14례(56%)중 8례(8/14, 57.1%)는 수술전후로 새로이 투석이 필요하였다. 술전 혈액 투석 중이었던 9례중 2례에서 수술후 복막 투석으로 전환하였다. 수술 사망률은 2례(8%)로 흡인성 폐렴과 종격동염으로 1례, 그리고 수술후 출형과 종격도염으로 1례가 사망하였다. 수술후 합병증은 14명(56%)의 환자에서 발생하여 매우 높은 발생율을 보였다. 만기사항은 2례(8%)에서 발생하였으며 사망원인은 카테터에 의한 복막염이었다. 생존 환자의 4년 생존률은 82$\pm$13% 였다. 결론: 말기 신부전 환자에서의 관상동맥 우회수술을 비교적 만족스러운 범위의 수술 사망률(8%)을 보였으나 합병증 발생률이 매우 높고 합병증 발생 시 사망률이 매우 높아 수술주위 감염 예방과 세심한 환자 관리가 필요하다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.1
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• pp.30-35
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• 2010

Purpose: Infectious ileocecitis is an infection confined to the ileocecal area and one of the most common causes of pediatric abdominal pain. This study was performed to demonstrate the clinical features of infectious ileocecitis in children. Methods: The medical records and radiologic findings of 37 patients with ileocecitis diagnosed by ultrasonography and/or computed tomography, who were admitted to Pusan National University Hospital from January 2004 and July 2008, were reviewed retrospectively. Viral gastroenteritis and secondary ileocecitis were excluded. Results: The mean age of the patients was 4.8${\pm}$3.4 years. One-half of the patients were preschool children. The chief complaint was abdominal pain (75.7%), diarrhea (10.8%), and vomiting (8.1%). Accompanying symptoms were fever (56.8%), vomiting (21.6%), and diarrhea (16.2%). The mean duration of abdominal pain, fever, diarrhea, and vomiting was 3.8${\pm}$2.1, 3.0${\pm}$1.9, 3.4${\pm}$1.9, and 2.4${\pm}$2.3 days, respectively. The frequency of diarrhea and vomiting was 5.8${\pm}$2.2 and 4.0${\pm}$2.8 per day, respectively. Diagnosis was made by abdominal ultrasonography in 22 patients (59.5%), abdominal CT in 2 patients (5.4%), and both modalities in 13 patients (35.1%). Besides the radiologic finding of thickening of the bowel wall, mesenteric lymphadenitis (59.5%), ascites (5.4%), and both mesenteric lymphadenitis and ascites (16.2%) were revealed. The mean duration of illness was 7.5${\pm}$5.0 days. There were no specific laboratory findings, and culture studies with stool or blood were negative. All of the patients recovered completely without specific treatment. Conclusion: Infectious ileocecitis has acute appendicitis-mimicking symptoms, but is self-limited within a few days, thus unnecessary treatment and work-up is avoided. However, distinguishing infectious ileocecitis from appendicitis, inflammatory bowel disease, and mesenteric lymphadenitis is important.

• Journal of Acupuncture Research
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• v.24 no.2
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• pp.83-100
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• 2007

목적 : 쥐의 콜라겐 유도 관절염에 대한 유근피 추출액의 면역 반응 효과 및 그 기전을 살펴보고자 하였다. 방법 : 유근피 추출액의 면역 반응을 관찰하기 위하여 콜라겐 유도 관절염 쥐가 사용되었다. 실험에 쓰인 쥐 뒷다리의 부종 용적은 volume meter로 측정하였고, lymphocyte 증식, 표1, 표2 및 TNF-${\alpha}$ 레벨은 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolirun bromide(MTT) assay에의해 측정하였다. 활막세포의 cAMP 레벨은 경쟁적 단백 결합검사 (CPBA)를 통하여 측정하였다. 2형 콜라겐에 대한 항체는 효소면역 협착검사법(ELISA)을 반복 사용하여 측정하였다. 결과 : 실험에서 유근피 추출액( 20， 80, 150mg/kg, ig ${\times}$ 7days)의 시술은 면역 반응을 억제하고 콜라겐 유도관절염 쥐의 체중과 면역 기관의 무게를 유지하였다. 콜라겐 유도 관절염 쥐에서 림프구의 증식과 IL-2의 생산은 복막의 대식세포 및 활막세포의 IL-1 , TNF-${\alpha}$와 함께 증가하였고, 유근피 추출액 (20, 80, 150mg/kg, ig ${\times}$ 7days)의 시술은 이러한 변화를 유의성 있게 감소시켰다. 0.5, 2.5, 12.5, 62.5, 125mg/l 농도에서의 유근피 추출액은 활막세포의 cAMP 레벨을 증가시킨데 반해 콜라겐 유도관절염 쥐에서의 시험관 실험결과에서는 감소시켰다. 유근피 추출액은 2형 콜라겐 항체의 농도에 대하여는 효과가 없었다. 결론 : 유근피 추출액은 항염증 작용과 면역조절 작용을 갖고 있고, 활막세포의 G protein-AC-cAMP transmembrane signal transduction 형질 도입 신호에의한 콜라겐 유도관절염 쥐의 치료 효과를 가지고 있는 것으로 여겨진다.

• Korean Journal of Veterinary Service
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• v.26 no.1
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• pp.67-71
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• 2003

A 8 months old, female domestic Shorthair cat with long-term signalment of anorexia, lacrimation, uveitis and coughing was submitted to the Pathology and Diagnosis Reference Division, NVRQS, Korea, for necropsy. Main gross lesions were characterized by ascities, some grayish-white nodular formation and fibrous adhesion on the surface of visceral organs including liver and kidney. Principle histopathological findings were fibrinous serositis, multifocal granuloma and necrosis, vasculitis, perivasculitis in various pharenchymal organs. Paraffin-embedded tissue sections taken from most of organs with granulomatous lesions were confirmed specific reaction to the monoclonal antibody of feline infectious peritonitis virus in the cytoplasm of many infiltrating macrophages by immunohistochemistry. The report was to describe the pathological lesions of the first naturally-occuring FIP case in companion cat of Korea.

• Journal of Physiology & Pathology in Korean Medicine
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• v.16 no.6
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• pp.1297-1301
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• 2002

Tubercular peritonitis become ill suddenly or insidiously. Common clinical symptom is an abdominal pain which is spread out to all abdomen or extention of abdomen by a localized pain and ascites. Besides, there is fever, nausea, vomiting, diarrhea and general whole body sign by tuburclosis. We watched a tubercular peritonitis patient which is a woman in poor health after childbirth and investigated treatment process, every disease after childbirth and tubercular peritonitis. We treated her with Herb-Medicine for 30 days according to chief symptom's changes. The patient improved in clinical symptoms.

• Journal of the korean veterinary medical association
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• v.37 no.5
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• pp.457-461
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• 2001

A 8 month old, female Domestic Shorthair cat with long-term signalment of anorexia, lacrimation, uveitis and coughing was submitted to the Pathology and Diagnosis Reference Division, NVRQS, Korea, for necropsy. Main gross lesions were characterized by asc

• Clinical and Experimental Pediatrics
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• v.48 no.4
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• pp.433-437
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• 2005

Bezoars are concretions commonly found in the stomach and small bowel, and four types of bezoars have been described based on their composition : trichobezoar, phytobezoar, lactorbezoar, and miscellaneous. Bezoars most often develop after gastric operations that alter the motility, emptying, and grinding of food in the stomach. Trichobezoars are most common in female children with normal gastrointestinal function and are usually associated with pica, mental retardation, and psychiatric disorders. Although uncommon, bezoars are a well-recognized cause of chronic abdominal complaints which, when undiagnosed, can result in serious complications including gastric ulceration, bleeding, perforation, intussusception and small bowel obstruction. Mortality rates of up to 30 percent have been reported in adults. Trichotillomania is behaviors surrounding hair-pulling, including stroking and playing with hair before pulling, or biting and swallowing the hair after it has been pulled(trichophagia). The most notorious of the medical sequelae of trichotillomania is the trichobezoar. We experienced a case of trichobezoar in an 11-year-old girl who frequently swallowed her hairs from age 4 years up to age 7 years, resulting in intermittent abdominal pain, nausea, and vomiting.