• Journal of Chest Surgery
• /
• v.41 no.6
• /
• pp.795-798
• /
• 2008

A 50 year old male patient was admitted due to fever and left upper-quadrant abdominal pain. He had a history of previous treatment for pulmonary TB and splenectomy due to plastic anemia. A large peritoneal abscess with connection to a chronic left side tuberculous empyema thoracis was diagnosed on admission. Chest CT also revealed a soft issue lesion on the left anterior chest wall. Staged drainage of the peritoneal lesion followed by left side pleuropneumonectomy with chest wall resection was performed. The pathologic studies showed a high grade sarcoma of the chest wall.

• The Korean Journal of Nuclear Medicine
• /
• v.32 no.1
• /
• pp.114-119
• /
• 1998

We present a case of a young female patient with fulminant hepatitis who showed an altered biodistribution of Ga-67, after being scanned twice at 10 month intervals. On initial scan, uplake of Ga-67 was increased in the liver, kidneys, and skeletons. Increased hepatic Ga-67 uptake may be explained by increased transferrin unbound Ga-67 that was taken up by the inflamed liver. The saturation of iron-binding proteins due to multiple transfusions may lead to increased renal and skeletal Ga-67 uptake. On follow-up scan hepatic Ga-67 uptake was markedly increased. Also increased Ga-67 uptake in the axial skeleton and normalized renal uptake were shown. The findings were consistent with iron deficiency anemia. This case demonstrates altered Ga-67 biodistribution associated with multiple transfusions, fulminant hepatitis, and iron deficiency anemia.

• The Korean Journal of Nuclear Medicine
• /
• v.4 no.1
• /
• pp.1-9
• /
• 1970

철대사(鐵代謝)에 관(關)한 연구(硏究)는 과거(過去) 30년(年)동안 새로운 검사방법(檢査方法)의 도입(導入)으로 눈부신 발전(發展)을이룩하였다. 1937년(年) Heilmeyer 등(等)에 의(依)하여 Ortho-phenanthrolin방법(方法)의 개발(開發)로 저색소성빈혈(低色素性貧血)의 원인(原因)이 구명(究明)되고 또한 이에 대(對)한 치료(治療)의 원칙(原則)이 세워졌다. 그 후 심(甚)한 감염(感染)이나 악성종양(惡性腫瘍)을 가진 환자(患者)者에서 관찰(觀察)되는 빈혈(貧血)에 대(對)해서 하나의 가설(假說)을 세워 이를 설명(說明)하려 하였는데 이는 곧 혈장(血漿)으로부터 철분(鐵分)이 신속(迅速)히 소실(消失)되어 망내계(網內系)나 병변(病變)이 있는 국소부위(局所部位)에 주(主)로 모여 들어 특수(特殊)한 방어기능(防禦機能)을 발휘(發揮)한다는것으로 연자(演者)는 방사성동위원소(放射性同位元素)를 이용(利用)하여 이 가설(假說)을 증명(證明)하였으며 이 연구(硏究)에는 또한 이문호교수(李文鎬敎授)가 Freiburg대학(大學) 유학중(留學中) 참여(參與)한 바 있다. 철대사(鐵代謝)를 파악(把握)하기 위(爲)해서 $^{59}Fe$가 흔히 사용(使用)되는데 이러한 방사성동위원소(放射性同位元素)를 이용(利用)함으로서 다음 사항(事項)들을 관찰(觀察)할 수 있었다. 즉(卽) 1. 소화장기(消化臟器)로 부터의 철흡수(鐵吸收) 2. 혈장(血漿)에서의 철(鐵)의 소실속도(消失速度) 3. 혈장내(血漿內)에서의 철교체율(鐵交替率) 4. 적혈구(赤血球)의 철이용(鐵利用) 5. 생체내(生體內)의 철분포(鐵分布) 6. 철배설(鐵排泄)의 정량적(定量的) 분석(分析) 또한 근년(近年)에는 특수(特殊)한 기능(機能)을 발휘(發揮)할 수 있는 동위원소(同位元素)를 이용(利用)하여 철흡수(鐵吸收) 및 대사이외(代謝以外)에도 적혈구(赤血球)의 수명(壽命)과 혈액량등(血液量等)을 측정(測定)하게 되었다. 경구적(經口的)으로 투여(投與)된 철(鐵)은 대부분(大部分) 십이지장(十二指腸)의 상부(上部)에서 흡수(吸收)되고 무기철(無機鐵)이 보다 쉽게 흡수(吸收)되어 가(價)의 상태(狀態)로 된다. 혈장(血漿)에서는 transferrin에 의(依)해서 철(鐵)이 운반(運搬)된다. 혈장철(血漿鐵)의 대부분(大部分)은 혈색소분해(血色素分解)에서 유래(由來)되며 이는 다시 혈색소(血色素)의 재생(再生)에 이용(利用)되는데 혈장내(血漿內) 철교체율(鐵交替率)은 방사성철(放射性鐵)을 이용(利用)하여 측정(測定)할수 있다 이와같이 방사성철(放射性鐵)을 이용(利用)하여 철대사과정(鐵代謝過程)을 숙지(熟知)함으르서 임상(臨床)에 응용(應用)하기에 이르렀으며 다음과 같은 질환(疾患)의 진단(診斷)에 특(特)히 큰 도움을 준다. A. 진성철결핍증(眞性鐵缺乏症) : 혁색소철(血色素鐵) 및 저장철(貯藏鐵)을 포함(包含)한 생체내(生體內) 전철분(全鐵分)의 부족(不足)된 상태(狀態)로서 실혈(朱血)에 의(依)한 것이 대부분(大部分)이다. 이 경우 철흡수(鐵吸收)는 증가(增加), 혈장철치(血漿鐵値)는 저하(低下), 철소실속도(鐵消失速度)는 증가(增加)되며 혈장철(血漿鐵) 교체율(交替率)은 항진(亢進) 혹(或)은 정상(正常)이다. B. 심(甚)한 염증성(炎症性) 질환(疾患) : 이 경우에도 혈장철치(血漿鐵値)의 저하(低下), 소실속도(消失速度)의 증가(增加), 교체율(交替率)은 정상(正常)보다 4배(倍)까지 증가(增加)할 수 있다. 골수(骨髓)에서 보다는 간(肝), 비(脾)와 같은 망내계(網內系)에 방사성철(放射性鐵)이 집결(集結)되는 것으로 보아 혈색소철(血色素鐵)보다는 저장철(貯藏鐵)이 관여(關與)되는 것이다. C. 원발성(原發性) 혈색소증(血色素症)(Idiopathic hemochromatosis) : 혈장철(血漿鐵)의 증가(增加)가 현저(顯著)하며 transferrin 농도(濃度)는 정상(正常)보다 낮으나 거의 대부분(大部分)의 철분(鐵分)으로 포화(飽和)된다. 철흡수(鐵吸收)는 증가(增加)되고 철소실속도(鐵消失速度)는 감소(減少) 되어 있으나 교체율(交替率)은 항진(亢進)되어 있다. 혈장철(血漿鐵)은 간(肝), 비(脾) 등(等)의 기관(器管)으로 저장집결(貯藏集結)되어 철저류(鐵貯溜)가 증대(增大)되므로 철이용증((鐵利用症)은 저하(低下)된다. D. 선천성(先天性) 무(無)$\ulcorner$트란스헤 린$\lrcorner$증(症)(Congenital atransferrinemia) : 방사성철(放射性鐵)을 이용(利用)한 진단방법(診斷方法)으로 Freiburg에서 7세(歲)의 소녀(少女)에서 발견(發見)한 증례(症例)인데 간(肝), 비(脾), 심(心)의 비대(肥大)가 임상적(臨床的)으로 인지(認知)되었고 중증(重症)의 철결핍상(鐵缺乏狀)을 검출(檢出)할 수 있었다. 철흡수율(鐵吸收率)의 상승(上昇), 혈장철치(血裝鐵値)의 감소(減少), 혈장철소실속도(血漿鐵消失速度)의 증가(增加), 혈장철교체율(血漿鐵交替率)의 상승(上昇) 및 적혈구(赤血球)에서의 철분이용율(鐵分利用率)의 저하(低下)를 ferrokinetic study에서 알 수 있었고 간(肝)에서 고도(高度)의 방사능(放射能)이 검출(檢出)되는 반면(反面), 비(脾)에서는 극소(極小), 골수(骨髓)에는 전(全)혀 방사능(放射能)이 들어가 있지 않았다. 이 증례(症例)와 같이 transferrin이 없으면 철분(鐵分)은 쉽게 조직(組織)으로 들어가 hemosiderin으로 저장(貯藏)되고 골수(骨髓)는 고도(高度)의 철결핍증(鐵缺乏症)을 나타내어 기관철침착증(器管鐵沈着症)과 철결핍성빈혈(鐵缺乏性貧血)이 동시(同時)에 나타나게 된다. 철대사장애면(鐵代謝障碍面)으로 보아 많은 미해결점(未解決點)이 남아 있으며 앞으로 자라나는 젊은 학도(學徒)들이 구명(究明)할 문제(間題)라고 믿는다.

• Pediatric Infection and Vaccine
• /
• v.30 no.2
• /
• pp.73-83
• /
• 2023

Purpose: This study aimed to investigate the viral load dynamics in children with underlying malignancies diagnosed with symptomatic coronavirus disease 2019 (COVID-19). Methods: This was a retrospective longitudinal cohort study of patients <19 years old with underlying hemato-oncologic malignancies that were diagnosed with their first symptomatic severe acute respiratory syndrome coronavirus 2 polymerase chain reaction (PCR)-confirmed COVID-19 infection during March 1 to August 30, 2022. Review of electronic medical records and telephone surveys were undertaken to assess the clinical presentations and transmission route of the patients. Thresholds of negligible likelihood of infectious virus was defined as E gene reverse transcription (RT)-PCR cycle threshold (Ct) value ≥25. Results: During the 6-month study period, a total of 43 children with 44 episodes of COVID-19 were included. Of the 44 episodes, the median age of the patients included was 8 years old (interquartile range [IQR], 4.9-10.5), and the most common underlying disease was acute lymphoid leukemia (n=30, 68.2%), followed by patients post-hematopoietic stem cell transplantation (n=8, 18.2%). Majority of the patients had mild COVID-19 (n=32, 72.7%), and three patients (7.0%) had severe/critical COVID-19. Furthermore, 2.3% (n=1) died of COVID-19 associated acute respiratory distress syndrome. The largest percentage of the patients showed E gene RT-PCR Ct value ≥25 between 15-21 days (n=13, 39.4%), followed by 22-28 days (n=10, 30.3%). In 15.2% (n=5), E gene RT-PCR Ct value remained <25 beyond 28 days after initial positive PCR. Refractory malignancy status (β, 67.0; 95% confidence interval, 7.0-17.0; P=0.030) was significantly associated with prolonged duration of E gene RT-PCR <25. A patient with prolonged duration of E gene RT-PCR Ct value <25 was suspected to have infectivity shown by the transmission of the virus to his mother at day 86 after his initial positive test. Conclusions: Children that acquire symptomatic COVID-19 during refractory malignancy state are at a high risk for prolonged shedding warranting PCR-based transmission precautions in this cohort of patients.

• Korean Journal of Food Science and Technology
• /
• v.45 no.5
• /
• pp.636-641
• /
• 2013

We prepared 2 different crude polysaccharides from persimmon leaves, by hot water (PLW-0) and pectinase digestion (PLE-0), respectively. PLW-0 and PLE-0 showed similar sugar compositions and contained 11 different sugars, including rarely observed sugars such as 2-methyl-fucose, 2-methyl-xylose, apiose, and aceric acid. However, the uronic acid content of PLE-0 was lower than that of PLW-0, because of pectinase treatment. In normal mice, administration of PLW-0 and PLE-0 increased the spleen index and splenocyte proliferation. The effect of PLE-0 on the spleen index and splenocyte proliferation was greater than that of PLW-0. We subsequently assessed the immunomodulatory activities of PLW-0 and PLE-0 on cyclophosphamide (CY)-induced immunosuppressed mice. We revealed that mice treated with PLW- 0 or PLE-0 showed increased splenocyte proliferation, NK cell activity, and white blood cell numbers. Taken together, our results indicate that PLW-0 and PLE-0 can enhance immune function in normal mice and modulate CY-induced immune suppression.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.26 no.3
• /
• pp.473-478
• /
• 1999

Osteopetrosis is an uncommon hereditary bone condition characterized by a generalized symmetric increase in skeletal density and abnormalities of bone resorption remodeling. In 1904, the first case of generalized sclerosis of the skeleton was reported by $Albers-Sch\ddot{o}nberg$. Osteopetrosis is generally divided into two main type. The infantile(malignant, congenita) type is the most severe form of the disease; It is characterized by skeletal and hematologic abnormalities. The adult(benign, tarda) type which is usually diagnosed in the third or fourth decade of life is limited predominantly to skeletal anomalies and it carries a more favorable prognosis. The recently recognized intermediate form with its mild and variable clinical recessive trait. There is no reported gender or racial predilection. The characteristic feature of osteopetrosis which is an abscence of physiologic bone resorption results in accumulation of bone mass and mainfests skeletal disturbance. Dental finding of osteopetrosis includes delayed eruption, congenitally absent teeth, unerupted and malformed teeth, and enamel hypoplasia. Our report involves a patient with a chief complaint of tooth mobility and delayed eruption. After clinical and radiologic examination, this patient was referred to dept. of pediatrics under the suspicion of osteopetrosis and it was confirmed.

• Clinical and Experimental Pediatrics
• /
• v.45 no.8
• /
• pp.1028-1032
• /
• 2002

Subcutaneous pannicultis-like T cell lymphoma is a rare cutaneous T cell lymphoma. It presents with multiple subcutaneous nodules or plaques involving the extremities or trunk, and with constitutional symptoms that include fever, malaise, fatigue, myalgia, chills and weight loss. Histologically, the lesions of this disease are reminiscent of panniculitis and are composed of a mixture of small and large atypical lymphoid cells infiltrating between adipocytes. The optimal treatment for this disease is undefined and prognosis of this disease is poor, even when treated with multiagent chemotherapy regimens considered optimal for agressive lymphoma of other types. Poor prognosis factors include clinical features such as anemia, leukocytopenia, hepatosplenomegaly, lymphadenopathy and coagulopathy, which are suggestive of hemophagocytosis. Much of the mortality of this disease is due not to disseminated lymphoma with organ failure, but rather to complications of the cytopenias associated with the hemophagocytic syndrome. We report a case of subcutaneous panniculitis-like T cell lymphoma in a 12 year-old boy who presented with initial complaints of fever and multiple subcutaneous nodules, and briefly review the related literature.

• Tuberculosis and Respiratory Diseases
• /
• v.65 no.6
• /
• pp.537-540
• /
• 2008

There are few reports of the pleuropulmonary involvement of a non-typhi Salmonella infection in immunocompromised patients with AIDS, malignancy, collagen vascular diseases, extended use of corticosteroids, sickle cell disease, or diabetes. We report a case of a non-immunocompromised patient who presented with concomitant empyema and mediastinitis due to Salmonella without a comorbid disease. A 26-year-old male patient, with a history of pneumonia 5 years earlier and having lived abroad for several years, presented chronic cough and febrile sensation. Pneumonia, empyema and mediastinitis were noted in a chest CT scan and Salmonella enteritidis and ${\beta}-hemolytic$ streptococcus were identified from a culture of the pleural fluid. Initially, he was treated with cefepime, metronidazole and clarithromycin. He was cured clinically and radiographically after an 8 week treatment with antibiotics. In conclusion, this report suggests that S. enteritidis can cause empyema and mediastinitis, albeit rarely.

• Childhood Kidney Diseases
• /
• v.13 no.2
• /
• pp.130-137
• /
• 2009

Purpose : Stem cell transplantation (SCT) has gained worldwide acceptance as a treatment for hematologic disorders. This study was performed to evaluate the clinical characteristics and outcomes of the acute kidney injury after SCT in children. Methods : The records of 53 patients who were treated with SCT at the pediatric department of Yeungnam University Hospital between January, 1996 and April, 2009 were used as subjects. Their were divided into two groups ; 'Early renal insufficiency' (ERI, n=18) and 'Non-early renal insufficiency' (NERI, n=35). ERI had greater than 25% of drop in GFR after SCT. Results: Total 53 patients were analyzed. In cord blood SCT (n=11), ERI was 4 (36.4%) and NERI was 7 (63.6%). In bone marrow SCT (n=16), ERI was 8 (50.0%) and NERI was 8 (50.5%). In autologous peripheral blood SCT (n=26), ERI was 6 (23.1%) and NERI was 20 (76.9%). There is no difference in both groups according to kinds of SCT. GVHD was developed in 22 patients, and there is no difference in each group. Twenty two of 53 patients died. ERI was 12 (66.7%) and NERI was 10 (28.6%). Acute renal failure is most important cause of the deaths. Conclusion : Out of 53 pediatric patients who were treated with SCT, 18 patients had greater than 25% of drop in GFR. There is no difference in both groups according to kinds of SCT. GVHD was found in 22 patients and there is no relation between GVHD development and acute kideney injury.

• Journal of Gastric Cancer
• /
• v.9 no.4
• /
• pp.262-268
• /
• 2009

Purpose: We wanted to analyze the clinicopathologic characteristics of patients with gastric carcinoid tumor, which is a rare gastric tumor (less than 2% of all gastric tumors). Materials and Methods: We reviewed all the carcinoid patients who were treated from 1996 to 2006. The clinicopathologic characteristics, the treatment modalities and the survival rates were retrospectively analysed. Results: There were 8 type I patients and 10 type III patients, but there were no type II patients. The mean age of onset for type I was 47.75 years and that for type III was 57.90 years. More type III patients were female, but the gender ratio of type I patients was equal at a ratio of 1：1. There were 4 cases of solitary tumor, which were all T1 except for one case, and there was neither distant metastasis nor lymph node involvement for the type T1 cases. In the 13 patients who had no metastasis, 5 underwent endoscopic mucosal resection and 8 underwent surgery, and their combined 5 year survival rate was 92.3%. For the 5 cases who had metastastses, their mean survival was 22 months and especially, 3 of them underwent palliative surgery and their median survival were 24 months (95%, ${\pm}6.52$). Conclusion: Higher incidence of type III gastric carcinoid tumor and less multiplicity in type I gastric tumor were identified in our study compared with previous reports. For the type III cases, there were some noteable differences compared with the Western country's survival rate for the patients who underwent palliative surgery, so physicians must pay close attention to the definite clinicopathologic characteristics of gastric carcinoid patients.