• Journal of Korean Neurosurgical Society
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• 제51권4호
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• pp.215-218
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• 2012

Objective: Traumatic epidural hematomas (EDHs) in children are a relatively unusual occurrence. The cause and outcome vary depending on period and reg ion of study. The aims of this analysis were to review the cause and outcome of pediatric EDHs nowadays and to discuss outcome-related variables in a large consecutive series of surgically treated EDH in children. Methods: This is a retrospective review of 29 patients with surgically treated EDHs between Jan 2000 and February 2010. Patients' medical records, computed tomographic (Cl) scans, and, if performed, magnetic resonance imaging (MRI) were reviewed to define variables associated with outcome. Variables included in the analysis were age, associated severe intracranial injury, abnormal pupillary response, hematoma thickness, severity of head injury (Glasgow Coma Scale score), parenchymal brain injury, and diffuse axonal injury. Results: The mean (SO) age of the patients was 109 months (0-185 months). Most of the injuries with EDHs occurred in traffic accident (14 cases, 48.2%) and followed by slip down in 6 cases and falls in 6 cases. There were one birth injury and one unknown cause. EDHs in traffic accidents occurred in pedestrians hit by a motor vehicle, 9 cases; motorbike and car accidents, 5 cases and bicycle accidents, 1 case. The locations of hematoma were almost same in both sides (left side in 15 cases). Temporal lobe is the most common site of hematomas (13 cases, 44%). The mean size of the EDHs was 18 mm (range, 5-40 mm). Heterogeneous hematomas in CT scans were 20 cases (67%). Two patients were referred with unilateral or bilateral dilated pupil(s). There was enlargement of EDH in 5 patients (17%). All of them were heterogeneous hematomas in CT scans. Except for 4 patients, all EDHs were associated with skull fracture(s) (87%). There was no case of patient with major organ injury. CT or MRI revealed brain contusion in 5 patients, and diffuse axonal injury in one patient The mortality was zero, and the outcomes were excellent in 26 and good in 2 patients. None of the tested variables were found to have a prognostic relevance. Conclusion: Regardless of the EDH size, the clinical status of the patients, the abnormal pupillary findings, or the cause of injury, the outcome and prognosis of the patients with EDH were excellent.

• BMB Reports
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• 제39권6호
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• pp.677-685
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• 2006

Proteins that are unfolded or misfolded in the endoplasmic reticulum (ER) must be targeted for refolding or degradation to maintain the homeostasis of the ER. Derlin-1 was reportedly implicated in the retro-translocation of misfolded proteins from the ER to the cytosol for degradation. In this report, we showed that Derlin-1 was down-regulated in the endothelial cells derived from human hepatic cavernous hemangioma (CHEC) compared with other tested cells. Electron microscopy analysis showed that ER was aberrantly enlarged in CHEC cells, but not in other tested cells. When overexpressed, Derlin-1 induced the dilated ER to return normal size. This ER dynamic was associated with the activation of unfolded protein response (UPR). In CHEC cells where Derlin-1 was down-regulated, increased expression of the immunoglobulin heavy chain-binding protein (Bip) and UPR-specific splicing of X-box DNA-binding protein 1 (XBP1) mRNA were detected, as compared with that in other tested cells, indicating that UPR was activated. After Derlin-1 overexpression, the extent of UPR activation diminished, as evidenced by decreased expression of Bip, reduced amount of the spliced form of XBP1 ($XBP1_S$), and elevated expression of the unspliced form of XBP1 ($XBP1_U$). Taken together, these findings provide another example of a single protein being able to affect ER dynamic in mammalian cells, and an insight into the possible molecular mechanism(s).

• Clinical and Experimental Pediatrics
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• 제51권11호
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• pp.1232-1235
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• 2008

삼환계 항우울제의 하나인 이미프라민은 우울장애와 야뇨증, 불안장애, 신경성 통증에 쓰인다. 그러나 이미프라민을 포함한 삼환계 항우울제는 많은 부작용이 관찰되는 데, 항콜린성 작용으로 초기에 입이 마르고 동공산대, 소변 정체, 동성빈맥을 보인다. 또한 중추신경계에 작용하여 섬망, 불안, 초조, 환각, 경련, 혼수를 야기할 수 있다. 그러나 앞에서 말한 부작용 보다도 치명적인 것인 삼환계 항우울제에 의해 소디움 채널 차단으로 인한 부정맥이다. QRS파의 연장과 QTc 연장, 넓은 QRS파 빈맥, Brugada 심전도 양상이 나타나며 이런 현상은 중탄산 나트륨을 통해 나트륨을 대량으로 공급하여 회복시킬 수 있다. 이미프라민을 포함한 삼환계 항우울제에는 아직도 널리 쓰이고 있지만 지금까지 소아에서 부정맥이 부작용으로 나타난 증례에 대한 보고가 없었다. 따라서 저자들은 이미프라민 과량복용 후 경련, 넓은 QRS파를 보이는 빈맥, Brugada 심전도 양상, 무뇨를 보인 환아를 경험, 치료하여 이를 보고한다.

• Applied Microscopy
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• 제31권2호
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• pp.175-184
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• 2001

본 연구의 목적은 염화수은이 간 미세구조에 미치는 독성에 대한 키토산의 억제효과를 연구하는데 있다. 염화수은 단독 투여군(A군)에는 $HgCl_2$ (5.0 mg/kg)만을 구강투여하였다. 그리고 키토산과 염화수은 동시투여군(B군)에는 키토산 (3% solution, 2times/day)과 $HgCl_2$, (5.0mg/kg)을 구강투여하였다. 그러고 각 군은 24, 48, 72, 96 시간대에 관찰하여 다음과 같은 결과를 얻었다. 1. A군 핵막은 다소 불규칙한 상태를 유지하였고, 사립체는 내외막이 파괴된 채로 관찰되었다. 과립형질내세망은 층판구조가 파괴되었고, 무과립형질내세망은 세포질 전체에 퍼져있는 것이 관찰되었다. 2. B군 핵막은 비교적 원형을 유지하였고, 사립체는 내외 막의 구분이 일부에서 불분명하게 관찰되었지만, 전자밀도가 높게 관찰되었다. 과립형질내세망의 내강 팽대가 앞시간대에서 관찰되었지만 전형적인 층판구조를 형성하였다. 그리고 무과립형질내세망이 세포질주변에서 관찰되었다. 이상의 결과는 키토산이 마우스 간중독을 야기한 염화수은의 독성을 감소시키는 것으로 사료된다.

• 한국임상수의학회지
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• 제26권2호
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• pp.176-180
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• 2009

2년령의 암컷 miniature schnauzer가 침울, 복통 및 식욕부진으로 내원하였다. 신체검사를 통해 빈맥, 발열과 복통을 확인하였다. 총혈구계수 검사에서 호중구수의 증가를 동반한 백혈구증가증이 관찰되었다. 방사선 검사에서 하행결장의 변위와 척추와 평행하게 방사선투과가 감소한 부위가 관찰되었다. 초음파검사시 방광내 결석과 슬러지, 우측 신장의 수신증 및 근위뇨관의 확장이 관찰되었다. 뇨검사결과 단백뇨와 혈뇨가 나타났으며 뇨침사검사에서 다수의 상피세포, calcium oxalate 결정, struvite 결정, 무정형 결정과 과립원주, 백혈구 및 구균이 관찰되었다. 상기의 결과와 배설성 요로 조영술을 통해 신우신염과 편측성 뇨관 완전폐색증으로 진단하였다. 신장절제술을 위한 개복술시 후복막강에 풍선형의 구조물을 발견하였다. 구조물로부터 채취한 시료의 세포검사와 배양검사결과 다수의 퇴행성 호중구와 탐식된 구균을 관찰하였다. 결론적으로 뇨관폐색과 방광결석을 동반한 Staphylococcus intermedius에 의한 복막후농양으로 최종 진단하였고 우측신장의 절제를 실시하여 치료하였다.

• Journal of Chest Surgery
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• 제16권2호
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• pp.139-146
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• 1983

Between 1974 and 1982, 31 patients from 7 to 15 years of age have undergone valve replacement for their acuqired cardiac valvular diseases at Seoul National University Hospital. Furteen patients (45.2%) had a definite history of rheumatic fever and only 4 patients (12.9%) had atrial fibrillation on their preoperative electrocardiograms. Characteristically, the valvular lesions were ones of insufficiency with or without associated stenosis in all patients except only one whose mitral valve was tightly stenotic. Thrity-seven valves were replaced in 31 patietns including a case of successful replacement of his failed xenogragt mitral valve : 4 mechanical valves were used in 3 patients and 33 xenograft valves were used in the remaining 28 patients. The size of the valves were not the major problem at the time of opertion because most of the patients had a dilated heart from disease. There were 3 diaths within 30 days of surgery (9.7% operative mortality rate) and 3 late deaths (9.7% late mortality rate) with an overall mortality rate of 19.4%. Twenty-eight early survivors were followed up for a total of 488 patient-months. Thromboembolic complications occurred in 5 patients with 2 deaths: cmbolic rate of 17.9% or the actuarial embolic incidence of 12.29%/patients-year. four xenograft tissue valves in 4 patients had failed during the period from 19 to 41 months of surgery with an overall valve failure rate of xenograft of 14.3% or the actuarial incidence of 9.84% failure/patient-year. One of these 4 patients had required replacement of his failed mitral xenograft valve which had severe calcification and tissue disruption with primary tissue failure rate of 3.6% or the actuarial incidence of 3.13% failure/patient-year. The actuarial survial including the operative morality was 50.0% at 5 years of surgery. /the actuarial incidence free from thromboembolism in bioprosthetic group was 85.4% at 42 months, while it was 33.4% in mechanicial group at 60 months after operation. The actuarial incidence free from overall valve failur of 100.0% until 18 months after surgery was followed by a rapid decrease during the next 2-year period, and it was only 17.8% at the follow-up end of 42 months after surgery. It was suggested that the major advantage of low thrombogenecity with xenograft valve should be balanced against the high incidence of accelerated valve failure when it is used in children whose age is younger than 15 years old. The possible role of recurrent rheumatic attacks to the early failure of xenograft tissue valve was also discussed.

• 대한핵의학회지
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• 제27권1호
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• pp.71-80
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• 1993

In order to evaluate the scintigraphic features of choledochal cyst and these diagnostic value, authors investigated the findings of fourteen patients with choledochal cyst undergone hepatobiliary scan with $^{99m}Tc$-DISIDA before surgery. Five cases demonstrated the decreased hepatic uptake at 5-minute image of which four cases revealed severe jaundice. Seven cases demonstrated visualization of the cystic dilated common bile duct within 1 hour after injection. Two cases showed the cyst activity between 1 and 12 hours, but the cyst activity was not visible in five cases. Nonvisualization of the gall bladder was noted in ten cases, while four cases demonstrated visualization of the gall bladder within 1 hour. The time of visualization of gut activity was variably delayed. The intestinal activity was found in three cases within 1 hour and appeared in three cases between 1 and 2 hours and eight cases showed no visible gut activity. In four cases, intrahepatic ductal prominence was visible on the scintigram. Seven cases showed early and persistent accumulation of tracer in the common bile duct. Three cases showed persistent photon-deficient area in the gall bladder region. Two cases showed early photon-deficient area around gall bladder region with progressive accumulation of tracer in the same region. Two cases showed no evidence of activity in the biliary tract but noted late excretion into the small intestine. We concluded that hepatobiliary scan using $^{99m}Tc$-DISIDA is a noninvasive test useful in the evaluation and the diagnosis of choledochal cyst.

• Applied Microscopy
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• 제27권3호
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• pp.333-346
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• 1997

The ischemia and reperfusion injury of the skeletal muscles is caused by generation of reactive oxygen during ischemia and reperfusion. It is well known that over 4 hours of ischemia injures the skeletal muscles irreversibly. The author has demonstrated the effects of SOD (superoxide dismutase), DMTU (dimethyl thiourea) and ischemic preconditioning on ultrastructural changes of the muscle fibers in the rectus femoris muscles after 4 hours of ischemia and 1 day and 3 days of reperfusion. A total of 72 healthy Sprague-Dawley rats weighing from 200 gm to 250 gm were used as experimental animals. Under urethane(1.15 g/kg, IP, 2 times) anesthesia, lower abdominal incision was done and the left common iliac artery was occluded by using vascular clamp for 4 hours. The left rectus femoris muscles were obtained at 1 and 3 days after the removal of vascular clamp. The SOD (15,000 unit/kg) or DMTU (500 mg/kg) were administered intraperitoneally at 1 hour before induction of ischemia. The ischemic preconditioned group underwent three episodes of 5 minutes occlusion and 5 minutes reperfusion followed by 4 hours of ischemia and 1 day and 3 days of reperfusion. The specimens were sliced into $1mm^3$ and prepared by routine methods for electron microscopic observation. All specimens were stained with uranyl acetate and lead citrate and then observed with Hitachi-600 transmission electron microscope. The results were as follows: 1. SOD or DMTU alone did not affect the ultrastructure of muscle fibers in the rectus femoris muscles. The electron density of mitochondrial matrix was decreased by ischemic preconditioning. 2. Dilated cisternae of sarcoplasmic reticulum, triad, mitochondria and the loss of myofilament in the sarcomere were observed in the 4 hours ischemia and 1 day reperfused rectus femoris muscles. Markedly changed sarcoplasmic reticulum, triad, disordered or loss of myofilament, indistinct A-band and I-band, and irregular electron lucent M -line and Z-line are seen in the 4 hours ischemia and 3 days reperfused rectus femoris muscles. 3. SOD reduced the changes of organelles in the muscle fibers of the 4 hours ischemia and 1 day reperfused rectus femoris muscles of the rats, but SOD did not affect the changes of muscle fibers in the 4 hours ischemia and 3 days reperfused muscles. On the other hand, DMTU markedly attenuated considerably the ultrastructural change of the 4 hours ischemia and 1 day or 3 days reperfused rectus femoris muscles. 4. By the ischemic preconditioning, the change was attenuated remarkably in the 4 hours ischemia and 1 day reperfused rectus femoris muscles. As the ischemic reperfused changes of muscle fibers were regenerated or recovered by ischemic preconditioning, the ultrastructures of them were similar to those of normal control in the 4 hours ischemia and 3 days reperfused rectus formoris muscles. Consequently, it is suggested that DMTU is stronger inhibitor to ischemic reperfused change than SOD. The ischemia and reperfusion-induced muscular damage is remarkably inhibited by ischemic preconditioning.

• Applied Microscopy
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• 제27권3호
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• pp.225-234
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• 1997

Vincristine, a kind of anticancerous drugs, interferes with development of microtubles and synthesis of nucleic acid and proteins in cells, and destructs cytoplasmic membrane so that mitosis of cancer cells is inhibited. Unfortunately these anticancerous effects by vioneristime are not limited to specific cancer cells, so several side effects are produced. This study was performed to explore the effects of vincristine on the fine structure of cytoplasmic organelles and cartilagenous matrix in proximal epiphyseal plate of the tibia in rat. The results were as follows: 1. Cisternae of rough endoplasmic reticulum (RER) were fragmented and sacculated, and membrane-bound ribocomes of RER were detached at 3 and 6 hours after vincristine treatment. Severely dilated, fagmented and sacculated cisternae of RER were found at 12 hours after vincristine treatment, and at 24 hours after vincristine treatment a few cisternae were framented and sacculated. At 72 hours after vincristine treatment cisternae of RER were parallely well arraged. 2. Golgi complex was atrophied at 3, 6, and 12 hours after vincristine treatment, while at 72 hours after vincristine treatment the cisternae of Golgi complex were made of 5-6 layers. 3. Mitochondria with disorganized mitochondrial cristae and outer membrane-losed mitochondria were found at 3 hours after vincristine treatment. At 6 and 12 hours after vincristine treatment mitochondria had possessed disorganized cristae, and a few mitochondria with disorganized cristae were. observed at 24 hours after vincristine treatment. While at 72 hours after vincristine treatment mitochondria were shown distinct cristae and double membranes. 4. Phagosome were begun to observe at 3 hourse after vincristine treatment, and at 24 hourse after vincristine treatment many phagosomes were found, while at 72 hours after vincristine treatment a few phagosomes were observed. 5. In the cartilagenous matrix large-sized matrix granules were decreased and collagen fibrils were dispersed at 3, 6, and 12 hours after vincristine treatment, while at 72 hours after vincristine treatment many large-sized matrix granules and numerous matrix it is suggested that although vincristine may induce the degenerative changes of the chondrocyte, resulting in changes of components of the cartilagenous matirx, these toxic effects may be regressed with time.

• Applied Microscopy
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• 제29권4호
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• pp.437-450
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• 1999

간세포의 기능적 연구를 위한 배양계를 확립하기 위하여 Sprague-Dawley계 흰쥐의 간장에서 collagenase와 hyaluronidase의 혼합액을 이용하여 간세포를 분리하고 배양하여, 배양중인 간세포의 구조적인 변화와 담세관의 형성 과정을 확인하고, cytochalasin D를 배양계에 첨가한 경우 발생되는 간세포 및 담세관의 구조적인 변화를 살펴보아 다음과 같은 결과를 얻었다. 분리 배양한 흰쥐의 간세포는 원형이었고, 표면에 미세융모를 가지고 있었으며. 배양중 서로 부착되어 세포띠를 형성하였다. Cytochalasin D처리후 간세포의 표면은 미세융모가 소실되어 편평하게 변화되었으며, 소포성 돌출물이 자주 관찰되었다. 담세관은 부착된 간세포의 사이에서 형성되었으며, 간세포 표면의 작은 융기에서 기시하는 다양한 길이 및 형태의 미세융모로 채워져 있었고, 양단에는 치밀결합 및 부착만 등으로 구성된 연접복합체가 존재하였다. Cytochalasin D 처리후 당세관의 내강은 팽창되었으며 미세융모는 소실되어 거의 존재하지 많았고, 양단에 존재하는 연접복합체는 파괴되어 간격이 벌어진 곳이 많았다. 담세관내에 존재하는 미세융모 속에 존재하는 액틴미세섬유심은 완전하게 형성되어 있는 경우, 불완전하게 적은 양만 존재하는 경우, 그리고 전혀 존재하지 않는 경우가 있었다. 담세관주변세포질에 존재하는 액틴미세섬유얼기의 형성은 불완전하여 부위에 따라 없는 곳도 있었다. Cytochalasin D처리후 담세관주변세포질의 액면미세섬유얼기는 존재하지 많았다. 이상의 결과로 흰쥐의 간장에서 분리한 간세포는 배양중 성장하면서 정상적인 담세관을 형성함을 알 수 있었으며, 담세관의 형성은 접착부위의 연접복합체의 형성 및 미세융모의 형성,담세관 내 액틴미세섬유심 및 담세관주변세포질내 액틴미세섬유얼기의 형성 등을 특정으로 하는 것으로 판단된다.