• Childhood Kidney Diseases
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• 제22권2호
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• pp.52-57
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• 2018

Purpose: Rhabdomyolysis is a metabolic disorder in which the content of damaged muscle cells is released into plasma. Its manifestations include asymptomatic, myalgia, gross hematuria, and complications of acute kidney injury. Because of limited data on rhabdomyolysis in children, we performed this study to determine clinical characteristics of rhabdomyolysis in children. Methods: We retrospectively reviewed the records of patients with rhabdomyolysis who were treated at the Pusan National University Children's hospital from January 2011 to July 2016. The diagnostic criteria were serum myoglobin level of ${\geq}80ng/mL$, exclusive of acute myocardial injury, cardiac arrest, and brain damage. Results: Forty-five patients were enrolled; mean age, $116{\pm}68$ months. Of these, 35 were boys and 10 were girls. Twenty-six patients experienced myalgia and 12 patients showed gross hematuria. Among these, seven patients initially had both myalgia and gross hematuria. The most common causes of rhabdomyolysis were infection, physical exertion, prolonged seizures, metabolic abnormalities, and drug addiction. Acute kidney injury (AKI) was the most common complication, followed by disseminated intravascular coagulation. Thirty-seven patients improved with sufficient fluid supply but two patients underwent hemodialysis due to deterioration of kidney function. Gross hematuria, positive occult blood test, and positive urine protein were more common in patients with AKI than in those without AKI. Conclusions: In children, infection was the most common cause of rhabdomyolysis. Most patients recovered by sufficient fluid therapy. However, in severe cases, especially in patients with underlying kidney disease, hemodialysis may be necessary in the present study.

• Pediatric Infection and Vaccine
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• 제16권2호
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• pp.210-214
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• 2009

저자들은 건강하던 8세 남아에서 A군 $\beta$-용혈성 사슬알균(Group A $\beta$-hemolytic streptococci, GABHS) 감염 후 발생한 일련의 면역반응으로 인한 응고장애와 좌측 편마비 및 경련이 발생한 수막뇌염을 경험하여 문헌고찰과 함께 보고하는 바이다.

• Childhood Kidney Diseases
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• 제8권1호
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• pp.57-62
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• 2004

Schinzel-Giedion 증후군은 상염색체 열성 유전을 하는 것으로 추정되는 매우 드문 질환으로서 선천성 수신증, 골격계 이형성, 심한 발달 지연 등이 특징인 이형 증후군이다. 저자들은 유전질환의 병력이 없는 건강한 부모에서 태어난 후 진단된 Schinzel-Giedion 증후군으로서 신 수질의 석회화와 K. pneumoniae에 의한 요로감염이 추가로 발생한 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 동의생리병리학회지
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• 제28권6호
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• pp.614-620
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• 2014

Kainic acid (KA) is a excitatory agonist causing epileptic seizure and excitotoxicity in the hippocampus. Gastrodia Elata (GE) is known to have anti-convulsant and anti-oxidant effects. This study was investigated a possible role of GE in suppressing epileptic seizure using KA-induced epilepsy mouse model. Eight-week-old male C57BL/6 mice were administrated GE (50 or 500 mg/kg) once a day for 5 days, and then injected KA (30 mg/kg) intraperitoneally. Behavioral changes in mice by KA were evaluated for 90 minutes immediately after the KA administration. Six hours after the KA administration, their brains were harvested and the expressions of glutamate decarboxylase 67 (GAD-67) and K+-Cl- cotransporter 2 (KCC2) in the hippocampus of the mice were measured by immunohistochemistry.GE delayed the onset of epileptic seizure after KA administration, suppressed the severity of the seizure and decreased the number of severe seizures dose dependently. Moreover, GAD-67 and KCC2 expressions in the cornu ammonis (CA) 1 and CA3 of 500 mg/kg GE administrated mice were significantly increased compared to those in KA-treated mice.GAD-67 and KCC2 play an important role in regulating GABAergic system. Our results suggest that GE has anti-convulsant effect against KA-induced epileptic seizure through enhancing GABAergic system.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1998년도 Proceedings of UNESCO-internetwork Cooperative Regional Seminar and Workshop on Bioassay Guided Isolation of Bioactive Substances from Natural Products and Microbial Products
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• pp.197-197
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• 1998

Chronic electroconvulsive shock(ECS) was shown to Increase phosphatidylinositol-4,5-bisphosphate(PIP$_2$) breakdown and the activity of PLC with the accumulation of inositol-1,4,5-triphosphate(IP3). The purpose of the present study was to determine the effect of ECS on the expression of phospholipase C(PLC) isotypes in rat brain. Two groups of animals were prepared: sham and ECS treated groups. Rats in ECS treated groups received maximal ECS(70mA, 0.5second, 60㎐) by constant current stimulator through ear-clip to induce tonic extension seizures for 12 consecutive days. The expression of PLC isotypes in rat brain was determined by immunohistochemical procedure using sagital section of rat brain. The immunoreactivity of PLC${\beta}$1 was observed in corpus striatum, hippocampus, thalamus and that of PLC${\gamma}$1 in corpus striatum, hippocampus, thalamus, frontal cortex, parietooccipital cortex, limbic forebrain, pons, medulla, superior colliculus, inferior colliculus, rest of midbrain. The amount of PLC was analyzed by Western blot using antibodies against PLC${\beta}$1 and PLC${\gamma}$1. Chronic ECS reduced the immunoreactivity of PLC${\beta}$1 in corpus striatum, hippocampus, thalamus but had little effect on PLC${\gamma}$1. To quantify this change, quantitative Western blot using antibodies against PLC${\beta}$1 and PLC${\gamma}$1 was conducted. The immunoreactivity of PLC${\beta}$1 in ECS treated rat whole brain was decreased by 40 % in cytosolic fraction and 26 % in membrane fraction. This different effect of ECS on PLC isotypes may results from the difference of their activation mechanisms and the different effects of ECS on them. The results from the present study suggest that chronic ECS primalily affects neurotransmitter receptors related IP$_3$ signaling in rat brain.

• Biomolecules & Therapeutics
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• 제5권4호
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• pp.369-375
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• 1997

General pharmacological effects of SB-31$^{R}$, the extracts of Pulsatilla koreana, were investigated in mice, rats and guinea-pigs. Intravenous injection of SB-31 (3 and 6 ml/kg) produced almost no effect on central nervous system no effects on the general symptom and behaviors of mice, spontaneous locomotor activity, pentobarbital- induced sleeping time , rotared performance , electroshock and pentylenetertrazole -induced seizures, acetic acid-induced writhing and normal body temperature in mice. SB-31 showed little effects on the spontaneous movement of the isolated ileum and contraction induced by agonists in isolated ileum, suggesting no influence on autonomic nervous system. Administration of SB-31 also did not show any effect on blood pressure in conscious rats. However, a slight decrease in heart rate was observed at high doses (6 and 10 ml/kg) of SB-31 in conscious rats. Similarly, a slight increase in respiratory rate was observed at 6 m1/kg of SB-31 in anesthetized rats. SB-31 did not produce any effect at the dose of 3 ml/kg, but showed a tendency to increase the urinary volume at 6 ml/kg, and produced a decrease in urinary excretions of N $a_{+}$and $K_{+}$at 6 ml/kg. However, transport capacity within the gastrointestinal tract and the secretion of the gastric juice were not influenced by 6 ml/kg of SB-31. In conclusion, these results suggest that SB-31 did not pro-duce any acute effects on the central nervous system, autonomic nervous system, respiratory and circulatory systems, digestive system and kidney function at the dose of below 3 ml/kg.ml/kg.

• 대한유전성대사질환학회지
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• 제18권1호
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• pp.18-22
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• 2018

Carbamoyl phosphate synthetase I (CPS1) 결핍은 상염색체 열성 유전을 하는 드문 요소회로 대사 이상 질환으로, 요소회로의 첫번째 단계 효소인 CPS1 결핍에 의해 고암모니아혈증이 발생하여 신경학적 이상을 초래하게 되는 질환이다. CPS1 결핍은 신생아기부터 성인까지 여러 시기에 발현될 수 있으나, 주로 신생아기에 증상이 발현하고, 신생아기에 증상이 발생할 경우 치명적인 고암모니아혈증이 발생하여 예후가 불량하여 사망에 이를 수 있다. 본 증례는 고암모니아혈증이 발견되어 투석 및 집중 치료하였음에도 심한 뇌손상이 빠르게 진행되어 사망한 신생아로, CPS1 유전자의 동종 접합자 변이를 확인하여 확진 되었으며 이후 시행한 가족 검사에서 부모와 생존한 자매가 모두 이종 접합자 보인자로 확인되어 보고하는 바이다.

• 대한한의학방제학회지
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• 제18권2호
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• pp.267-277
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• 2010

Objective : Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke like episodes (MELAS) syndrome is a progressive neurodegenerative disorder. The typical presentation of patients with MELAS syndrome includes features such as mitochondrial encephalomyopathy, lactic acidosis, and stroke like episodes. Other features, such as seizures, diabetes mellitus, hearing loss, cardiac disease, short stature, endocrinopathies, exercise intolerance, and neuropsychiatric dysfunction are clearly part of the disorder. Approximately 80% of patients with the clinical characteristics of MELAS syndrome have a genetic mutation. This progressive disorder is reported to have a high morbidity and mortality. This case report is intended to estimate clinical effects of oriental meedicinal treatment of MELAS syndrome. Methods : A 44 year old female patient diagnosed as MELSA syndrome was treated with general oriental medicinal therapy including acupuncture, moxibustion, cupping, pharmacupunture and herbal medication in 20XX in Wonkwang Medical Center Gwangju. And the changes in symptoms and signs were evaluated as time dependently. Results : Although there is currently no curable treatment and MEALS syndrome is tend to progress, our treatment showed improvement in general weakness, gait disturbance and pain in the patient. Conclusion : Our case report suggests that various oriental medicinal treatment could be effective for improvement of MELAS syndrome and may represent a new potential therapeutic approach to control the disease. It could be applied to improve general condition, prevent relapse, enhance the quality of life and reduce complaints in the patient.

• 대한임상독성학회지
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• 제7권2호
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• pp.77-82
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• 2009

Purpose: In highly doses, endosulfan lowers the seizure threshold and elicits central nervous system stimulation, which can result in seizures, respiratory failure, and death. Management of seizure control is essential for survival and prognosis of intoxicated patients. This study assessed whether seizure time was an independent predictor mortality in patients with endosulfan poisoning. Methods: This retrospective study enrolled patients with endosulfan poisoning presenting to Masan Samsung Hospital and Gyeongsang National University Hospital from January 2003 to December 2008. The data were collected from clinical records and laboratory files. Using a multivariate logistic analysis, data on the total population was retrospectively analyzed for association with mortality. Results: Of the 24 patients with endosulfan poisoning, nineteen (79.1%) experienced seizure. The patients in the seizure group showed significantly lower Glasgow coma scale score, base excess, bicarbonate, and significant existence of mechanical ventilation, as compared to the non seizure group (n=5). Seizure, Glasgow coma scale score, systolic blood pressure, bicarbonate level, need for respiratory support, pulse rate, respiratory rate, pH, base excess, and seizure time were associated with mortality. The fatality rate of endosulfan poisoning was 54.1% with higher mortality among patients experiencing. Longer seizure time was associated with higher mortality. Conclusion: Seizure time can be a significant independent predictor of mortality in patients with acute endosulfan poisoning. Physicians should aggressively treat for seizure control in patients with acute endosulfan poisoning.

• Clinical and Experimental Pediatrics
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• 제55권10호
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• pp.383-387
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• 2012

Purpose: Although benign rolandic epilepsy (BRE) is a benign condition, it may be associated with a spectrum of behavioral, psychiatric, and cognitive disorders. This study aimed to assess the cognitive and other neuropsychological profiles of children with BRE. Methods: In total, 23 children with BRE were consecutively recruited. All children underwent sleep electroencephalography (EEG) and were assessed on a battery of comprehensive neuropsychological tests including the Korean versions of the Wechsler intelligence scale for children III, frontal executive neuropsychological test, rey complex figure test, Wisconsin card sorting test, attention deficit diagnostic scale, and child behavior checklist scale. Results: The study subjects included 13 boys and 10 girls aged $9.0{\pm}1.6$ years. Our subjects showed an average monthly seizure frequency of $0.9{\pm}0.7$, and a majority of them had focal seizures (70%). The spike index (frequency/min) was $4.1{\pm}5.3$ (right) and $13.1{\pm}15.9$ (left). Of the 23 subjects, 9 showed frequent spikes (>10/min) on the EEG. The subjects had normal cognitive and frontal executive functions, memory, and other neuropsychological sub-domain scores, even though 8 children (35%) showed some evidence of learning difficulties, attention deficits, and aggressive behavior. Conclusion: Our data have limited predictive value; however, these data demonstrate that although BRE appears to be benign at the onset, children with BRE might develop cognitive, behavioral, and other psychiatric disorders during the active phase of epilepsy, and these problems may even outlast the BRE. Therefore, we recommend scrupulous follow-up for children with BRE.