Purpose : HUS usually occurs in children after infection with shiga toxin-producing microorganism(D+HUS). In contrast, non-postdiarrheal(D-) HUS occurs at any age and has a high rate of relapse and a poor prognosis. The clinical presentation of D-HUS is similar to that of thrombotic thrombocytopenic purpura(TTP). Recently severe deficiencies of ADAMTS13 were reported not only in TTP and D- HUS but also in D+ HUS during their acute phase. The purpose of the study is to evaluate the plasma ADAMTS13 activity in D+ and D-HUS. Methods : Nineteen children with HUS(D+ HUS 12 and D- HUS 7) were enrolled. The assays of plasma ADAMTS13 activity were performed during the acute stage in the D+ HUS and at various stages of relapsing courses in the D- HUS patients by multimer assay, based on electrophoresis. Results : The median plasma activity of ADAMTS13 in D+ HUS and D- HUS were 80.9%(37.8-132.4%) and 53.9%(1.0-94.1%), respectively, which were not statistically significantly different from control(86.4%, 34.2-112.3%)(P>0.05). One boy with D- HUS had severe deficiency of ADAMTS13(1.0%). His platelet count was normalized temporarily by fresh frozen plasma infusion. Conclusion : We have demonstrated that there is no significant difference of the plasma ADAMTS13 activity between D+ HUS, D- HUS and control. We detected severe deficiency of ADAMTS13 in one boy who presented with relapsing episodes of D- HUS. ADAMTS13 deficiency should be considered in the subgroup of D- HUS especially with early onset and recurrent courses. Plasma therapy can be beneficial in this subgroup.
Hwang Seock Yeon;Yang Jin Bae;Chang Cheoul Soo;Lee Young Chan;Lee Hyung Chul
Journal of Physiology & Pathology in Korean Medicine
/
v.16
no.4
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pp.674-679
/
2002
The toxicity and bioaccumulation of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and polychlorinated biphenyls (PCBs) continues to be a focus of research in human and various species. The main human exposure is via the dietary route. This study was carried out to investigate the protective effect of Cornu Cervi Parvum extract on clinical parameters and hepatotoxicity in Sprague-Dawley rat (SD rat) accutely exposured to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Male SD rats received single intraperitoneal (ip) injection of TCDD (40 ㎍/kg), and administered 10 or 20 mg/kg/day of the ethanol extract oral injection for 4 weeks from 1 week before TCDD treatment. The gain in body weight was less in group treated with TCDD than in CON group, while that of C/H+ TCDD group (Cornu Cervi Parvum extract 20 mg/kg/day) increased. The decrease in spleen and testis weight caused by TCDD was prevented by Cornu Cervi Parvum extract 20 mg/kg/day. The fluctuation in BUN content, WBC and platelet count by TCDD intoxication were significantly attenuated by the ethanol extract treatment (20 mg/kg/day for 4 weeks). Treatments of rats with the extract (10 or 20 mg/kg/day) were significantly reduced AST and ALT levels compared with TCDD-treated group. Moderate swelling of hepatocytes, hyperchromatism, acidophilic cytoplasm and cytoplasmic vacuolation were observed in TCDD-treated animals (TCDD group). The administration of EtOH extract 10 or 20 mg/kg along with TCDD significantly alleviated the liver histopathological alteration induced by TCDD. These results suggest that Cornu Cervi Parvum extract can be useful as a protective agent against TCDD, an endocrine disruptor.
Objectives: The study aims were to evaluate the Anti-stress and Sleep-inductive effects of Yunjogyosim-tang (YJGS) in rats induced by Chronic Mild Stress (CMS). Methods: 25 healthy Rats were randomly divided into 5 groups; Normal, CMS (Control), YJGS 50, YJGS 100, and YJGS 200. All rats except the normal group were exposed to random stress conditions like water deprivation, empty bottles, forced runs on the treadmill, etc. according to the timetable of CSM for 3 weeks. After a week starting the experiment, Rats in YJGS 50, YJGS 100, and YJGS 200 groups were fed orally once a day for 2 weeks. Blood samples were taken afterward from each rat for analysis of Complete blood count, AST, ALT, and glucose levels. Corticosterone, serotonin, and melatonin were measured by ELISA kit. BDNF and $TNF-{\alpha}$ were measured by RT-PCT. Results: 1. Corticosterone levels were lower in YJGS 50, and YJGS 200 groups compared to the control group. 2. Serotonin levels were lower in the YJGS 100 and YJGS 200 groups compared to the control group. 3. Melatonin levels were higher in the YJGS 50 group compared to the control group. 4. Activity levels were higher in the BDNF, and YJGS 50 groups compared to the control group. 5. In the Activity of $TNF-{\alpha}$, YJGS 50 group showed a significant decrease compared to the control group. 6. In the Glucose content, YJGS 50, YJGS 100, and YJGS 200 groups showed a significant decrease compared to the control group. 7. When analyzing leukocytes, monocytes were found to be increased in YJGS 100 and YJGS 200 groups compared to the control group. 8. When analyzing red blood cells, more changes occurred to erythrocytes and thrombocytes in the YJGS 50 and YJGS 200 groups than in the control group. Hemoglobin was significantly increased in the YJGS 100 group and platelet levels were significantly increased in all experimental groups compared with the control group. Conclusions: These results suggest that Yunjogyosim-tang has anti-stress and sleep-inductive effects on rats induced by CMS.
The normal physiological values of Korean mongrel dogs were studied, comparing them with foreign references, on the basis of control physiological data measured on 110 cases out of the dogs submitted to the experiments in our department. The hemodynamic measurements varied widely between the both limits of reported normal control data, with the mean value of heart rate $140.4{\pm}26.6$/min., and both the systolic and diastolic arterial blood pressures $137.2{\pm}31.7$mmHg and $104.7{\pm}14.4$ mmHg, as well as the venous pressure of $9.11{\pm}2.18$ cm.$H_2O$. Hematologically, the number of red blood cells $4,571,000{\pm}767,000$per cu.mm., the amount of hemoglobin $11.57{\pm}3.74$ gm/dl and the hematocrit $37.3{\pm}7.2$ per cent, were equally the values a little lower than the reported normal means. However, the white blood cells were within the reported normal limits both in number, $10,384{\pm}4,877$ per cu. mm and their differential counts with slightly broader ranges of variation. The platelet count was $149,800{\pm}47,000 $per cu. mm and was also far below the normal, while the coagulation time $9.03{\pm}2.69$min. and the prothrombin time $13.17{\pm}6.52$sec were within normal limits, though a little prolonged. The serum electrolytes, Na $146.6{\pm}10.44$mEq/L.,K $4.46{\pm}0.84$mEq/L., CI $118.3{\pm}7.88$mEq/L. and Ca $11.45{\pm}5.62$mg./dl, and the blood glucose level of $94.9{\pm}31.79$mg./dl were essentially not different from the reported normal values. The serum proteins, total protein $7.15{\pm}1.41$gm/dl., albumin $4.09{\pm}0.77$gm./dl. and globulin $3.18{\pm}0.88$gm/dl. were included near the higher limits of the reported normal levels. The thymol turbidity 0.1-3.04 units were normal in 10 cases, and the cephaline flocculation was within normal range except 2 cases out of 26 dogs, showing two positive in 24 hours. And the nitrogen series, NPN $34.61{\pm}10.29$mg/dl. and BUN $12.77{\pm}6.37$mg./dl. were normal. It may be concluded that from the point of view of hereby measured physiological data compared with the foreign references, the Korean mongrel dogs have a compatible laboratory data with only the special regards to their tendency toward anemia in red blood cell series.
Purpose : Adiponectin is an endogenous modulator of vascular remodeling that suppresses vascular inflammation. However, the role of adiponectin in Kawasaki disease (KD) has not been elucidated. The purpose of this study is to investigate the correlation between serum adiponectin level and several parameters, such as interleukin (IL)-6, tumor necrosis factor $(TNF)-{\alpha}$, lipid profile, and C reactive protein (CRP), and to clarify the association between adiponectin and cardiac function. Methods : Twenty-two KD patients (22 patients in acute phase and 20 patients in subacute phase) were enrolled in the study group. The control group consisted of 31 subjects (13 febrile patients and 18 healthy children). Both groups underwent blood sampling and tissue Doppler imaging (TDI). Results : CRP was significantly increased in the KD group compared with the control group. There were no significant differences in serum $TNF-{\alpha}$, IL-6, and adiponectin levels between groups. However, a negative correlation was found between adiponectin level and CRP level or platelet count. Systolic myocardial velocity and A myocardial velocity measured by TDI were decreased significantly in the acute KD group compared with the subacute KD group and control group. Positive correlations were found between adiponectin level and systolic myocardial velocity or A myocardial velocity. Conclusion : In acute KD patients, low adiponectin level was related to severe inflammatory reactions and decreased left ventricular functions.
Seok- Cheol Choi;Jai-Young Kim;Jin-Bog Koh;Won-Jae Lee
Biomedical Science Letters
/
v.3
no.2
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pp.83-88
/
1997
In septic patients, disseminated intravascula. coagulation (DIC) occurs frequently and is a pathologic condition associated with a variety of critical illness. DIC may complicate the already complex clinical situations and contribute to the high mortality. Nevertheless, its pathogenic mechanisms are not completely elucidated. Present study was prospectively designed to understand the pathogenetic mechanisms involved in the development of DIC. 15 rats were subjected to study and according to the aim, they were divided into three groups: group I, control (not treated-endotoxin, n=5); group II (12 hours after endotoxin injection, n=5); group III (24 hours after endotoxin injection, n=5). Experimental DIC was induced in rats by a bolus injection of endotoxin (1mg/kg, E. coli serotype 055:B5). Blood was collected by direct puncture of the heart. Platelet count, fibrinogen and plasminogen concentration, antithrombin III, D-dimer and complement components (C3 and C4) were measured in all subjects. In group II and III, there were apparent signs of DIC, including thrombocytopenia, decreased fibrinogen (but increase in group III), reduced C3 and antithrombin III, and elevated D-dimer. These data indicated that endotoxin might induce the activation of several pathways such as coagulation, fibrinolytic and complement cascade, causing DIC and subsequent multiple organ failures. Ultimately, the increased knowledge of the various pathogenetic mechanisms of coagulation activation and fibrinolysis in endotoxin-induced DIC may have prophylactic or therapeutic implications.
Immune-mediated hemolytic anemia(IMHA) is one of the most common causes of anemia in small animals and immune-mediate thrombocytopenia(IMT) is also an immune mediated disease that affects small animals. The initial treatment for IMHA and IMT is medical suppression of the immune system with glucocorticoids and other immunosuppressive drugs. However, even with appropriate treatments, some animals are not responsive to the treatment and may need further immunosuppressive therapies or some alternative medicines. An eight-year-old spayed female Siamese cat with IMHA and an eight-year-old castrated male King Charles Spaniel dog with IMT were referred to the traditional medical service of the veterinary medical center. Both animals were unresponsive to steroids or other immunosuppressive treatments. Gui-Pi-Tang, one of the traditional herbal medicines, was administered to the animals. After 1-month of Gui-Pi-Tang administration, the packed cell volume(PCV) of the cat and platelets count of the dog had showed remarkable improvement. After four months of follow up in the cat, and 18 months of follow up in the dog, the improved PCV and platelet counts of the animals were maintained normally. Therefore, Gui-Pi-Tang might be considered as an alternative treatment in small animals with immune-mediated blood disorders.
Total body water is increased after cardiopulmonary bypass resulting in tissue edema and organ dysfunction. Ultrafiltration has been used to reduce this accumulation of water. We have carried out a prospective randomized study in 17 children undergoing open heart surgery, comparing modified ultrafiltration(MUF) with nonfiltered controls. MUF was carried out for about 10 minutes after completion of cardiopulmonary bypass to a hematocrit 36∼42%. Blood loss, blood transfused, hemodynamics, and laboratory data were recorded for 24 hours postoperatively. The results were analyzed using Mann-Whitney U test, comparing controls(n=7) to ultrafiltered(n=10). There was no death in each group. The mean filtrate volume(ml/kg) was 42(30∼68). Blood loss(ml/kg/24hr) was 14.5 mean(4.0∼26.6) in controls versus 12.1 mean(6.0∼21.5) in MUF(P>0.05) ; blood transfused(ml/kg/24hr) was 9.4 mean (6.0∼36.3) in controls versus 3.4 mean(0∼11.4) in MUF(P<0.05). There was rise in arterial blood pressure during MUF. Percent rise of systolic blood pressure was 4.2(0∼11.7) in controls versus 19.8(7.0∼36.9) in MUF(P=0.001). Percent rise of diastolic blood pressure was 10.0(1.6∼20.8) in controls versus 30.6(5.8∼73.3) in MUF(P<0.05). Platelet count, fibrinogen, and oncotic pressure rose after MUF. No complications directly attributable to the ultrafiltration were observed. Conclusively, MUF is safe, effective means of removing body water and beneficial to hemodynamics.
Kim, Dae-Yeon;Kim, Seong-Chul;Kim, Kyung-Mo;Kim, Ellen Ai-Rhan;Kim, Ki-Soo;Pi, Soo-Young;Kim, In-Koo
Advances in pediatric surgery
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v.9
no.1
/
pp.19-23
/
2003
Necrotizing Enterocolitis (NEC) is usually a disease of premature infants, but occasionally it affects the term neonate. Twenty-five infants with NEC were treated at Asan Medical Center between January 2000 and December 2002, and 13 of them were term infants. In each case, the diagnosis of NEC was established by a clinical illness fulfilling the Bell's stage II or III NEC as modified by Walsh or by surgical findings. There were six males and seven females. The birth weight was from 1,960 to 3,700 g. The age at diagnosis was from 1 to 40 days. Four patients had congenital heart disease: one of who had hypothyroidism and cleft palate. Abdominal distension was present in all, and bloody stools in four. One patient had history of hypoglycemia, three had Rota viral infection. Eight patients had leucopoenia (<$5.0{\times}10^9/L$), seven had thrombocytopenia (<$100{\times}10^9/L$), and three severe thrombocytopenia (<$50{\times}10^9/L$). Laparotomy was required in 10 of the 13 patients. Indications for operation in the acute phase were failure to respond to aggressive medical therapy in five, and perforation in three patients. There were two late phase operations for intestinal stricture and fistula. There were no operative complications. Ten of thirteen patients survived (76.9%). Two patients died of septic complication. There was a delayed death due to heart failure. There was a significant difference in survival according to platelet count ($50{\times}10^9/L$) (p<0.05). Congenital heart disease and Rota viral infection are associated with NEC in term infants and thrombocytopenia and leucopoenia may be surgical indications.
Pentastarch is a new synthetic hydroxyethyl starch similar to hetastarch. We report on the clinical comparisons the clinical efficacy and safety of 10% pentastarch in prime solutions for CPB in cardiac operations with that of 20% serum albumin. During CPB, group P [n = 20] received 500ml of 10% pentastarch and group A [n = 20] received 100ml of 20% albumin in prime solutions The postoperative time of ICU stay in group P and the day and amount of chest drain, hospital stay in group A were longer [p<0.05]. Fresh whole blood and PRBC were added only in group A and a higher amount of hartman solution was added in group A during CPB [p<0.05]. Prothrombin time was prolonged preoperatively and 2 days postoperatively in group A and 7 days postoperatively in group P [p<0.05] but there were no significant differences in bleeding time or fibrinogen level. Platelet count was higher immediately postoperatively in group A and preoperatively and 1, 2, and 7 days postoperatively in group P [p<0.05].Total protein and albumin level were higher 1 day postoperatively in group A and 2 and 7 days postoperatively in group P [p<0.05]. BUN was increased 2 days postoperatively in group A and Cr was increased 1 day postoperatively in group P [p<0.05]. CPK was higher preoperatively and 1, 2, and 7 days postoperatively in group A and plasma hemoglobin level was also higher 2 and 7 days postoperatively in group A [p<0.05]. There were no significant differences in arterial blood gas analysis but higher pO2 and lower pCO2 levels were maintained in group P and ejection fraction was higher 7 days postoperatively in group P [p<0.05]. Both groups were improved postoperatively in NYHA class and the hemodynamic parameters such as MAP, CO, CI, SV, LVSWI were well maintained in group P [p<0.05]. The amount of blood products used was higher in group A and urine output was higher immediately postoperatively in group A and 1, 2 days postoperatively in group P and the chest output was higher in group A. The complications were developed in 7 patients in group A and 5 patients in group P and mortality was not present in both groups.In conclusion, 10% pentastarch is as safe and effective as 20% albumin in prime solutions for cardiopulmonary bypass in cardiac operations.
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