• Advances in pediatric surgery
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• v.9 no.1
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• pp.30-34
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• 2003

Spontaneous gastric perforation in the newborn is a rare disease that requires early diagnosis and prompt surgical treatment. Between 1988 and 2001 at the Department of Pediatric Surgery. Kyungpool National University Hospital, 9 cases of spontaneous gastric perforation were treated. Seven were males and two females. The mean gestational age and birth weight were 36.7 weeks and 2,455 g respectively. All patients presented with severe abdominal distention and pneumoperitoneum on cross table lateral film of the abdomen. Perforations were located on the anterior wall along the greater curvature of the stomach in six and on the posterior wall along the greater curvature in two. One case showed two sites of perforation on the anterior and posterior wall along the greater curvature. Six patients were managed with debridement and primary closure and the others with debridement and partial gastrectomy. Peritoneal drainage was not performed. There were four deaths; two from sepsis due to leakage from the anastomotic site, one as a result of acute renal failure, and the other by associated respiratory distress syndrome. Spontaneous gastric perforation in the newborn is usually located along the greater curvature. Elevated intragastric pressure is a possible cause of the perforation. Poor prognosis is related to associated diseases and prematurity.

• The Korean Journal of Food & Health Convergence
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• v.5 no.5
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• pp.33-36
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• 2019

Arginine is one of the basic aminoacid found to be associated with histones and also one of the essential aminoacids now. Arginine is provided by diet, and also found to be synthesised in the body through intestinal-renal axis. Justification---BMI---Associated Risks-How to gain body weight---Healthy. Foods to Gain Weight Fast---High-Protein Vegetables and Fruits(with Image)-Recipes---Physical exercises-List of fruits and vegetables grown in Bangladesh with local names, English names and Botanical names-taxonomic family names. Arginine as drug was first approved by FDA and has recognised as a excellent dietary supplement for curing diseases like preeclampsia during gestation, diabetes and insulin resistance in obese patients. Preeclampsia is characterised by high blood pressure and proteinuria in gestational period of after 20 weeks. Severe preeclampsia is characterised by headaches, blurred vision, and inability to have high photovision, nausea and vomiting. L-Arginine along with Vit C and E are given as medical food to the patients and decrease in condition symptoms is the project now under phase II clinical trial. However the role of arginine in ameolirating preeclampsia symptoms is uncertain except with that of hypertension. Arginine is used to treat pain in sickle cell anaemia, lung damage, reperfusion injury, Trauma and shock but should be excluded during sepsis.

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.648-652
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• 2005

In 1940, Kasabach and Merritt first described the association of a large vascular tumor and thrombocytopenia and termed this Kasabach-Merritt(KM) syndrome. It is characterized by a rapidly enlarging vascular anomaly and consumptive coagulopathy with thrombocytopenia, prolonged prothrombin time and partial thromboplastin time, hypofibrinogenemia, and the presence of D-dimer and fibrin split product, with or without microangiopathic hemolytic anemia. This is a potentially life-threatening condition with mortality rates from 20 to 30% as a result of severe sepsis, coagulopathy, or invasion of vital organs. Treatment modalities are corticosteroids, interferon alfa-2a or 2b, chemotherapy(vincristine, cyclophosphamide, etc.), aspirin, dipyridamole, com- pression, radiation therapy, embolization of feeding vessels and surgical excision. A standard treatment regimen for KM syndrome has not been established and most reports on definitive management of these complex vascular lesions have been anecdotal, involving small numbers of patients. The authors have successfully treated a patient of KM syndrome with actively bleeding huge hemangioma by surgical excision. They present it with the review of articles.

• Journal of Dairy Science and Biotechnology
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• v.37 no.2
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• pp.94-101
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• 2019

Probiotics stabilize intestinal microflora, reduce constipation, reduce decay by inhibiting harmful bacteria, and prevent diseases. Probiotics have also been studied for their possible roles in immune activation, treatment of cancer, remediation of cholesterol, treatment of diabetes, alleviation of allergies, and relief of lactose intolerance. However, recent data concerning the side effects of probiotics have prompted debate regarding their efficacy and safety. Major adverse events associated with probiotics are gastrointestinal symptoms, such as diarrhea, gastrointestinal disorders, and vomiting, along with skin rash and urticaria. Probiotics occasionally cause sepsis in infants with poor immunity and elderly people with severe diseases. In contrast to previous studies that described the efficacy of probiotics in intestinal regulation, some recent studies have reported that the activity of intestinal microbes becomes weak as a result of the influx of probiotics. The data indicate that the safety of probiotics is not guaranteed and that further investigations are needed.

• Archives of Plastic Surgery
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• v.46 no.1
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• pp.75-78
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• 2019

It is difficult to differentiate acute skin failure (ASF) from pressure ulcer (PU). ASF is defined as unavoidable injury resulting from hypoperfusion caused by severe dysfunction of another organ system. We describe a case of ASF mistaken as PU that resulted in a legal dispute. A 74-year-old male patient was admitted to our intensive care unit with sepsis due to bacterial pneumonia. Despite the use of air cushions and regular position changes, skin ulcerations occurred over his occiput, back, buttock, elbow, and ankle. After improvement in his general condition, he was transferred to the department of plastic and reconstructive surgery. Debridement was performed immediately, followed by conservative treatment (including a vacuum-assisted closure device) for 6 weeks. The buttock and occiput wounds were treated surgically. Despite complete healing, his caregivers sued the hospital for failing to prevent PU formation. ASF is a pressure-related injury resulting from hemodynamic instability due to organ system failure. Unlike PU, ASF may occur despite the implementation of all appropriate preventive measures. Furthermore, misdiagnosis of ASF as PU can lead to litigation. Therefore, it is critical for the proper diagnosis to be made quickly, and for physicians to explain that ASF occurs despite proper preventative treatment.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.469-473
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• 2010

Nocardia farcinia, an aerobic, gram-positive bacilli actinomycetes of the genus Nocardia, is an uncommon pathogen found in humans. The most common Nocardia infection sites are the lung, central nervous system, and skin. Even though hematogenous dissemination can occur, isolation of the organism from blood cultures is very rare. We report a case of Nocardia infection that was isolated on blood cultures. A 59-year-old male with a medical history that includes a liver transplantation 6-years prior due to hepatocellular carcinoma secondary to chronic hepatitis B, developed pneumonia and was transferred to Severance Hospital. At the time of admission, the patient's initial exam showed hypothermia, tachypnea, and hypotension. His chest radiograph showed severe pneumonia and a large abscess on left upper lobe. Under the presumptive diagnosis of bacterial pneumonia or other opportunistic infection, we started broad spectrum antibiotics. However, he developed Nocardia sepsis, rapidly deteriorated, and subsequently died.

• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.861-870
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• 1997

Background : Though acute respiratory distress(ARDS) often occurs in the early stage of severe acute pancreatitis and significantly contributed to the mortality of the condition, the characteristics of the group who develops ARDS in the patients with acute pancreatitis have not been fully found. The objective of this investigation was to identify predictable factors which distinguish a group who would develop ARDS in the patients with acute pancreatitis. Method : A retrospective analysis of 94 cases in 86 patients who were admitted the Medical Intensive Care Unit with acute pancreatitis was done. ARDS were developed in 13 cases among them (13.8%). The possible clinical factors related to the development were analyzed using univariate analysis and $x^2$-test. Results : The risk of ARDS development was increased in the patients with abonormal findings of chest X-ray at admission compared to the patients with normal chest X-ray (p<0.05). The risk was also increased according to the sevecrity index score in abdominal computed tomography at the time of admission (p<0.05). The higher APACHE III score of the first day of admission, the more risk increment of ARDS development was observed (p<0.01). Patients with more than one points of Murray's lung injury score showed higher risk of ARDS compared to the patients with 0 points of that. The patients with sepsis and the patients with more than three organ dysfunction at admission had 3.5 times and 23.3 times higher risk of the development of ARDS compared to the patients without sepsis and without organ failure in each (p<0.05, p<0.01). Conclusion : The risk of ARDS development would be higher in the acute pancreatitis patients with abnormal chest X-ray, higher CT severity index, higher APACHE III or Murray's lung injury score, accompanying sepsis, and more than three organ failure at admission.

• Journal of Chest Surgery
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• v.34 no.6
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• pp.477-484
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• 2001

Background: Initial symptoms for esophageal perforation have not been clarified, but when there is no early diagnosis and proper treatment to follow immediately after the diagnosis, it is fatal for the patients. Therefore, this study attempted to discover the factors that influence the prognosis of esophageal perforation to contribute to the improvement of the treatment result. Material and Method: The subjects of this study are 32 patients who came to the hospital with esophageal perforation from October, 1984 to June, 2000. This study examined the items for clinical observation such as patients' sex, age, cause of the perforation, perforation site, the time spent until the beginning of the treatment, symptoms caused by the perforation and its complication, and treatment methods. This study tried to find out the relationship between the survival of patients and each item. Result: There were 24 male and 8 female patients and their mean age was 49.7+16.4. For the causes of perforation, there were 14 cases(43%) of iatrogenic perforation, which ranked first, caused by the medical instrument operation and surgical damage. As for the perforation sites, thoracic esophagus was the most common site(26 cases of 81.2%) and chest pain was the most frequent symptom. The complication caused by esophageal perforation showed the highest cases in the order of mediastinitis, empyema, sepsis and peritonitis. After the treatment, there were 23 cases of survival and 9 cases of mortality. The total mortality rate was 28.1% and the main causes of mortality were sepsis and acute respiratory distress syndrome(ARDS). As for the treatment, 8 cases(25.0%) treated the perforation successfully using conservative treatment only. As for the surgical treatment, there were 5 cases(15.6%) of cervical drainage, 7 cases (21.8%) of primary repair and 12 cases(37.5%) of esophageal reconstruction after performing an exclusion-diversion. There were 18 cases(56.2%) of complete treatment of esophageal perforation at its initial treatment and in 14 cases(43.8%) of treatment failure at its initial treatment, patients were completely cured in the next treatment stage or died during the treatment. The cases of perforation in thoracic esophagus, complication into severe mediastinitis or sepsis and the cases of failure at initial treatment showed a statistically significant mortality rate (p<0.05).

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.104-110
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• 2007

Streptococcus pyogenes, which is classified to Group A streptococcus (GAS), is one of the most common bacterial pathogens of the childhood infection. This organism can cause acute bacterial pharyngitis, impetigo, peritonsilar abscess or scarlet fever. It can also cause severe invasive diseases such as toxic shock syndrome, sepsis, septic arthritis, necrotizing pneumonia or necrotizing fasciitis. Usually, invasive GAS infections are accompanied by systemic symptoms and signs. Necrotizing pneumonia presents with acute fever, pleuritic chest pain and cough. The progress of disease is usually rapid and typically, pleural effusion develops in the early course of disease. Necrotizing fasciitis is relatively rare but once it has developed, it may be life threatening and cause necrosis of adjacent soft tissues with rapid progress. Clinical manifestations of parapharyngeal abscess are fever, dysphagia or bulging of pharyngeal wall. We experienced three cases of GAS infections which were presented atypically.

• Advances in pediatric surgery
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• v.1 no.2
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• pp.122-132
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• 1995

Teratoma contains elements derived from all three embryonic germ layers and mature teratomas are entirely composed of mature differentiated tissues, while immature types always contain additional embryonic tissues of variable degree of immaturity, especially neuroepithelial elements. Twenty cases of teratoma in infancy and childhood were reviewed and the clinical features and pathologic findings including PCNA expression were studied. Sacrococcygeal teratomas were the most common type(45%), followed by retroperitoneal and ovarian teratomas. There was a predilection of females in a ratio of 4:1 and age distribution was most prevalent below the first year of age(45%). But in ovarian teratomas, the age at diagnosis was above 4 years of age in all cases. Serum alpha-fetoprotein levels were checked in 18 cases. In all mature teratomas and 1 of 5 immature teratomas, the levels were normal. But in 4 of 5 immature teratomas, the serum levels were elevated and progressively declined to normal range after mass excision. Radiologically, calcifications in tumor were found in 60.0% of teratomas and was higher in mature teratomas(69.2%) than immature teratomas(42.9%). Immunohistochemical staining for PCNA(proliferating cell nuclear antigen) was done in 16 cases and PCNA expression was higher in grade III immature teratomas than grade I and II. The operative modes were complete mass excisions. Five immature teratomas were treated with multiagent PEB(Bleomycin, Etoposide, Cisplatin) adjuvant chemotherapy, 3 tolerated well without significant complications, but in one case, severe bone marrow suppression was developed and died of sepsis. In conclusion, grade III immature teratoma showed higher PCNA expression than mature or lower grade immature teratoma, which suggests that chemotherapy after surgical excision may be effective modality for grade III immature teratoma. We think, however, multicenter study is necessary because of low incidence of immature teratoma.