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Acute Appendicitis in Children and Adolescents: Factors Associated with Perforation and the Causative Organism (소아 청소년의 급성 충수염: 천공과 연관된 인자 및 원인균)

  • Lee, Sol;Kwon, Hyuck Jin;Ahn, Soo Min;Lee, Kwan Seop;Kim, Kwang Nam
    • Pediatric Infection and Vaccine
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    • v.25 no.1
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    • pp.1-7
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    • 2018
  • Purpose: This study aimed to determine which factors are related to perforated appendicitis. We also conducted a survey to identify the causative organism. Methods: From January 2011 to December 2014, 569 pediatric patients (322 male) younger than 19 years old who underwent an appendectomy due to acute appendicitis at Hallym University Sacred Heart Hospital were enrolled. Patients' medical records were reviewed retrospectively to determine their clinical manifestations, laboratory and imaging results, and pathogens. Results: About 127 patients (22%) had perforated appendicitis. The rate of perforated appendicitis in preschool, late childhood, and adolescent ages were 50%, 27%, and 16.8%, respectively. The risk factors of perforation were high C-reactive protein levels and the presence of appendiceal fecalith (P<0.001). Of the 24 samples of peritoneal fluid and periappendiceal pus that were collected intraoperatively, 16 were culture positive. The most common pathogen was Escherichia coli (n=10), and others were Pseudomonas aeruginosa, Streptococcus spp., and Staphylococcus spp. Conclusions: The perforation rate of appendicitis among patients younger than 5 years old was 50%, and this decreased in proportion with age. Clinicians should be aware of the possibility of perforation when patients with appendicitis have high C-reactive protein levels or the presence of appendiceal fecalith on imaging.

Wording on Acupuncture "鍼" & "針" Used by Historic Doctors (역대의학성씨(歷代醫學姓氏)의 침(針)과 침(鍼)에 대하여)

  • Kim, Hong-Kyoon;An, Sang-Woo
    • The Journal of Korean Medical History
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    • v.25 no.2
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    • pp.155-193
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    • 2012
  • From the part "歷代醫學姓氏(Historic Doctors)" in "醫林撮要(Uirimchualyo)", the following has been noticed and concluded. 1. Because acupuncture was originated from stony needle, the word "石(sok)" contains the meaning of needle, and from this point on, words like 石(sok), 砭石(pyumsok), 箴石(Jamsok), 鑱石(Chamsok) had been derived. 2. The word 砭石(pyumsok) used in "Hwangjenaekyong(Yellow Emperor's Canon of Medicine or Hwangdineijing)" should be interpreted as acupuncture in a verb form, not a noun form. 3. 鑱石(Chamsok) or 鑱鍼(Chamchim) was used for surgical treatment for tumor, by cutting open tumors and pressing the pus out. Therefore, 砭石(pyumsok), 鑱石(Chamsok) are the same kind of needles, and 鑱鍼(Chamchim) is the tool improved from 鑱石(Chamsok) used in the Bronze Age. 4. Kwakpak put a note on 鑱石(Chamsok) in "山海經(Sanhaekyong)" that reads "it is defined as 砥鍼(Jichim) and treats tumor." This let us know the shape of 石(sok), 砭石(pyumsok), 鑱(Chamsok), 鑱鍼(Chamchim), and the stone that can be used as a surgical tool with slim & sharp shape is obsidian. 5. Because obsidian is only found around Mt. Baekdu and limited area in South Korea & Japan in Asia, it is closely related with the life & medical environment of the tribe "Mt. Baekdu". 6. The development of 鑱鍼(Chamchim) was influenced by surgical treatment used in early stage of civilization, and its origin is traced upto Gochosun dynasty. Korea's own traditional medical knowledge is derived from this surgical treatment skill. 7. Because the acupuncture is originated from Gochosun dynasty, 鍼(chim) was derived from 箴(Jam) of 箴石(Jamsok), 䥠(Chim) & 䥠(Chim) both were used for a time being, and finally settled into 鍼(Chim). 8. The word 針(Chim) showed up at Myung dynasty, and started to be used in Korea from early Chosun dynasty. 9. In the early Chosun dynasty, 鍼(Chim) was used for medical term, and 針(Chim) for non-medical term. In the mid Chosun dynasty, 針(Chim) was used as a term for tool, and 鍼(Chim) as a term for acupunctural medical treatment. 10. Under the order of King Sunjo, Dr. Yesoo Yang published "醫林撮要(Uirimchualyo)", added "醫林撮要續集(Sequel to Uirimchualyo)", and added "歷代醫學姓氏(Historic Doctors)" again which eventually made totally 13 books of "醫林撮要(Uirimchualyo)". In addition, many parts of "醫林撮要續集(Sequel to Uirimchualyo)" were quoted in "東醫寶鑑(Donguibogam)", and influenced much in publishing "Donguibogam". 11. In "歷代醫學姓氏(Historic Doctors)" of "醫林撮要(Uirimchualyo)", the same way in "Donguibogam", referred to 針(Chim) as a term for a needle, and 鍼(Chim) as a term for Acupuncture. 12. From the usage of 針(Chim) & 鍼(Chim), shown in "鄕藥集成方(Hyangyakjipsungbang)", "醫林撮要(Uirimchualyo)" and "東醫寶鑑(Donguibogam)", we can notice the spirit of doctors who tried to take over the legitimacy of Korean tradition, and their elaboration & historical view that expresses confidence on our own medical technology, through the wording 鍼(Chim).

Tetanus occurred by misuse of syringe in Korean native cattle (한우에서의 주사기 오사용으로 발생한 파상풍 증례)

  • Lee, KyungHyun;Kim, HaYoung;Jung, ByeongYeal;Kim, JongWan;Lee, KiChan;So, ByungJae;Oem, JaeGu;Song, JaeChan;Choi, Eun-Jin
    • Korean Journal of Veterinary Service
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    • v.42 no.1
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    • pp.39-42
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    • 2019
  • Tetanus is an acute, often fatal, and infectious disease of all species of domestic animals caused by the neurotoxin of Clostridium tetani (C. tetani). This disease is usually known to develop after microbial contamination in the deep or penetrating wound sites. In February 2017, a farmer who was raising 76 cows injected foot and mouth disease vaccine to three or more cows with one syringe. Their clinical symptoms were observed 2 to 16 days after the vaccination. The initial symptoms were stiffness, rigidity of the neck and limbs, pricked ears, and prolapse of the third eyelid. Subsequently, there was recumbency with extension of the limbs, convulsions and opistotonus and the affected 20 cows were all died. Two dead cows were submitted to Animal and Plant Quarantine Agency for disease diagnosis. At necropsy, a focal edematous abscess of 15 to 20 cm in diameter was grossly observed in the subcutaneous and intramuscular tissue of scapular region and filled with a large amount of greenish pus. The feed was full in oral cavity and slightly observed in the trachea and lobes of lung. Histopathologically, focal granulomatous nodules with eosinophilic materials in the tissue were observed. In the lung, aspiration pneumonia and gram (+) bacteria were seen. The C. tetani was isolated in samples anaerobically cultured using reinforced clostridial medium and identified by PCR. To our knowledge, no previous outbreak of tetanus in cattle has affected such a high number of animals; neither has it been associated with misuse of the same syringe and needle to administer multiple individuals.

Kerion Celsi Caused by Trichophyton verrucosum Mimicking a Hypervascular Tumor in a Pediatric Patient: A Case Report (고혈관성 종양으로 오인된 Trichophyton verrucosum에 의한 두피 백선종창 1례)

  • Kim, Kyung-Ran;Park, Hwanhee;Kim, Doo Ri;Yoon, Yoonsun;Jeon, Chiman;Lee, Sanghoon;Lim, So Young;Kim, Ji Hye;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.29 no.2
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    • pp.118-123
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    • 2022
  • A dermatophyte is a zoonotic infection that causes infection on the skin, hair, and nails and is transmitted through contact. The species of Microsporum, Trichophyton, and Epidermophyton are the major dermatophytes that infect humans. Tinea capitis is a dermatophyte infection in the scalp, and it may progress to kerion celsi, including severe redness, swelling, and pus formation. Kerion celsi is sometimes misdiagnosed as a bacterial infection or a tumor. Trichophyton verrucosum is a zoophilic dermatophyte that mainly causes infection in cattle. It can be spread to dairy farmers or ranchers who have frequent contact with infected cattle. We report a pediatric case who received scalp tumor excision and a split-thickness skin graft for extensive and severe inflammatory scalp tumors that occurred after contact with cattle with ringworm. Finally, the patient was diagnosed with kerion celsi caused by T. verrucosum infection. This was based on the patient's medical history, clinical manifestations, and histopathologic findings.

Estimation of Ultimate Lateral Resistances of Piles Using CPT Cone Resistance in Sand (사질토지반에서 콘관입저항치 $q_c$에 의한 단말뚝의 극한수평단위지지력 평가)

  • Kim, Min-Kee;Kyung, Doo-Hyun;Hong, Jung-Moo;Lee, Jun-Hwan
    • Journal of the Korean Geotechnical Society
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    • v.24 no.11
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    • pp.71-77
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    • 2008
  • In this study, CPT-based methodology for estimating the ultimate lateral resistance, $p_u$, is proposed and verified for lateral loaded piles in sandy soil. Preexistent methods estimating the ultimate lateral resistance, $p_u$, and the ultimate lateral capacity, $H_u$, of pile have been based on the vertical effective stress, relative density, and the coefficient of lateral earth pressure. Similarly, cone resistance $q_c$ in pure sandy soil is expressed by those essential factors. As correlation between $p_u$ and $q_c$ are normalized with average effective stress ${\sigma}_m$, estimation methodology for the lateral loaded pile of $p_u$ in sandy soil is proposed. The method is verified by calibration chamber test results in pure sand. The standard derivation of estimated $p_u$ is 0.279, and COV (Coefficient Of Variation) of estimated $p_u$ is 0.272. These results showed that the estimated pus by the method are analogous with the measured $p_us$ in calibration chamber test.

Thymus quinquecostatus Extracts Suppress IFN-γ/TNF-α -induced Inflammatory Cytokine in Lung Fibroblast MRC-5 Cells

  • Young-Jae Song;Sa-Haeng Kang;Jae-Bin Seo;Se-Woong Ko;Ju-Ryoun Soh;Jeong-Hyang Park;Dong-Keun Kim;Tae-Hyun Kim;Hyuck-Se Kwon;Na Young Lee;Jong-Sik Jin
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2020.12a
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    • pp.81-81
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    • 2020
  • Pneumonia is infection of air sacs in lungs by bacteria, viruses, fungi and abnormal atmosphere condition. That causes to inflammation and fills up with pus and fulid in air sacs. The symptoms of pneumonia are heavy cough, fever, shortness and rapid respiration and sputum with blood. Also, that remains sequela after the recovery. Thymus quinquecostatus (TQ) has a strong antibacterial effect. That has been used a natural medicine for bronchitis, asthma and nervous inflammation. In this study evaluated anti-inflammatory effects of TQ on IFN (interferon)-γ/TNF (tumor necrosis factor)-α (20 ng/ml) stimulation. MRC-5 cells were seeded at 1 × 105 cells/well in a 24-well plate and stabilized overnight at 37℃. The cells were treated with various concentrations of TQ extracts (DW, 30, 50, 70, 95% EtOH, 0.1~100 mg/ml) for 4h, Subsequently IFN-γ/TNF-α (20 ng/ml) was added to each well and incubated over 12h. the production of inflammatory cytokines were measured by Enzyme-linked immunosorbentassay(ELISA) method. The absorbance was measured at 450 nm using microplate reader. The treatment with TQ extract at dose of 0.1 to 100 mg/ml did not show cytotoxicity in MRC-5 cells (showed cytotoxicity at 95% EtOH 100 mg/ml). The results demonstrated that stimulation of TNF-α/IFN-γ significantly increased the production of inflammatory mediators in the MRC-5 cells compared with unstimulated cells. By contrast, treatment with TQ extreats doses of 0.001 to 10 mM significantly suppressed the production of IL-6 and IL-8. Especially. The higher percent of ethyl alcohol extracts suppressed the production of inflammatory cytokines. This results are considered that essential oil of TQ is extracted according to ethyl alcohol percent. Therefore, TQ has potential to mitigate pulmonary disease that can be used a medicine for pneumonia

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Relationship between Incidence of Endometritis and Metabolic Status during Peri- and Postpartum Periods in Dairy Cows (젖소의 자궁내막염 발생과 분만 전·후 대사 상태와의 상관관계)

  • Jeong, Jae-Kwan;Choi, In-Soo;Kang, Hyun-Gu;Jung, Young-Hun;Hur, Tai-Young;Kim, Ill-Hwa
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.426-432
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    • 2015
  • This study compared blood metabolites during peri- and postpartum periods among cows with clinical or subclinical endometritis and cows without endometritis. Blood samples from 207 Holstein dairy cows were collected at 4 weeks prepartum, just after calving, and at 1, 2, 4, and 6 weeks postpartum to measure serum concentrations of calcium, magnesium, non-esterified fatty acids (NEFAs), total cholesterol, albumin, urea nitrogen, ${\beta}$-hydroxybutyrate (BHBA), aspartate aminotransferase (AST), ${\gamma}$-glutamyltransferase, glucose, and phosphorus. Clinical endometritis was diagnosed by the observation of vaginal discharge (> 50% pus) and subclinical endometritis was diagnosed by the evaluation of uterine cytology (> 18% neutrophils) at 4 weeks postpartum. Cows were divided into three groups based on the presence or absence of clinical or subclinical endometritis: the control group (n = 104), the clinical endometritis group (n = 66), and the subclinical endometritis group (n = 37). Calcium and magnesium concentrations were lower in the clinical endometritis group than in the control and subclinical endometritis groups throughout the study period (p < 0.05 to 0.0001), whereas the NEFAs concentration was higher in the clinical endometritis group than in the control group throughout the study period (p < 0.01). The total cholesterol concentration was lower in the clinical endometritis group than in the control and subclinical endometritis groups throughout the pre- and postpartum periods (p < 0.05 to 0.001). The albumin concentration was lower in the clinical endometritis group than in the control and subclinical endometritis groups during the postpartum period (p < 0.05 to 0.001). The urea nitrogen concentration was lower in the clinical endometritis group than in the control and subclinical endometritis groups at 4 and 6 weeks postpartum (p < 0.01). At 1 week postpartum, the BHBA concentration was higher in the clinical endometritis group than in the control group (p < 0.05), whereas the AST concentration was higher in the clinical endometritis and subclinical endometritis groups than in the control group (p < 0.05). In conclusion, lower serum concentrations of calcium, magnesium, total cholesterol, albumin, and urea nitrogen, but higher concentrations of NEFAs, BHBA, and AST during the postpartum period were associated with the incidence of clinical endometritis, indicating the importance of balanced nutrition during the transition period.

Clinical Analysis of Bronchogenic Cyst (기관지성 낭종의 임상적 고찰)

  • 안재범;정성철;김우식;신용철;유환국;이정호;김병열;김인섭
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.585-590
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    • 2004
  • Bronchogenic cyst is a rare and benign disease. Because of its complication or associated disease, Bronchogenic cyst requires surgical treatment. Recently, with the development of diagnostic methods, its incidence has increased. So we reviewed our results from the past 30 years. Material and Method: We reviewed 27 cases surgically treated from March 1971 to March 2003. This investigation is designed to illustrate the peak age incidence, sex ratio, symptoms, anatomic location, radiologic imagings, associated diseases, operative methods, postoperative pathologic findings and postoperative complications. Result: The peak age incidence laid in the 1st to 3rd decade and the ratio of male and female was 1 : 1.5. The most common complaints were cough and dyspnea, but some had hemoptysis. There were 22 cases (81%) of Intrapulmonary bronchogenic cysts and 5 cases(19%) of mediastinal bronchogenic cysts. Thirteen cases (48.1%) showed cystic lesion in simple chest X-ray. Ten cases showed cystic lesion among 13 cases that had taken computed tomography. We found associated disease in 15cases (56%). The inflammatory diseases from infection were many in intrapulmonary bronchogenic cysts and especially, one case showed carcinosarcoma. Mitral regurgitation and Bronchial obstruction could be seen in mediastinal bronchogenic cysts. The 13 cases (48%) were managed by lobectomy, and cystectomy, pneumonectomy, and segemental resection were done in 7 cases (26%), 4 cases (15%), 3 cases (11%) respectively. Cystic contents were mucus in 9 cases, pus in 9 cases, blood in 2 cases, and carcinosarcoma in 1 case. Bronchotracheal communications were in 13 cases (48%). Five cases showed Postoperative complications, which were pneumothorax, empyema, bleeding. Postoperative death could not be found. Conclusion: Almost all patients had clinical symptoms. Severe complications could be associated with bronchogenic cysts. Recently, With the development of diagnostic methods, preoperatively accurate diagnosis is possible; therefore, invasive study has decreased. Bronchogenic cyst is a benign disease. However, because of its clinical symptoms, complications, and possibility of malignant change, immediate surgical treatment is needed.

Perceptions of Clothing Norms Clothing Behavior and their Relations to Psychological Variables of College Student (남녀 대학생의 의복규범에 대한 의식과 복식행동 및 심리적변인에 관한 연구)

  • 박찬부
    • Journal of the Korean Society of Costume
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    • v.31
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    • pp.165-188
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    • 1997
  • This study aims at 1) examining the perceived importance of clothing norms 2) examining relationship between perceptions of clothing norms clothing behavior and psycho-logical variables-ego identity(uniqueness and self acceptance) and sex role identity and 3) ascertaining any significant differences in the level of the perceived importance of clothing norms among variables-sex role identity and the uniqueness in psychological variables-and which variables are influencingon perception of clothing norms. The perception of cloth in norms inventory clothing norms inventory clothin behavior inventory ego identity in-ventory and the Bem Sex Role Inventory were administered to 620 college students. Sex role identity was classified into androgynous mas-culine feminine and undifferentiated type. Subjects were asked to rate each statement on the clothing norms under two kinds of instructions: their attitudes(TATT) and their beliefs about the expectations of others toward clothing norms(TBEO). 1) The scores of 3 TBEO of the students were higher than the scores of TATT. But the scores of TBEO concerning modesty of students were lower than the scores of TATT. Discrepancy scores of TATT and TBEO of the students were revealed significances differently according to clothing norms. males lower and higher class students had more free attitudes to the norms concerning genaral clothing attitudes. Females and higher class students had less free attitudes to the clothing norms concerning modesty. Females and lower and higher class students had more free attitudes to the norms concening sex-role related clothing attitudes but male students had less free to the sex-role related clothing norms. 2) Significant negative correlations between each variable of clothing norms and conform-ity-individuality were found. But negative correlations between those variables of the males and lower class students were higher than the correlations of the female and higher class students and the former had more posi-tive relationships with clothing norms and con-formity as compared with the latter. And sig-nificant positive correlations between each variable of clothing norms and modesty were found. But positive correlations between those variables of the males females and higher class students were higher than the correlations of the lower class students and the latter had less positive relationship with clothing norms and modesty as compared with the former. 3) Significant negative correlations between clothing norms and uniqueness were found in the subjects groups. The females and lower class students had more negative relationships with clothing norms and uniqueness as compared with the male and higher class students. Significant positive correlations be-tween uniqueness and conformity-individuality were found in all subjects groups, Therefore the higher uniqueness the student have the less they perceive theimportance of clothing norms and the more they have individuality. Significant positive correlations between sex-role related(higher class) general(female) clothing norms and self acceptance were found. but significant negative correlations be-tween campus style(higher class) general(female) clothing norms and self acceptance were found. But significant negative correlations be-tween campus style(males lower class, higher class) clothing norms and self acceptance were found. Clothing norms therfore related posi-tively or negatively with self acceptance ac-cording to the subjects groups. And significant negative correlations between conformity in-dividuality and self acceptance was found in higher class students. 4) The female masculine groups and the masculine groups of lower class revealed high scores than the scores of andrgynous group and undifferentiated group in clothing norms concerning modesty. And the feminine group revealed high scores in conformity-individu-ality than the scores of the masculine group. Male masculine and feminine group revealed high scores in clothing norms concerning cam-pus style than the scores of the androgynous group. The masculine group and feminine group of the lower classes revealed high scores in general clothing norms than the scores of the androgynous group. 5) The most influencing variables on the clothing norms were sex conformity-individu-altiy and masculine-feminine variables in the right order. The general clothing norms and clothing norms concerning modesty were influened by the sex role identity but the sex role related clothing norms and clothing norms concerning campus style were influenced by the ego identity. 6) Based on the sum scores of the uniqueness each group of the subjects was separately segmened into "high medium and low" groups. By the analysis of variances sig-nificant differences in discrepancy scores of TBEO and TATT among 3 uniqueness level groups were found on all clothing norms variables in all students three clothing norms variables in male and female students and one clothing norms variable in lower and higher students and in each clothing norms variable the mean discrepancy scores of the high uniqueness group were higher than those of the other groups. The findings indicated that the differences in the discrepancy score mainly contributed to the results of correla-tions described above.bed above.

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A clinical study of deep neck abscess in children (소아 심경부 농양의 임상적 고찰)

  • Lee, Soo Jung;Shin, Mee Yong;Kim, Chang Hwi;Koh, Yoon Woo
    • Clinical and Experimental Pediatrics
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    • v.50 no.4
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    • pp.363-368
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    • 2007
  • Purpose : It has been reported that deep neck abscesses are recently increasing again. We analyzed pediatric cases with deep neck abscesses during the last several years to contribute to the treatment of the disease. Methods : The clinical data of 30 children under 16 years of age with deep neck abscess from February 2001 to July 2006 were analysed retrospectively. Results : The mean age was 9 years (2-16 years), and the male/female ratio was 19/11. Abscesses in the peritonsillar space were most common (57%), followed by the retropharyngeal (30%) and parapharyngeal (13%) spaces. Upper respiratory infection in 10 cases (33%), dental infection in four case (14%), cervical lymphadenitis in three case (10%) and sinusitis in two case (6%) contributed to the development of deep neck infections. The frequent symptoms were fever in 16 case (53%), sore throat in 15 case (50%), poor oral intake in 10 (33%), odynophagia in eight (27%), and neck pain in eight (27%). Unilateral tonsillar hypertrophy and displacement in 15 case (50%) were most common. Neck mass in 13 patients (43%), neck stiffness in three (10%) and trismus in three (10%) were also found. Bacteria were isolated in 8 among 10 pus cultures; Streptococcus species 7 and Micrococcus luteus 1. All of those bacteria except Micrococcus luteus were sensitive to penicillin G. Surgical intervention was applied to 12 cases (40%), and the remaining 18 patients (60%) were treated with antibiotics only. There were no differences between the two groups in the duration of admission and antibiotic treatment. No complicated cases were observed. Conclusion : Peritonsillar abscesses were most frequent. Upper respiratory infection was the most common predisposing factor, followed by dental infection and sinusitis. Symptoms of respiratory tract obstruction were not found. The most common pathogens were Streptococcus species. Deep neck abscesses in children, if diagnosed at the early stage, possibly can be treated by antibiotics only, without surgical intervention.