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Fatal plastic bronchitis with eosinophilic casts in a previously healthy child (건강하였던 소아에서 발생한 치명적인 호산구성 증식성 기관지염)

  • Cho, Young Kuk;Oh, Soo Min;Choi, Woo-Yeon;Song, Eun Song;Han, Dong-Kyun;Kim, Young-Ok;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.1048-1052
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    • 2009
  • Plastic bronchitis is a rare disease characterized by the recurrent formation of branching mucoid bronchial casts that are large and more cohesive than those that occur in ordinary mucus plugging. Casts may vary in size and can be spontaneously expectorated, but some require bronchoscopy for removal. Plastic bronchitis can therefore present as an acute life-threatening emergency if obstruction of the major airways occurs. Three of 22 reported patients with eosinophilic casts were fatal, with death due to central airway obstruction. Here, we report a child with no history of atopy, allergy, or congenital heart disease who was diagnosed with plastic bronchitis with eosinophilic casts. Although he was administered intravenous (iv) antibiotics; iv corticosteroids; and a vigorous pulmonary toilet regimen, including chest physiotherapy and routine bronchoscopic removal of casts, he had brain death secondary to hypoxic brain damage. Plastic bronchitis can be fatal when casts obstruct the major airways, as in the present case. Clinicians should intervene early if a patient exhibits signs and symptoms consistent with plastic bronchitis.

Disease Severity of Angular Leaf Spot Disease by Different Inoculation Method and Eco-Friendly Control Efficacy in Strawberry. (접종방법에 따른 딸기모무늬병원균의 발병도 검증 및 친환경 방제 효과)

  • Kim, Da-Ran;Gang, Gun-hye;Cho, Hyun-ji;Yoon, Hae-Suk;Myoung, In Sik;kwak, Youn-Sig
    • The Korean Journal of Pesticide Science
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    • v.20 no.1
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    • pp.35-40
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    • 2016
  • Recently, bacterial angular leaf spot disease, caused by Xanthomonas fragariae, causes severe damage in strawberry production and its' export to other countries, since the pathogen has been classified as an A2 quarantine pathogen. Typical the Angular Leaf Spot (ALS) disease represent that water-soaked angular spots symptoms, bacteria ooze exudate under relatively high humidity condition and later the spot become reddish brown on the leaf surface. The pathogen disseminated by irrigation water, infected mother plant and farmer's hand. In this study, we reported that rubbing inoculation method showed more effective in the pathogen dissemination than infiltration with needles, regardless the strawberry cultivars. Additionally, Dichloroisocyanurate (NaDCC) treatment in commercial strawberry fields provided reliable efficiency to reduce the bacterial angular leaf spot disease incidency and severity.

The influence of accumulated clinical experience with Soyang-type patients on the conceptualization of the Soyang pathology (소양인(少陽人) 치험례(治驗例)가 소양인(少陽人) 병리관(病理觀) 형성과정에 미친 영향에 대한 고찰)

  • Kang, Mi-Jeong;Lee, Ji-Won;Lee, Jun-Hee;Koh, Byung-Hee;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.23 no.3
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    • pp.275-284
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    • 2011
  • 1. Objective: This literary review investigates Lee Jema's clinical experiences with Soyang-type patients and their influence on his conceptualization of the Soyang physiology and pathology. 2. Methods: 1) The case reports in "Soyang constitutional type: Spleen Cold-based Exterior-Cold disease" were compared before and after the Sinchuk revision to explore the temporal change in the Sasang medical concepts. 2) The texts in Donguisusebowon (Gabo edition) and Donguisusebowon (Sasangchobongwon) were analyzed to investigate the pathological concepts appearing before the completion of the Donguisusebowon (Gabo edition). 3) The texts in Donguisusebowon (Sinchuk edition) was analyzed to investigate the pathological concepts formed between the Gabo and Sinchuk editions of Donguisusebowon. 3. Results and Conclusions: 1) Gabo edition : The Gabo edition divided the External-origin Exterior disease into Cold-dominant (Heat-moderate) and Heat-dominant (Cold-moderate) patterns and differentiated the severity of Exterior-based Exterior disease and Interior-based Interior disease into mild, moderate, severe, and critical conditions. Cold-damage Delirium disease pattern was categorized as an Interior-based Interior disease, and the treatment protocol using Baekho-tang (Baihu-tang) was established. The stool condition and bowel movement reflecting the patient's defecation habits, the prime indicator of health in the Soyang constitutional type, were emphasized on their importance. 2) Sinchuk edition: The Delirium disease pattern was moved into the Exterior-cold disease, and the treatment protocol applying Jihwangbaekho-tang (Dihuangbaihu-tang) and Hyeongbangsabaek-san (Jingfangxiebai-san), with variational usage of Gypsum, was newly established. The Seong-Jeong and basal disease patterns were suggested as important factors in treating the patients. Also, it was proposed that the symptoms and signs reflecting the condition of the life-preserving energy be assessed to understand the patient's current condition. The importance of post-acute rehabilitation and aftercare as well as the most appropriate acute-stage treatment were emphasized.

Artemisia capillaris and Paecilomyces japonica Stimulate Lipid Metabolism and Reduce Hepatotoxicity Induced by Carbon Tetrachloride in Rats (사염화탄소를 투여한 흰쥐에서 인진쑥 및 동충하초의 지질대사촉진 및 간독성저하효과)

  • Jin, Yong-Xie;Yoo, Youn-Sook;Han, Eun-Kyung;Kang, Il-Jun;Chung, Cha-Kwon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.5
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    • pp.548-554
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    • 2008
  • The aim of this study was to identify the inhibitory effect of hepatic toxicity and liver lipid metabolism after the administration of Artemisia capillaris and Paecilomyces japonica. SD rats were divided into $CCI_4$ treated group with subgroups of 6% Artemisia capillaries (6A), 4% Artemisia capillaris+2% Paecilomyces japonica (4A2P), 3% Artemisia capillaris+3% Paecilomyces japonica (3A3P), 2% Artemisia capillaris+4% Paecilomyces japonica (2A4P) and 6% Paecilomyces japonica (6P). In this study we also intended to verify the optimum ratio of Artemisia capillaris and Paecilomyces japonica which can reduce hepatotoxicity. Artemisia capillaris and Paecilomyces japonica reduced cholesterol and triglyceride levels which were increased by the treatment of $CCI_4$. HDL-cholesterol level was the most enhanced in the group of 4A2P. On the other hand, athrogenic index (AI) was reduced statistically (p<0.05). When the ratio of Artemisia capillaris and Paecilomyces japonica was 2:1, the improvement of rat serum and liver lipid metabolism and the alleviation of hepatic damage induced by $CCI_4$ were shown to be the most effective in this study. It is considered that the symptoms of severe chemically induced hepatotoxicity could be lessened by Artemisia capillaris and Paecilomyces japonica administration.

Evaluation of Chemotherapy Induced Peripheral Neuropathy by Cisplatin, Carboplatin and Oxaliplatin (Cisplatin, Carboplatin, Oxaliplatin 투여로 인한 말초신경병증에 대한 평가)

  • Yoon, Wan Ki;Heo, Mi Jung;Lee, Ok Sang;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.356-366
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    • 2012
  • Background: Chemotherapy-induced peripheral neuropathy (CIPN) involving sensory and motor nerve damage or dysfunction is a common and serious clinical problem that affects many patients receiving cancer treatment. This condition may pose challenges for the clinician to diagnose and manage, particularly in patients with coexisting conditions or disorders that involve the peripheral nervous system. Many chemotherapeutic agents used today are associated with the development of serious and dose-limiting CIPN that can adversely affect the administration of planned therapy and can impair quality of life by interference with the patients' activities of daily living. The most important clinical objective in the evaluation of patients with CIPN is to determine their level of functional impairment involving activities of daily living. These findings are used to make medical decisions to continue, modify, delay, or stop treatment. The most commonly reported drugs to cause CIPN include taxanes, platinum agents, vinca alkaloids, thalidomide, and bortezomib. We aimed to determine PN incidence during cisplatin, carboplatin and oxaliplatin administration. Methods: We collected data from 125 patients who received at least one cycle of cisplatin, carboplatin or oxaliplatin. They completed a self-reported questionnaire and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. Patient Neurotoxicity Qeustionnaire developed by Bionumerik company were applied for PN assessment. Results: The incidences of sensory neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 23%, 56% and 50%. The incidences of motor neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 18%, 42% and 19%. The incidences of severe neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 13%, 28% and 14%. The incidences of PN were associated with cumulative dose but not age, gender and concurrent illness. 19.2% of the patients (24/125) were prescribed with gabapentin, nortriptyline or gabapentin plus nortriptyline to reduce these peripheral symptoms and 75% of the patients answered the drug were effective. Conclusion: Incidence of PN after cisplatin or oxaliplatin administration is cumulative dose-related. Physician-based assessments under-reported the incidence and severity of CIPN. To overcome this limitation, diagnostic tools specifically designed to assess peripheral neuropathy severity associated with chemotherapy must be developed.

Effects of Aluminium on Growth, Chlorophyll Content, ALAD Activity and Anatomy of Root rind Shoot in Azuki Bean (Vigna angularis) Seedlings (Aluminium이 팥(Vigna angularis) 유식물의 생장, 엽록소함량, ALAD활성 및 뿌리와 경엽부의 형태에 미치는 영향)

  • 구서영;홍정희
    • Journal of Environmental Science International
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    • v.5 no.6
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    • pp.813-826
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    • 1996
  • The toxic effects of aluminium (Al) on growth, chlorophyll content, $\delta-aminolevulinic$ acid dehydratase (ALAD) activity and anatomy of root and shoot were investigated in 7-day-old azuki bean (Vigna angularis) seedlings. Significant depressions in root elongation was observed in the low concentrations of Al (50, 100 $\muM)$ and increasing Al concentrations caused a sharp decline of root and shoot growth. The degree of inhibition was dependent upon Al supply. Exposure to 50 $\muM$ Al or more inhibited root elongation within 1 day. In the 50 $\muM$ Al treatments, a recovery of root growth was seen after 7 days exposure. In contrast, lateral root initials was little affected by Al exposure. Al toxicity symptoms and growth responses were more well developed in the roots than in the shoots. Analysis of Al localization in root cells by hematoxylin stAlning showed that Al entered root apices and accumulated in the epidermal and cortical cells immeadiately below the epidermis. There was a good positive correlation between the level of chlorophyll and ALAD activity. Increasing Al concentrations caused a decrease in total chlorophyll contents, accompanied by proportional changes in ALAD activity, suggesting a cootr-dinated reduction of a photosynthetic machinery. Al exerted specific influence on the morphology of root ann shoot. At higher concentrations of Al the roots induced drastic anatomical changes. The epidermal cells were disorganized or destructed while the cortical cells exhibited distortion of cell shape and/or disintegration. The diameter of root and transectional area of cortical cells decreased considerably with Al treatment. In the shoot Al also enhanced reduction of diameter of shoot and cell size. Gross anatomy of leaves treated with Al did not differ significantly from the controls, except for fewer and smaller chloroplast. Our results indicate that toxic effect of Al appear to be manifested primarily in roots and secondarily on shoots, and changes in root morphology are related to changes in the root growth patterns. Results are further discussed in re181ion to the findings in other plant species, and it is concluded that Al causes morphological, structural and, presumably, functional damage to the roots of the species investigated.

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A Case of Classical Galactosemia caused by Compound Heterozygous Mutations of the GALT Gene (GALT 유전자의 복합 이형 돌연변이에 의한 전형적 갈락토오스혈증 1례)

  • Cheon, Chong-Kun;Cho, Min-Sung;Ko, Jung-Min;Kim, Gu-Hwan;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.5 no.2
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    • pp.131-135
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    • 2008
  • Classical galactosemia is an autosomal recessive disorder of galactose metabolism, caused by a deficiency of the enzyme galactose-1-phosphate uridyltransferase (GALT). Buildup of galactose-1-phosphate is toxic at high levels and can damage the liver, brain, eyes, and other vital organs. The case presented here was that of an 11-day-old female infant who had elevated galatose levels upon initial neonatal screening test with persistent cholestatic jaundice, coagulopathy, and hepatomegaly. The patient was transferred due to aggravation of clinical symptoms including bleeding and jaundice. She had a delayed galactose free diet because of an inappropriate diagnosis. We quickly provided her with a lactose/galactose-restricted diet as per her final diagnosis. Clinical and laboratory results were improved after a few days of treatment. For confirmatory testing for classical galactosaemia, we simultaneously analyzed for GALT enzyme activity and allele-specific PCR/fragments for seven mutations and two polymorphisms in the GALT gene. We were able to find several GALT-deficient and compound heterozygous mutations of the GALT gene.

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Screening of Preventive Effects of Herbal Prescriptions in Rat Model of Arterial Thrombosis Induced by Ferric Chloride

  • Lee, Ki Mo;Bang, Jihye;Lee, In Sun;Heo, Eun Jung;Kim, Bu Yeo;Kang, Hyung Won;Lyu, Yeoung Su;Jeon, Won Kyung
    • The Journal of Korean Medicine
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    • v.34 no.2
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    • pp.20-28
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    • 2013
  • Objectives: This study examined the effects of 8 types of herbal prescriptions prescribed to alleviate dementia symptoms in a rat model of arterial thrombosis induced by ferric chloride ($FeCl_3$). Methods: Thirty minutes before 35% $FeCl_3$ treatment, SD rats were intraperitoneally injected with the 8 types of herbal prescriptions, respectively. We tested the effects of the herbal prescriptions on time to occlusion (TTO) in an arterial thrombosis model using a laser Doppler flow meter. In addition, thrombus weight (TW) and collagen fiber damages were evaluated in the same condition. Results: Herbal prescriptions showed the following rank-order based on their TTO: Chong-myung-tang (CMT) > modified Jangwonhan 02 (LMK02) > Toki-shakuyaku-san (TSS) ${\geq}$ Oren-gedoku-to (OGT) ${\geq}$ Yokukansan (YKS). In particular, CMT (100 mg/kg, i.p.) and LMK02 (100 mg/kg, i.p.) delayed the TTO the most ($14.83{\pm}0.98$ and $13.67{\pm}1.03$ min, respectively) compared with the vehicle group ($7.95{\pm}0.78$ min, P<0.001). In addition, CMT, LMK02, and OGT treatment ($0.63{\pm}0.01$, $0.66{\pm}0.02$ and $0.67{\pm}0.01$ mg/mm, respectively) significantly reduced thrombus weight compared with the vehicle treatment ($0.78{\pm}0.03$, P<0.001) and also alleviated collagen fiber damage (CMT; $28.40{\pm}2.22$%, LMK02; $30.79 {\pm} 4.07$%, OGT; $26.20{\pm}1.48$%) in the vessels injured by $FeCl_3$. Therefore, CMT and LMK02 showed the greatest preventive activity in rat model of arterial thrombosis induced by $FeCl_3$. Conclusions: These results provide experimental evidence for traditional use of herbal prescriptions, suggesting that CMT and LMK02 extracts could be used to prevent vascular injury and thrombosis in the early stages of dementia.

Hepatitis C Virus - Proteins, Diagnosis, Treatment and New Approaches for Vaccine Development

  • Keyvani, Hossein;Fazlalipour, Mehdi;Monavari, Seyed Hamid Reza;Mollaie, Hamid Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.5917-5935
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    • 2012
  • Background: Hepatitis C virus (HCV) causes acute and chronic human hepatitis infection and as such is an important global health problem. The virus was discovered in the USA in 1989 and it is now known that three to four million people are infected every year, WHO estimating that 3 percent of the 7 billion people worldwide being chronically infected. Humans are the natural hosts of HCV and this virus can eventually lead to permanent liver damage and carcinoma. HCV is a member of the Flaviviridae family and Hepacivirus genus. The diameter of the virus is about 50-60 nm and the virion contains a single-stranded positive RNA approximately 10,000 nucleotides in length and consisting of one ORF which is encapsulated by an external lipid envelope and icosahedral capsid. HCV is a heterogeneous virus, classified into 6 genotypes and more than 50 subtypes. Because of the genome variability, nucleotide sequences of genotypes differ by approximately 31-34%, and by 20-23% among subtypes. Quasi-species of mixed virus populations provide a survival advantage for the virus to create multiple variant genomes and a high rate of generation of variants to allow rapid selection of mutants for new environmental conditions. Direct contact with infected blood and blood products, sexual relationships and availability of injectable drugs have had remarkable effects on HCV epidemiology. Hundreds of thousands of people die each year from hepatitis and liver cancer caused by HCV virus infection. Approximately 80% of patients with acute hepatitis C progress into a chronic disease state leading to serious hepatic disorders, 10-20% of which develop chronic liver cirrhosis and hepatocellular carcinoma. The incubation period of HCV is 6-8 weeks and the infection is often asymptomatic so it is very hard to detect at early stages, making early treatment very difficult. Therefore, hepatitis C is called a "silent disease". Neutralizing antibodies are produced against several HCV proteins during infection but the virus mutates to escape from antibodies. Some patients with chronic hepatitis C may have some symptoms such as fatigue, muscle aches, nausea and pain. Autoimmune and immunecomplex-mediated diseases have also been reported with chronic HCV infection.

Proteomic analysis of serum proteins responsive to styrene exposure (Styrene 노출에 반응을 보이는 혈청 단백질에 대한 프로테오믹스 분석)

  • Kim, Ki-Woong;Heo, Kyung-Hwa;Won, Yong Lim;Jeong, Jin Wook;Kim, Tae Gyun;Park, Injeong
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.17 no.3
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    • pp.235-244
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    • 2007
  • By comparing the proteins from the workers exposed to styrene with the ones from controls, it may be possible to identify proteins that play a role in the occurrence and progress of occupational disease and thus to study the molecular mechanisms of occupational disease. In order to find the biomarkers for assessing the styrene effects early, before clinical symptoms develop and to understand the mechanisms of adverse health effects, we surveyed 134 employees, among whom 52 workers(30 male and 22 female) were chronically exposed to styrene in 10 glass-reinforced plastic boat manufacturing factories in Korea and 82 controls had never been occupationally exposed to hazardous chemicals including styrene. The age and drinking habits and serum biochemistry such as total protein, BUN and serum creatinine in both groups were significantly different. Exposed workers were divided into three groups according to exposure levels of styrene(G1, below 1/2 TLV; G2, 1/2 TLV to TLV; G3, above TLV). The mean concentration of airborne styrene in G1 group was $10.93{\pm}11.33ppm$, and those of urinary mandelic acid(MA) and phenylglyoxylic acid(PGA) were $0.17{\pm}0.21$ and $0.13{\pm}0.11g/g$ creatinine, respectively. The mean concentration of airborne styrene in G2 and G3 groups were $47.54{\pm}22.43$ and $65.33{\pm}33.47ppm$, respectively, and levels of urinary metabolites such as MA and PGA increased considerably as expected with the increase in exposure level of styrene. The airborne styrene concentration were significantly correlated to the urinary concentration of MA(r=0.784, p=0.000) and PGA(r=0.626, p<0.001). In the 2D electrophoresis, the concentration of five proteins including complement C3 precursor, alpha-1-antitrypsin(AAT), vitamin D binding protein precursor(DBP), alpha-1-B-glycoprotein(A1BG) and inter alpha trypsin inhibitor(ITI) heavy chain-related protein were significantly altered in workers exposed to styrene compared with controls. While expression of complement C3 precursor and AAT increased by exposure to styrene, expression of DBP, A1BG and ITI heavy chain-related protein decreased. These results suggest that the exposure of styrene might affects levels of plasma proteinase, carriers of endogenous substances and immune system. In particular, increasing of AAT with the increase in exposure level of styrene can explain the tissue damage and inflammation by the imbalance of proteinase/antiproteinase and decrease of DBP, A1BG and ITI heavy chain-related protein in workers exposed to styrene is associated with dysfunction and/or declination in immune system and signal transduction