• Title/Summary/Keyword: Central nervous System

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Clinical Manifestation of Extrapulmonary Tuberculosis in Children : A Single Center Experience (단일기관에서 경험한 소아 폐외결핵의 임상적 고찰)

  • Seung, So Jin;Kwak, Ga Young;Lee, Soo Young;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.167-173
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    • 2008
  • Purpose : We evaluated the prevalence and clinical, microbiological features of extrapulmonary tuberculosis (EPT) in pediatric patients. Methods : We retrospectively reviewed medical records of pediatric patients diagnosed with EPT at The Catholic University of Korea, Incheon St. Mary's Hospital between 2000 and 2007. Results : Of 109 patients diagnosed with tuberculosis (TB), 12 patients (11%) were admitted with EPT. At 2006-2007, the proportion of patients with EPT among patients with TB was the highest (20%) comparing with last 6 years. The ratio of male to female patients was 1.4:1 and the mean age was 9.2 years (range, 3 months-15 years). The involved sites were pleura in 5 (41.6%), central nervous system in 3 (25%), miliary TB in 2 (16.7%), gastrointestinal tract in 1 (8.3%) and bone and joint in 1 (8.3%). The most common symptom at admission was fever (91.6%) and mean duration of fever was 15.8 days (range, 0-47 days) in spite of the proper treatment. Confirmed rate for acid fast bacillus stain, culture, and polymerase chain reaction were 33.3%, 41.6% and 41.6%. Of 5 culture proven cases, 4 (80%) were resistant to more than one antituberculosis drugs. Eleven patients recovered without complication and 1 patient died. Conclusion : Total incidence of TB decreased steadily according to the nationwide survey. However, our results suggest that the proportion of diagnosis with EPT among diagnosis with TB in children has increased. Microbiological diagnosis of EPT in children was more difficult than that of pulmonary TB. And drug resistance rate has increased.

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Prognostic Significance of CD44v6/v7 in Acute Promyelocytic Leukemia

  • Chen, Ping;Huang, Hui-Fang;Lu, Rong;Wu, Yong;Chen, Yuan-Zhong
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3791-3794
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    • 2012
  • CD44v, especially splice variants containing exon v6, has been shown to be related closely to development of different tumors. High levels of CD44v6/v7 have been reported to be associated with invasiveness and metastasis of many malignancies. The objective of this study was to detect expression of CD44v6-containing variants in patients with acute promyelocytic leukemia (APL) and evaluate the potential of CD44v6/v7 for risk stratification. Reverse transcription polymerase chain reaction (RT-PCR) followed by PCR product purification, ligation into T vectors and positive clone sequencing were used to detect CD44 v6-containing variant isoforms in 23 APL patients. Real-time quantitative PCR of the CD44v6/v7 gene was performed in patients with APL and in NB4 cells that were treated with all-trans retinoic acid (ATRA) or arsenic trioxide ($As_2O_3$). Sequencing results identified four isoforms (CD44v6/v7, CD44v6/v8/v10, CD44v6/v8/v9/v10, and CD44v6/v7/v8/v9/v10) in bone marrow mononuclear cells of 23 patients with APL. The level of CD44v6/v7 in high-risk cases was significantly higher than those with low-risk. Higher levels of CD44v6/v7 were found in three patients with central nervous system relapse than in other patients inthe same risk group. Furthermore, in contrast to ATRA, only $As_2O_3$ could significantly down-regulate CD44v6/v7 expression in NB4 cells. Our data suggest that CD44v6/v7 expression may be a prognostic indicator for APL.

Childhood Cancer Incidence and Survival 1985-2009, Khon Kaen, Thailand

  • Wiangnon, Surapon;Jetsrisuparb, Arunee;Komvilaisak, Patcharee;Suwanrungruang, Krittika
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7989-7993
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    • 2014
  • Background: The Khon Kaen Cancer Registry (KKCR) was established in 1984. Previous population-based incidences and survivals of childhood cancer in Thailand were determined using a short cancer registration period. Materials and Methods: Data were retrieved of all children residing in Khon Kaen, between 0-15 years, diagnosed as having cancer and registered in the KKCR (1985-2009). The follow-up censored date was December 31, 2012. The childhood cancers were classified into 12 diagnostic groups, according to the International Classification of Childhood Cancer. The incidence was calculated by the standard method. Survival of childhood cancer was investigated using the KKCR population-based registration data and overall survival calculated using the Kaplan Meier method. Results: In the study period, 912 newly diagnosed cases of childhood cancer were registered. The respective mean and median age was 6.4 (SD=4.6) and 6 (0-14) years. The age-peak for incidence was 0-4 years. The age-standardized rate (ASR) was 83 per million. Leukemia was the most common cancer (N=360, ASR 33.8) followed by neoplasms of the central nervous system (CNS, N=150, ASR 12.8) and lymphoma (N=79, ASR 7.0). The follow-up duration totaled 101,250 months. The death rate was 1.11 per 100 person-months (95%CI: 1.02 -1.20). The 5-year overall survival was 52% (95%CI: 53-56.9) for all cancers. The respective 5-year overall survival for (1) acute lymphoblastic leukemia (ALL), (2) acute non-lymphoblastic leukemia (ANLL), (3) lymphoma, (4) germ cell tumors, (5) renal tumors, (6) retinoblastoma, (7) soft tissue tumors, (8) CNS tumors, (9) bone tumors, (10) liver tumors, and (11) neuroblastoma was (1) 51%, (2) 37%, (3) 63%, (4) 74%, (5) 67%, (6) 55%, (7) 46%, (8) 44%, (9) 36%, (10) 34%, and (11) 25%. Conclusions: The incidence of childhood cancer is lower than those of western countries. Respective overall survival for ALL, lymphoma, renal tumors, liver tumors, retinoblastoma, soft tissue tumors is lower than that reported in developed countries while survival for CNS tumors, neuroblastoma and germ cell tumors is comparable.

Physiological Characteristics and GABA Production of Lactobacillus plantarum K74 isolated from Kimchi (김치에서 분리한 Lactobacillus plantarum K74의 GABA 생산 및 생리적 특성)

  • Park, Sun-Young;Shim, Hye-Young;Kim, Kee-Sung;Lim, Sang-Dong
    • Journal of Dairy Science and Biotechnology
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    • v.31 no.2
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    • pp.143-152
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    • 2013
  • Aminobutyric acid (GABA), a major inhibitory neurotransmitter in the central nervous system of animals, has several physiological effects including anti-hypertensive, diuretic, tranquilizing, and anti-stress properties, in humans. The purpose of this study was to investigate Lactobacillus plantarum K74, which was isolated from kimchi and selected as a strain with a high ability to produce GABA, to develop a new starter culture for fermented milk production. L. plantarum K74 produced $134.52{\mu}g/mL$ GABA in MRS broth containing 1% MSG, $212.27{\mu}g/mL$ GABA in MRS broth containing 2% MSG, and $234.63{\mu}g/mL$ GABA in MRS broth containing 3% MSG. The optimum growth temperature of L. plantarum K74 was $34^{\circ}C$, reaching a pH of 4.4 after 18 hours of growth. L. plantarum K74 was most sensitive to novobiocin out of 16 different antibiotics tested, and was most resistant to kanamycin and polymyxin B. L. plantarum K74 did not produce ${\beta}$-glucuronidase, a carcinogenic enzyme, and was comparatively tolerant to bile juice and low pH. Furthermore, it displayed resistance to Escherichia coli, Salmonella typhimurium, and Staphylococcus aureus at rates of 54.9%, 46.3%, and 0.7%, respectively.

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Serological Diagnosis of Human Sparganosis by means of micro-ELISA (효소면역측정법을 이용한 스파르가눔증의 혈청학적 진단)

  • Hyuck Kim;Suk-Il Kim;Seung-Yull Cho
    • Parasites, Hosts and Diseases
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    • v.22 no.2
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    • pp.223-228
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    • 1984
  • Seven cases of surgically proven sparganosis were serologically tested by means of microELISA for their specific IgG antibody levels. For that purpose, crude saline extract of spargana from snake, Natrix tigrina lateralis was prepared and used as antigen. The sparganosis sera were also tested with Paragonimus and Cysticercus antigens to observe the cross reactivity. A total of 71 sera from normal control, ectopic and pulmonary paragonimiasis, clonorchiasis, cysticerCOSIS and Taenia saginata cases were also included. Except for one case of old calcified infection, all of 6 human sparganosis showed higher serum levels of specific IgG antibody when the differential point of positive reaction was set at the absorbance value of 0.25 (the sensitivity being 85.7%). In control and other helminthic infections, all except 3 cases of T. saginata infection showed negative reaction to sparganum antigen (the specificity being 90.7%). None of sparganosis cases showed cress reactivity to Paragonimus and Cysticercus antigens. Undiluted cerebrospinal l1uid also showed high levels of antibody when central nervous system was invaded. The serologic diagnosis by means of micro ELISA could be a useful tool in epidemiological study of human sparganosis in susceptible population, as well as in individual diagnosis.

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Glatiramer acetate inhibits the activation of NFκB in the CNS of experimental autoimmune encephalomyelitis (Glatiramer acetate 투여에 의한 자가면역성 뇌척수염 마우스의 중추신경계에서의 NFκB 활성 억제)

  • Hwang, Insun;Ha, Danbee;Kim, Dae Seung;Joo, Haejin;Jee, Youngheun
    • Korean Journal of Veterinary Research
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    • v.51 no.3
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    • pp.217-225
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    • 2011
  • Glatiramer acetate (GA; Copaxone) has been shown to be effective in preventing and suppressing experimental autoimmune encephalomyelitis (EAE), the animal model of multiple sclerosis (MS). It has been recently shown that GA-reactive T cells migrate through the blood-brain barrier, accumulate in the central nervous system (CNS), secrete antiinflammatory cytokines and suppress production of proinflammatory cytokines of EAE and MS. Development of EAE requires coordinated expression of a number of genes involved in the activation and effector functions of inflammatory cells. Activation of inflammatory cells is regulated at the transcriptional level by several families of transcription factors. One of these is the nuclear factor kappa B ($NF{\kappa}B$) family which is present in a variety of cell types and involved in the activation of immune-relative genes during inflammatory process. Since it is highly activated at site of inflammation, $NF{\kappa}B$ activation is also implicated in the pathogenesis of EAE. In this study, we examined whether the inhibition of $NF{\kappa}B$ activation induced by GA can have suppressive therapeutic effects in EAE mice. We observed the expression of $NF{\kappa}B$ and phospho-$I{\kappa}B$ proteins increased in GA-treated EAE mice compared to EAE control groups. The immunoreactivity in inflammatory cells and glial cells of $NF{\kappa}B$ and phospho-$I{\kappa}B$ significantly decreased at the GA-treated EAE mice. These results suggest that treatment of GA in EAE inhibits the activation of $NF{\kappa}B$ and phophorylation of $I{\kappa}B$ in the CNS. Subsequently, the inhibition of $NF{\kappa}B$ activation and $I{\kappa}B$ phosphorylation leads to the anti-inflammatory effects thereby to reduce the progression and severity of EAE.

One Case of Systemic Arterialization of Lung Without Sequestration (Systemic Arterialization of Lung Without Sequestration 1예)

  • Kang, Dong-Won;Kwon, Seon-Joong;Ahn, Jin-Young;Kim, Myung-Hoon;Park, Hee-Sun;Lee, Kyu-Seung;Kim, Geun-Hwa;Jeong, Seong-Su;Kim, Jin-Whan;So, Young;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.378-384
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    • 2001
  • Systemic arterialization of the lung without sequestration is the rarest form of congenital anomalous systemic arterial supply to the lung, where an anomalous systemic artery arising from aorta supplies a normal unsequestrated segment of the lung. The non-sequestrated lung parenchyma which is supplied by an aberrant artery, has no parenchymal or bronchial abnormalities, and there is a normal connection with the bronchial trees. The symptoms of this disease varies. In most patients, it is often asymptomatic, but symptoms including dyspnea, hemoptysis, and central nervous system complications are possible. Here, we report a case of systemic arterialization of the lung without sequestration, which confirmed by angiography, with a review of the literature.

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Clinical Characteristics and Prognosis of Lung Cancer Patients Admitted to the Medical Intensive Care Unit at a University Hospital (한 대학병원 내과계 중환자실로 입원한 폐암 환자들의 임상 특성 및 예후)

  • Moon, Kyoung Min;Han, Min Soo;Lee, Sung Kyu;Jeon, Ho Seok;Lee, Yang Deok;Cho, Yong Seon;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.27-32
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    • 2009
  • Background: The management of patients with lung cancer has improved recently, and many of them will require admission to the medical intensive care unit (MICU). The aim of this study was to examine the clinical characteristics and to identify risk factors for mortality in patients with lung cancer admitted to the MICU. Methods: We conducted retrospective analysis on 88 patients with lung cancer admitted to the MICU between April 2004 and March 2008. Results: Of the 88 patients (mean age, 66 years), 71 patients (80.7%) had non-small cell lung cancer and 17 patients (19.3%) had small cell lung cancer. Distant metastasis were present in 79 patients (89.8%). The main reasons for MICU admission were acute respiratory failure (77.3%), sepsis (11.4%), and central nervous system dysfunction (4.5%). Mechanical ventilation was used in 54 patients (61.4%). Acute Physiology and Chronic Health Evaluation (APACHE) II score, length of MICU stay, need for mechanical ventilation, source of MICU admission were correlated with MICU mortality. The type of lung cancer and metastasis were not predictive factors of death in MICU. Conclusion: Most common reason for ICU admission was acute respiratory failure. Mortality rate of lung cancer patients admitted to the MICU was 65.9%. APACHE II score, length of ICU stay, need for mechanical ventilation, source of MICU admission were predicted factors of death in the MICU.

A LONG-TERM NEGLECTED BED PATIENT WITH CEREBRAL PALSY : A CASE REPORT (병상에서 장기간 방치 된 뇌성마비 환자 : 증례보고)

  • Kim, Do-young;Yang, Yeon-mi;Kim, Jae-gon;Lee, Dae-woo
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.1
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    • pp.33-36
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    • 2017
  • Cerebral palsy(CP) is a motor disorder of the central nervous system resulting from irreversible brain injury due to congenital or acquired causes. Health-related quality of their life is associated with severity of impairment and socioeconomic factors. These patients are particularly easy to be neglected because they lack capacity to care themselves unless they have the help of caregiver from high socioeconomic status. A 11-year-old girl with severe motor impairment came with the chief complaint of severe calculus deposition on whole dentition. She was taken with bed-ridden state with pediatrician not her parents. Since brain was damaged at the age of two, she has been left alone in the city care hospitals without parental care. Main caregiver is her father with not high educational level. Oral hygiene was not performed at all. Severe calculus deposition, gingival swelling, and gingival redness around the whole dentition were observed. During the 1st and 2nd visit, scaling and extraction was performed. CP patients with low socioeconomic status and severe motor impairment tend to be neglected from dental treatment. Dental care, along with medical care, is crucial to the quality of CP patients' lives. Therefore it is important that they visit for regular dental check ups and receive preventative care.

TREATMENT OF BRUXISM USING THE OCCLUSAL SPLINT (교합안정장치를 이용한 이갈이의 치료)

  • Baik, Byeoung-Ju;Lee, Sun-Young;Yang, Yeon-Mi;Kim, Jae-Gon;Jeon, Young-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.4
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    • pp.586-591
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    • 2002
  • Bruxism can be generally regarded as a diurnal clenching or nocturnal teeth grinding or a combination of both. Clenching of the teeth is forceful closure of the opposing dentition in a static relationship of the mandible to the maxilla, whereas grinding of the dentition is forceful closure of the opposing dentition in a dynamic maxillo-mandibular relationship as the mandibular arch moves through various excursive positions. The causes of bruxism are not yet discovered clearly, but most consistently mentioned cause is psychological stress. Bruxism can be also associated with sleep disorders, medication, and disturbances of the central nervous system. There is no permanent treatment method of bruxism, so the objectives for management of bruxism are reduction of psychological stress and treatment of signs and symptoms of bruxism by occlusal adjustment, occlusal splint, systemic medication and physical therapy. These cases report present three cases of children with bruxism. The bruxism was reduced in these patients wearing occlusal splint.

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