• Advances in pediatric surgery
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• v.4 no.2
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• pp.149-155
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• 1998

Thirty three members of the Korean Association of Pediatric Surgeons were surveyed to determine the clinical manifestations and current management of infantile hypertrophic pyloric stenosis (IHPS). The members completed a registration form and a questionnaire that indicated their treatment preferences for patients treated during 1996. The response rate was 84.8 %, and 23 institutions participated. Three hundred and sixty-three cases of IHPS were analysed. The male to female ratio was 5.15: 1. The presenting symptoms were nonbilious vomiting in 363 cases(100 %), palpable mass in the upper abdomen in 200 cases (55.1 %) and visible peristaltic waves in 67 cases(18.5 %). Fluid therapy was done in 161 cases(44.4 %) for preoperative preparation. Twenty patients(5.5 %) were premature. There were 27 low birth weight babies(7.7 %). The onset of symptoms ranged from 1 to 14 weeks of age with a peak occurrence at 2 to 4 weeks of age. Two hundred and thirty-six cases(66.6 %) presented within 4 weeks of age. There was one set of male twins and a family history of twins. The modes of feedings were: breast feeding; 69 cases(24.5 %), formula feeding; 176 cases(62.4 %) and mixed feeding; 37 cases(13.1 %). The preferred diagnostic modalities were ultrasonography (US) 229 cases(63.1 %), UGI series 27 cases(7.4%) and US and UGI series combined 86 cases(23.7 %). Only 21 cases(5.8 %) were operated on without imaging study, ie. with positive physical finding. Perforation of the mucosa during pyloromytomy occurred in 5 cases. All were treated successfully with primary closure. Persistent vomiting over 2 weeks after operation were reported in 5 cases. Three wound infections, one aspiration pneumonia and one postoperative bleeding were reported. There was no mortality in 363 cases.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.753-759
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• 2005

Purpose : This study was performed to characterize clinical features of benign convulsions with gastroenteritis(CwG) in infants. Methods : We reviewed clinical features of 67 episodes in 64 patients with afebrile seizure accompanied gastroenteritis admitted to Dept. of Pediatrics Bundang CHA hospital from January 2001 to June 2004. Patients with meningitis, encephalitis/encephalopathy or apparent history of epilepsy were excluded. Results : There were 32 boys and 35 girls. The age of onset ranged from 1 to 42 months($18.5{\pm}6.1$ months). The number of children admitted to the hospital with acute gastroenteritis was 2,887 in the same period. The percentage of patients with CwG was 2.3. Seizure type was exclusively generalized tonic or tonic-clonic seizure. The average number of seizures during a single episode was 3.1 (range, 1-13). Two or more seizures occurred in 53(79.1%) of the 67 episodes. Antiepileptic drugs were administered for 42 episodes. Seizure did not cease after the administration of one kind of antiepileptic drug in 23 episodes(54.7%). The seizures were rather refractory to initial antiepileptic treatment. There were no abnormalities in serum biochemistry test including glucose and electrolytes. Cerebrospinal fluid was normal in all 54 episodes. Stool cultures were negative in 49 episodes. Rotavirus was positive in stools in 51(82.3%) of 62 episodes. Norovirus was positive in stools in 2 episodes and astrovirus in 1 of 18 episodes. CT and/or MRI were performed in 15 cases and demonstrated no neuroradiologic abnormalities. Of 73 Interictal EEG, initial 24 cases showed occasional spike or sharp wave discharges from the mid-line area during stage I-II sleep, which were apparently differentiated from vertex sharp transient or K-complexes. The mean follow-up period was 5.7 months(1-36 months). Three patients experienced a recurrence of CwG, but all patients exhibited normal psychomotor development at the last follow-up. Conclusion : Afebrile infantile convulsions with gastroenteritis are brief generalized seizure in cluster with normal laboratory findings and good prognosis. Therefore CwG is likely to be categorized as situation-related seizure of special syndrome. Recognition of this entity should lead to assurance of the parents and long-term anticonvulsant therapy is not usually warranted.

• Analytical Science and Technology
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• v.24 no.2
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• pp.69-77
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• 2011

Ethylene glycol (EG) is produced commercially in large amounts and is widely used as antifreeze or deicing solution for cars, boats, and aircraft. EG poisoning occurs in suicide attempts and infrequently, either intentionally through misuse or accidental as EG has a sweet taste. EG has in itself a low toxicity, but is in vivo broken down to higher toxic organic acids which are responsible for extensive cellular damage in various tissues caused principally by the metabolites glycolic acid and oxalic acid. The most conclusive analytical method of diagnosing EG poisoning is determination of EG concentration. However, victims are sometimes admitted at a late stage to hospitals or died during emergency treatment like a gastric lavage or found rotten dead, when blood EG concentrations are low or not detected. Therefore, in this study, the identification of EG was not only performed by gas chromatograpyc-mass spectrometry (GC-MS) following derivatization but also further toxicological analyses of metabolites, glycolic acid (GA) and oxalic acid (OA), were performed by ion chromatography in various biological specimens. A ranges of blood concentrations (3 cases) was $10\sim2,400\;{\mu}g/mL$ for EG, $224\sim1,164\;{\mu}g/mL$ for GA and ND $\sim40\;{\mu}g/mL$ for OA, respectively, In other biological specimens (liver, kidney, bile and pleural fluid), a range of concentrations (3 cases) was ND $\sim55,000\;{\mu}g/mL$ for EG, ND $\sim1,124\;{\mu}g/mL$ for GA and ND $\sim60\;{\mu}g/mL$ for OA, respectively. Liver and kidney tissues were recommended specimens including blood because OA, a final metabolite of EG, was identified large amounts in these despite no detectable EG caused by some therapy.

• Pediatric Infection and Vaccine
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• v.20 no.3
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• pp.161-167
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• 2013

Purpose: This study was performed to describe the clinical manifestations of hospitalized children due to varicella-zoster virus (VZV) infection Methods: This study included 40 children who were hospitalized for varicella or herpes zoster at Seoul National University Children's Hospital, 2009-2012. Diagnosis of VZV infection was confirmed by VZV PCR or culture from vesicular fluid. Medical records were reviewed to collect clinical features and outcome, antiviral treatment, history of varicella vaccination, and underlying diseases. Results: Sixteen patients with varicella and 24 patients with herpes zoster were included. Their median age was 10.5 years (16 days-19 years). Thirty-five (87.5%) patients had underlying diseases. Among 24 patients with herpes zoster, 11 patients had previous history of varicella and 1 had herpes zoster. Twenty patients (50%) had a history of varicella vaccination, and 19 immunocompromised patients had VZV infection despite of vaccination. Most (95%) patients were treated by intravenous or oral acyclovir, and no treatment failure of intravenous acyclovir was found. The median duration of fever was 4.4 days (1-10 days), and that of antiviral treatment was 12 days (7-23 days) in immunocompromised patients. Immunocompromised patients received longer duration of antiviral treatment than imunocompetent patients (P=0.014). Eleven (27.5 %) immunocompromised patients had postherpetic neuralgia, 2 (5%) had proven co-infection by Streptococcus pyogenes and Klebsiella oxytoca, and 1 (2.5%) complicated with pneumonia. Conclusion: Immunocompromised children require longer duration of treatment and are at risk of severe complication associated with VZV infection. Early initiation of antiviral therapy and close monitoring are necessary for those in immunocompromised conditions.

• Applied Microscopy
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• v.37 no.4
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• pp.271-280
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• 2007

Tonicity-responsive enhancer binding protein(TonEBP) is a transcriptional factor essential in the function and development of the renal medulla. TonEBP plays a critical role in protecting renal medullary cells from the deleterious effect of hypertonicity. TonEBP is a key regulator of urinary concentration via stimulation of transcription of urea transporter(UT) in a manner independent of vasopressin. UT in the renal inner medulla is important for the conservation of body water due to its role in the urine concentrating mechanism. Mongolian gerbil(Meriones unguiculatus) has been as an model animal for studying the neurological disease such as stroke and epilepsy because of the congenital incomplete in Willis circle, as well as the investigation of water metabolism because of the long time-survival in the condition of water-deprived desert condition, compared with other species animal. In this study, we divide 3 groups of which each group include the 5 animals. In the study of 7 or 14 days water restricted condition, we investigated the TonEBP and UT-A by using a immunohistochemistry in the kidney. In the normal kidney, the distribution of TonEBP is generally localized on nuclei of inner medullary cells. Nuclear distribution of TonEBP is generally increased throughout the medulla in 7 and 14 days dehydrated group compared with control group. Increased nuclear localization was particularly dramatic in thin limbs. In control groups, UT-A was expressed in inner stripe of outer medulla(ISOM) and inner medulla(IM). UT-A was present in the terminal part of the short-loop of descending thin limbs (DTL) in ISOM and also present in the inner medullary collecting duct(IMCD), where the intensity of it gradually increased toward the papillary tip. In the dehydrated kidney, UT-A immunoreactivity was increased in the short-loop of DTL in ISOM and in the long-loop of DTL in the initial part of IM, where was expressed moderate positive reaction in the normal kidney. Also it was up regulated in the IMCD in initial & middle part of IM. However UT-A down regulated in the IMCD, where the intensity of it gradually decreased toward the papillary tip. These findings suggest that increased levels of TonEBP in medulla and UT-A in shot-loop of DTL and IMCD play a important role for maintain fluid balance in the water-deprived mongolian gerbil kidney.

• Journal of Life Science
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• v.19 no.6
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• pp.735-743
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• 2009

The common word flavonoids is often used to classify a family of natural compounds, highly abundant in all higher plants, that have received significant therapeutic interest in recent years. Naringin is associated with a reduced risk of heart disease, neurodegenerative disease, cancer and other chronic diseases; however the molecular basis of this effect remains to be elucidated. Thus we attempted to elucidate the anti-allergic effect of Naringin in ovalbumin (OVA)-induced asthma model mice. The OVA-induced mice showed allergic reactions in the airways. These included an increase in the number of eosinophils in bronchoalveolar lavage (BAL) fluid, an increase in inflammatory cell infiltration into the lung around blood vessels and airways, airway luminal narrowing, and the development of airway hyper-responsiveness (AHR). The administration of Naringin before the last airway OVA challenge resulted in a significant inhibition of all asthmatic reactions. Accordingly, this study may provide evidence that Naringin plays a critical role in the amelioration of the pathogenetic process of asthma in mice. These findings provide new insight into the immunopharmacological role of Naringin in terms of its effects on asthma in mice.

• Tuberculosis and Respiratory Diseases
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• v.50 no.2
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• pp.213-221
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• 2001

Background : There is a well recognized interlaboratory variation in the results using the polymerase chain reaction(PCR) to detect the IS6110 sequence. The clinical utility of a commercially developed PCR test(Amplicor) in bronchial washings for detecting pulmonary tuberculosis in smear negative patients was evaluated. The sensitivity and specificity of Amplicor was compared with that of an in-house PCR test used for detecting the IS6110 sequence of Mycobacterium tuberculosis(M.tbc) in the bronchial washing fluid. Methods : 66 patients whose sputum smear for M. tbc were negative or who could not produce any sputum were recruited from January 1999 to July 1999. They all had a bronchoscopy performed to determine if there were signs of hemoptysis, patients who could not cough up sputum, lung lesion that exclude pulmonary tuberculosis. Pulmonary tuberculosis was diagnosed on the basis of a positive culture or a response to anti-tuberculosis therapy. Results : 19 patients with tuberculosis were identified and samples from 16 patients were later confirmed by culture. Bronchial washing for Amplicor PCR revealed a sensitivity, specificity, positive and negative predictive values of 94.7%, 97.9%, 94.7%, 97.9%, respectively. Using IS6110 based PCR, the sensitivity, specificity, positive and negative predictive values were of 73.7%, 87.2%, 70%, 89.1% respectively. Conclusion : Bronchial washing for Amplicor PCR proved to be more useful than IS6110 based PCR in rapidly diagnosing smear negative pulmonary pulmoary tuberculosis in patients where tuberculosis was likely to be differential and rapid diagnosis was essential for optimal treatment.

• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.683-692
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• 1996

Background: Although most of the patients with tuberculous pleural effusions completely reabsorbed their effusions and became asymptomatic within 2 to 4 months, later surgical procedures such as decortication is needed in some patients because of dyspnea caused by pleural loculations and thickening despite anti-tuberculous chemotherapy. It is obligatory to secure adequate drainage to prevent the development of complications. But, the best methods for treating loculated tuberculous pleural effusions remain debatable. Recent several reports revealed that intrapleural instillation of fibrinolytic agents is an effective adjunct in the management of complicated empyema and may reduce the need of surgery. Purpose : The effects of catheterization with intrapleural urokinase instillation were prospectively evaluated in the patients with septated tuberculous pleural effusion, and compared with other therapeutic effects of different modalities of therapy such as repeated thoracentesis and small-bored catheterization. Methods : Forty-eight patients diagnosed with tuberculous pleurisy were randomly separated into three groups; control group(n=13), catheter group(n=12), urokinase group(n=22). In urokinase group, dose of 100.000U urokinase was instilled into the pleural cavity via a percutaneous drainage catheter for complete drainage or total dose of 700,000U of urokinase. After two hours clamping, the catheter was opened and intermittently irrigated. The early and late effectiveness of therapies was assessed by radiographically and by measuring the volume of fluid drained from the catheter. Results : There was statistically significantly better result in the urokinase group in respect of frequency of catheterization, frequency of catheter obstruction and the duration of catheterization in early effectiveness(p < 0.05). There were no difference in radiologic improvement of follow-up in later phase chest X-ray between urokinase group and catheter group in later phase(p > 0.05). But there were more failure rates in control group especially honeycomb septa in pleural effusion sonographically than former two groups. And there were no complications of urokinase such as fever or hemorrhage. Conclusion : In the treatment of septated tuberculous pleurisy, there were better results in urokinase than those of catheterization alone in early effectiveness. And there was no difference in radiographic improvement between urokinase group and catheter group. Intrapleural instillation of urokinase is an effective and safe mode of treatment for septated tuberculous pleural effusions and alleviates the need for thoracotomy.

• The Journal of Korean Medicine
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• v.17 no.1 s.31
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• pp.280-301
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• 1996

This thesis is on the effects of the Injections of Mokhyangsunkisan extract, Mokhyangsunkisan plus Rheum undulatum L. extract and Palmisunkisan extract clinical experiments wre done with medicines to research their analgesic and anti-convulsive action and their efficiency on $O_3$ and Xylene-poisoned lung damage and the pulmonary thromboembolism of rats and mice. The results are as follows; 1. As to the analgesic action, each Injection of Mokhyangsunkisan extract, Mokhyangsunkisan plus Rheum undulatum L. extract and Palmisunkisan extract had significant effects. Among them the Injection of Mokhyangsunkisan plus Rheum undulatum L. extract had the highest effect. 2. As to the anti-convulsive action, each Injections of Mokhyangsunkisan extract and Palmisunkisan extract had significant effects whereas that of the Injection of Mokhvangsunkisan plus Rheum undulatum L. extract had no effect. 3. In the frsearch of the Lung TBA values of $O_3$-poisoned rats. each Injection of Mokhyangsunkisan extract and Palmisunkisan extract had significant effects whereas that of the Injection of Mokhyangsunkisan plus Rheum undulatum L. extract had no effect. 4. None of the Injection of Mokhyangsunkisan extract, Mokhyangsunkisan plus Rheum undulatum L, extract and Palmisunkisan extract had significant effects in the experiments about the variation of the $Na^+$ contents and $K^+$ contents in the serum electrolytes of the $O_3$-poisoned rats. 5. In the research of the Lung TBA values of Xylene-poisoned rats all the three Injections had prominent effects. 6. In the research of the Lung weight in Xylene-poisoned rats each Injections of Mokhyangsunkisan extract and Palmisunkisan extract had significant effects whereas that of the Injection of Mokhyangsunkisan plus Rheum undulatum L. extract had no effect. 7. In the experiments about the variation of the $Na^+$ contents in the serum electrolytes of the Xylene-poisoned rats the Injection of Mokhyangsunkisan extract had a significant effect whereas those of the Injections of Mokhyangsunkisan plus Rheum undulatum L. extract and Palmisunkisan extract had no significant effects. 8. None of the Injection of Mokhyangsunkisan extract, Mokhyangsunkisan plus Rheum undulatum L. extract and Palmisunkisan extract had significant effects in the experiments about the variation of the $K^+$ contents in the serum electrolytes of the Xylene-poisoned rats. 9. All the three Injections had prominent death-repressive effects on the pulmonary thromboembolism induced by Sodium Arachidonate. 10. Each Injection of Mokhyangsunkisan extract and Palmisunkisan extract had death-repressive effects on the pulmonary thromboembolism induced by ADP, whereas the Injection of Mokhyangsunkisan plus Rheum undulatum L. extract had a feeble death-repressive effect By all results of the clinical experiments. the following conclusions are drown; Each Injection of Mokhyangsunkisan extract and Palmisunkisan extract has analgesic and anti-convulsive effects and is also effective for the $O_3$ and Xylene-poisoned Lung damage and pulmonary thromboembolism of rats and mice. The Injection of Mokhyangsunkisan plus Rheum undulatum L. extract has on analgesic effect and is also effective for the pulmonary thromboembolism. Especially its analgesic effect is prominent. Therefore, each Injection of Mokhyangsunkisan extract and Palmisunkisan extract can be used for injection to improve the pulmonary functions whereas the Injection of Mokhyangsunkisan plus Rheum undulatum L. extract is partly effective for the improvement of the pulmonary function. In view of the results so far achieved, fluid acupuncture therapy can be applied as well as traditional way of oral administration of the decoction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.3
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• pp.199-218
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• 2005

Purpose of Study: Peripheral nerve regeneration depends on neurotrophism of distal nerve stump, recovery potential of neuron, supporting cell like Schwann cell and neurotrophic factors such as BDNF. Peripheral nerve regeneration can be enhanced by the conduit which connects the both sides of transected nerve. The conduit maintains the effects of neurotrophism and BDNF produced by Schwann cells which can be made by gene therapy. In this study, we tried to enhance the peripheral nerve regeneration by using calcium phosphate coated porous conduit and BDNF-Adenovirus infected Schwann cells in sciatic nerve of rats. Materials and Methods: Microporous filter which permits the tissue fluid essential for nerve regeneration and does not permit infiltration of fibroblasts, was made into 2mm diameter and 17mm length conduit. Then it was coated with calcium phosphate to improve the Schwann cell adhesion and survival. The coated filter was evaluated by SEM examination and MTT assay. For effective allogenic Schwann cell culture, dorsal root ganglia of 1-day old rat were extracted and treated with enzyme and antimitotic Ara-C. Human BDNF cDNA was obtained from cDNA library and amplified using PCR. BDNF gene was inserted into adenovirus shuttle vector pAACCMVpARS in which E1 was deleted. We infected the BDNF-Ad into 293 human mammary kidney cell-line and obtained the virus plaque 2 days later. RT-PCR was performed to evaluate the secretion of BDNF in infected Schwann cells. To determine the most optimal m.o.i of BDNF-Ad, we infected the Schwann cells with LacZ adenovirus in 1, 20, 50, 75, 100, 250 m.o.i for 2 hours and stained with ${\beta}$-galactosidase. Rats(n=24) weighing around 300g were used. Total 14mm sciatic nerve defect was made and connected with calcium phosphate coated conduits. Schwann cells$(1{\times}10^6)$ or BDNF-Ad infected Schwann cells$(1{\times}10^6)$ were injected in conduit and only media(MEM) was injected in control group. Twelve weeks after surgery, degree of nerve regeneration was evaluated with gait analysis, electrophysiologic measurements and histomorphometric analysis. Results: 1. Microporous Millipore filter was effective conduit which permitted the adhesion of Schwann cells and inhibited the adhesion of fibroblast. We could enhance the Schwann cell adhesion and survival by coating Millipore filter with calcium phosphate. 2. Schwann cell culture technique using repeated treatment of Ara-C and GDNF was established. The mean number of Schwann cells obtained 1 and 2 weeks after the culture were $1.54{\pm}4.0{\times}10^6$ and $9.66{\pm}9.6{\times}10^6$. 3. The mRNA of BDNF in BDNF-Ad infected Schwann cells was detected using RT-PCR. In Schwann cell $0.69\;{\mu}g/{\mu}l$ of DNA was detected and in BDNF-Adenovirus transfected Schwann cell $0.795\;{\mu}g/{\mu}l$ of DNA was detected. The most effective infection concentration was determined by LacZ Adenovirus and 75 m.o.i was found the most optimal. Conclusion: BDNF-Ad transfected Schwann cells successfully regenerated the 14mm nerve gap which was connected with calcium phosphate coated Millipore filter. The BDNF-Ad group showed better results compared with Schwann cells only group and control group in aspect to sciatic function index, electrophysiologic measurements and histomorphometric analysis.