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The Clinical Comparison between Monomicrobial and Polymicrobial Urinary Infection in Febrile Pediatric Acute Pyelonephritis (발열성 소아 신우 신염에서 단일 세균 감염과 혼합 세균 감염의 임상적 비교)

  • Lee, In Hak;Nam, Seong Woo;Seo, Hyeon Seok;Yim, Hyung Eun;Yoo, Kee Hwan;Hong, Young Sook;Lee, Joo Won
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.102-108
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    • 2012
  • Purpose: We investigated the clinical presentation of febrile pediatric patients with acute pyelonephritis (APN) with a mixed urine culture from an aseptic urine sample, and compared with that of those with a single culture. Methods: We retrospectively reviewed the medical charts of 95 patients diagnosed as APN with fever between January 2008 and October 2010 at Korea University Medical Center. We classified the patients with APN into two groups with a positive single culture (S group) and a positive mixed culture (M group) from an aseptic urine sample of suprapubic bladder aspiration or urethral catheterization and compared the fever duration, laboratory markers such as serum white blood cell (WBC) counts and C-reactive protein (CRP) values in peripheral blood, and the presence of hydronephrosis, renal scar and vesicoureteral reflux (VUR) between the two groups (If presence of hydronephrosis, scar and VUR=1 and no=0). Results: Total pediatric patients with febrile APN were 95 patients, a positive S group was 89 patients and a positive M group was 6 patients. Fever duration (S vs. M, $4.7{\pm}3.1$ vs. $6{\pm}5.7$ days), serum WBC (S vs. M, $18,630{\pm}6,483$ vs. $20,153{\pm}7,660/{\mu}L$) and CRP (S vs. M, $100.6{\pm}2.46$ vs. $81.1{\pm}0.09\;mg/L$) values, and the presence of hydronephrosis, renal scar and VUR were not different between the two groups. Conclusion: Our data shows that there were no specific differences of clinical manifestation between a positive single urine culture and a positive mixed urine culture in pediatric APN. A mixed urine culture from an aseptic urine sample should be interpreted cautiously.

Comparison of Clinical Outcome According to the Duration of Corticosteroid Therapy in Childhood Henoch-$Sch{\ddot{o}}nlein$ Purpura: a Bicentric Study (소아 Henoch-$Sch{\ddot{o}}nlein$ purpura에서 스테로이드 치료 기간에 따른 임상적 결과의 비교)

  • Lee, Su-Jin;Shin, Jae-Il;Lee, Chong-Guk;Kim, Kee-Hyuck
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.170-177
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    • 2008
  • Purpose : The aim of this study was to evaluate whether the incidence of relapse or nephritis might be influenced by the duration of corticosteroid therapy in children with Henoch-Schonlein purpura(HSP). Methods : We retrospectively analyzed 186 children with a diagnosis of HSP in two major hospitals in Ilsan, Korea from the years 2000 to 2003. To evaluate whether renal involvement or relapse might be influenced by the duration of corticosteroid therapy in children with HSP, one pediatric nephrologist from hospital A, maintained corticosteroid therapy for at least 2 weeks(Group A, n=94). The other from hospital B used only during the symptomatic period(Group B, n=92). Results : There were no significant differences in age, sex, body weight, white blood cell count, hemoglobin, hematocrit, platelet count, serum protein and albumin levels between the two groups. The incidence of abdominal pain or arthralgia also did not differ between two groups. However, the duration of steroid therapy was significantly longer in Group A than in Group B and the cumulative dose of prednisolone was also higher in Group A than in Group B. The development of nephritis was more frequent in Group A. Conclusion : The longer duration of steroid use was not associated with the decreased rate of nephritis. Therefore, corticosteroids should be used carefully in a selected group of HSP children, and be tapered rapidly after control of the acute symptoms.

Effects of Supplementary Copper Sources (Cu Sulfate, Cu-Methionine, Cu-Soy Proteinate) on the Performance Broiler Chickens (구리 공급원들(Cu Sulfate, Cu-Methionine, Cu-Soy Proteinate)의 첨가가 육계의 생산성에 미치는 영향)

  • Lee, Mun-Ku;Kim, Chan-Ho;Shin, Dong-Hun;Jung, Byoung-Yun;Paik, In-Kee
    • Korean Journal of Poultry Science
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    • v.38 no.2
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    • pp.121-128
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    • 2011
  • This study was conducted to investigate the effects of dietary supplementation of Cu-sulfate, Cu-methionine chelate (Cu-Met) and Cu-soy proteinate (Cu-SP) on the performance, blood parameters and mineral contents of muscle. It was conducted with a total of 1,000 one d old broilers chickens (Ross$^{(R)}$) which were assigned to four dietary treatments; Control, Cu sulfate (200 ppm Cu as $CuSO_4{\cdot}5H_2O$), Cu-Met (200 ppm Cu as Cu-methionine chelate), Cu-SP (200 ppm Cu as Cu-soy proteinate). There were significant differences (p<0.05) among treatments in weight gain. Weight gain of Cu treated groups were higher than the control during 3~5 wk. There were significant differences (p<0.05) among treatments in feed intake during 0~3 wk. Cu-Met was significantly (p<0.05) lower than the control but the differences among Cu treatments were not significant. There were significant differences (p<0.05) among treatments in feed conversion rate (FCR). Cu treated groups were lower than the control during the whole period. Production efficiency factor (PEF) was significantly higher (p<0.01) in Cu treated groups than the control. Nutrient availabilities of diets were not significantly different among the treatments. The count of white blood cell (WBC) and eosinophil (EO) were lower in Cu-SP treatment than in the control. Copper concentration in the liver was significantly (p<0.01) higher in Cu treated groups than the control. Zinc concentration in the breast and wing muscle was lower in Cu treated and that of leg muscle was higher in Cu-Met than the control. The result of this experiment showed that Cu supplementation at the level of 200 ppm as Cu sulfate, Cu-Met and Cu-SP improves weight gain (4~5 wk), FCR and PEF. Differences among Cu sources were not significant.

Factors Associated with the Development of Pleural Thickening in Tuberculous Pleurisy (결핵성 흉막염 치료 후 흉막비후의 예측인자)

  • Park, Jae-Seuk;Chun, Yong;Choi, Eun-Kyung;Jee, Young-Koo;Lee, Kye-Young;Kim, Keum-Youl
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.17-24
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    • 1999
  • Background : A sizable percentage of tuberculous pleurisy patients are known to have residual pleural thickening(RPT) despite adequate anti-tuberculous chemotherapy. But, the predictive factors related to the development of RPT is not well known. Therefore, we studied to determine which factors are related to the development of RPT after completion of therapy. Methods: By retrospective review of medical records, fifty-eight patients initially diagnosed as having tuberculous pleurisy between March 1995 and January 1998 were separated into two groups : 27 patients in group 1 had RPT on simple chest radiography, while 31 patients in group 2 had no RPT after 6 month of anti-tuberculous chemotherapy. The clinical characteristics, radiologic findings and pleural fluid findings of the two group were compared at the time of diagnosis and during the course of therapy. Results: 47% of patients had RPT after 6 month of chemotherapy, and RPT was more common in man than in women(54% vs 29%, p=0.092). In group 2 patients, complete resorption of pleural lesion occurred rather late stage of therapy(1-2 month: 26%, 3-4 month: 29%, 5-6 month: 45%). Group 1 patients had increased percentage of loculated pleural lesion(26 % vs 19%) and increased white blood cell and lymphocyte count, lactate dehydrogenase level in pleural fluid ($3527\pm5652$ vs $2467\pm2201$/ml, $2066\pm2022$ vs $1698\pm1835$/ml and $1636\pm1143$ vs $1441\pm923$IU/mL respectively) than group 2 at the time of diagnosis, but statistically insignificant. Duration of symptom prior to treatment, size of pleural effusion, presence of parenchymal lung lesion, level of total protein, glucose and adenosine deaminase(ADA)activity in pleural fluid were similar in both group. Conclusion: 53% of tuberculous pleurisy patients showed slow but complete resorption of pleural lesion after 6 month of chemotherapy. But, no clinical, radiological and pleural fluid findings are predictive for the development of RPT.

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Efficacious Pleurodesis with OK-432 Plus Autoblood or OK-432 Against the Pneumothorax with Persistent Air Leak (지속성 기흉에서 OK-432와 자가혈액을 이용한 흉막 유착술의 효과)

  • Kim, Hyoung Soo;Choi, Goang Min
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.72-75
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    • 2006
  • Background : This report reviews our experience with persistent air leaks in the peumothorax that were not considered candidates for surgical treatment in order to evaluate the efficacy and risks of the OK-432 plus autoblood or OK-432 pleurodesis. Material & Methods : From March 2004 to July 2005, 8 consecutive patients who had an air leak in the pneumothorax over 5 days and had been treated with OK-432 plus autoblood or OK-432 pleurodesis. The patients were not considered candidates for surgical treatments because the chest CT findings revealed severe chronic lung disease with multiple bullae and/or bullous changes. A prolonged air leak with/without dead space was treated with either OK-432 plus autoblood or OK-432 pleurodesis. The efficacy and side effects of OK-432 pleurodesis were assessed by determining the duration of the air leak, the number of pleurodesis, the patients' symptoms, measurements of the white blood cell count and the c-reactive protein level. Results : All of eight patients were male and the mean age was $72.4{\pm}8.5$. The mean number of pleurodesis was $1.9{\pm}1.1$ and the mean duration of the air leak was $4.6{\pm}4.6days$ after pleurodesis. Side effects after pleurodesis were encountered in 7 patients, which included a chilling sensation in 7 cases, chest pain in 5 cases, headache in 3 cases, local heat sensation in 2 cases, and fever in 1 case. Leukocytosis was observed in 6 patients, and the mean of WBC count and CRP were $14500{\pm}2100$ and $21.9{\pm}11.4mg/dL$, respectively. Conclusion : Either OK-432 plus autoblood or OK-432 pleurodesis has acceptable side effects, and can be considered a treatment option for persistent air leaks in the pneumothorax that are not candidates for surgical treatment.

Modification of Herbal Product(Herb Mix®) to Improve the Efficacy on the Growth and Laying Performance of Chickens (닭의 성장과 산란 생산성 개선 효과 증대를 위한 한방제제(Herb Mix®)의 개량에 관한 연구)

  • Lee, W.S.;Paik, I.K.
    • Korean Journal of Poultry Science
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    • v.34 no.4
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    • pp.245-251
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    • 2007
  • This study was conducted to investigate the effects of modification of a herbal recipe(Herb $Mix^{(R)}$) on the growth of pullet and laying performance of hens. The formula of Herb $Mix^{(R)}$, a mixture of Rehmannia glutinosa, Angelica gigas, Discorea japonica, Glycyrrhiza uralensis, Schisandra chinensis and Ligusticum jeholense, was modified in mixing ratio. A total of 1,120 pullets(Hy-Line Brown) of 14 wks old were assigned to seven treatments; control, Herb $Mix^{(R)}$(HM), R. glutinosa fortified HM, A. gigas fortified HM, D. japonica fortified HM, G. uralensis fortified HM, S. chinensis fortified HM, L. jeholense fortified HM and Flavomycin supplemented diet. Each treatment had 8 replicates of 20 birds each housed in 2 birds cages. Body weight at 10% egg production was significantly(P<0.05) influenced by treatments. Birds fed A. gigas fortified HM diet were heaviest followed by L. jeholense fortified HM, HM-original and D. japonica fortified HM, Flavomycin supplemented diet and R. glutinosa while those fed control diet were lightest. Also, age reaching 50% egg production and peak production was earliest in A. gigas fortified HM and latest in the control. Egg production, feed intake, feed conversion and egg weight were significantly influenced by treatments. Significant improvement in egg production and feed intake was shown in A. gigas fortified HM treatment. Feed conversion ratio was lowest in antibiotic(Flavomycin) treatment and egg weight was heaviest in L. jeholense fortified HM treatment. There were no significant differences among treatments in intestinal microflora but cfu of Cl. perfringnes and E. coli tended to be lower in HM treatments than the control. Among the leucocytes of blood, the HM treatments were lower than the control in counts of white blood cell and heterophils. It was concluded that modification of Herb $Mix^{(R)}$ fortifying with A. gigas, D. japonica and L. jeholense significantly influence growth and laying performance of birds.

The significance of vascular endothelial growth factor(VEGF) in children with asthma and pneumonia (소아 천식과 폐렴에서 혈청 vascular endothelial growth factor 농도의 의의)

  • Choi, Seong Hwan;Shim, Jung Yeon;Yoo, Myung Hwan;Kim, Deok Soo;Shim, Jae Won;Jung, Hye Lim;Park, Moon Soo
    • Clinical and Experimental Pediatrics
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    • v.49 no.2
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    • pp.192-197
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    • 2006
  • Purpose : Vascular endothelial growth factor(VEGF) is a key cytokine for controlling vascular permeability and angiogenesis, which is one of the major findings in airway remodeling. However, it is not well known if it is associated with acute lower respiratory tract disease such as lobar pneumonia. The aim of this study is to compare serum VEGF levels in patients with asthma according to its severity and duration of cough, and to compare its levels with children with lobar pneumonia. Methods : Using a sandwich enzyme-linked immunosorbent assay, the serum VEGF levels were measured in 16 mild asthmatics, 14 moderate to severe asthmatics, six children with lobar pneumonia, and 22 control subjects. The asthmatics were also classified into three groups according to the duration of cough. Serum VEGF levels were compared in each group. Results : Serum VEGF levels were significantly increased in the children with moderate to severe asthma and lobar pneumonia compared to the children with mild asthma and control subjects. Serum VEGF levels were higher in children with chronic coughs of more than two weeks than in children with coughs lasting less than two weeks. Serum levels of VEGF showed positive correlations with blood platelet and white blood cell counts. Conclusion : VEGF increased according to the severity of asthma and duration of cough in children with asthma. It may play an important role not only in chronic airway inflammation, but also in the acute inflammation in children with lower respiratory tract disease.

The role of $Na^+-Ca^{2+}$ exchange on calcium activated chloride current in single isolated cardiac myocyte in pulmonary vein of rabbit.

  • Kim, Won-Tae;Lee, Yoon-Jin;Ha, Jeong-Mi;Han Choe;Jang, Yeon-Jin;Park, Chun-Sik;Lee, Chae-Hun m
    • Proceedings of the Korean Biophysical Society Conference
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    • 2003.06a
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    • pp.37-37
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    • 2003
  • We have shown the $Ca^{2+}$-activated chloride current is present in cardiac myocyte in rabbit pulmonary vein (Kim et al., 2002). This current amplitude was increased as [N $a^{+}$]$_{i}$ was increased and we suggested this chloride current may be involve in the spontaneous action potential frequency change. Since this current is activated by the increase of intracellular $Ca^{2+}$, we would like to test what is the inducer of the increase of [C $a^{2+}$]$_{i}$ between a L-type $Ca^{2+}$-current or a reverse mode of N $a^{+}$-C $a^{2+}$ exchange current. White rabbit (1.5 kg) was used and anesthetized with Ketamin (100 mg/kg). Pulmonary vein (PV) was isolated and sleeve area between left atrium and PV was dissected. Using collagenase (Worthington 0.7 mg/cc), single cardiac myocytes were isolated. In the presence of 15 mM of N $a^{+}$, three steps of voltage pulses were applied (holding potential : -40 ㎷, -80 ㎷ for 50 msec, 30 ㎷ for 5 msec, 10 ㎷ steps from -70 ㎷ to 60 ㎷). The inward and outward tail current was activated after brief 5 msec prepulse. The outward tail current was blocked by the removal of extracellular chloride substituted by glucuronic acid or by a chloride channel blocker, 5 mM 9-AC. But the inward tail current was still remained even though the amplitude was decreased. The reversal potentials were changed to the direction of the change of chloride equilibrium potential ( $E_{Cl}$ ) but the shift of equilibrium potential was not enough to match to the theoretical equilibrium potential shift. In the presence of L-type $Ca^{2+}$ channel blocker, nifedipine 1 uM, inward tail currents were greatly reduced but the outward current tail currents were still remained. In the presence of N $a^{+}$-C $a^{2+}$ exchange current blocker, 10 uM KB-R7943, the inward and outward tail currents were blocked almost completely. We tried to test the $Ca^{2+}$sensitivity of the chloride current with various [C $a^{2+}$]$_{i}$ in pipette solution from 100 nM to 1 uM but we failed to activate $Ca^{2+}$-activated chloride currents even though the cell became contracted in the presence of 1 uM $Ca^{2+}$. From these results, we could conclude that the increase of [C $a^{2+}$]$_{i}$ to activate the outward $Ca^{2+}$-activated chloride current was mainly induced by the activation of the reverse mode of N $a^{+}$-C $a^{2+}$ exchanger, But for the increase of [C $a^{2+}$]$_{i}$ to activate the inward tail current, L-type $Ca^{2+}$ current may be the major provoking current. Since the cytosolic increase of [C $a^{2+}$]$_{i}$ through pipette solution have failed to activate $Ca^{2+}$-activated chloride current, this chloride current may have very low $Ca^{2+}$ sensitivity or a comparmental increase $Ca^{2+}$ such as in subsarcolemmal space may activate the chloride current. Since there are several reports and models that the increase of $Ca^{2+}$ in subsarcolemmal space would be over several to tens of uM, both possibility may be valid together.uM, both possibility may be valid together.

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Coagulation and Fibrinolysis in Exudative Pleural Effusions (삼출성 흉막액에서 응고 및 섬유소 용해계에 관한 연구)

  • Ryu, Jeong-Seon;Lee, Hong-Lyeol
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1214-1222
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    • 1998
  • Background : The intrapleural hypofibrinolysis is caused by mainly excessive concentration of pleural plasminogen activator inhibitor-1 antigen(PAI-1 Ag), which binds tissue type plasminogen activator. In pleural inflammation induced by sclerosing agents for pleurodesis, levels of pleural PAI-1 antigen increase in relation to decreasing D-dimer levels. It has been known that the pleural mesothelial cells have the capability of secreting PAI-1 Ag in response to inflammation in vivo. Therefore, we estimated whether pleural inflammation changes the balance between fibrinolytic and coagulative properties in exudative pleural effusions. Method : The thirty cases was included in our study. We determined the pleural levels of glucose, lactic dehydrogenase(LDH), pH and the counts of white blood cell(WBC), polymorpho leukocyte(PMN), lymphocyte as the parameters of pleural inflammation and cellular components of pleural fluid. The plasma level of fibrinogen in fluid and the neutrophil count in blood were determined. The levels of D-dimer, PAI-1 Ag and thrombinantithrombin III complex(TAT) were determined by ELISA(Behring, Marburg, Germany). Result : The causes of pleural effusion were as following : tuberculous in 14 cases, malignant in 10 cases and parapneumonic in 6 cases. The levels of pleural D-dimer, PAI-1 Ag and TAT was significantly higher than that of plasma(p<0..001). The severity of pleural inflammation did not correlated with pleural D-dimer, PAI-1 Ag, TAT and their plasma levels. But the level of pleural TAT correlated with pleural WBC and lymphocyte count. Conclusion : We found that the severity of pleural inflammations did not correlated with pleural D-dimer, PAI-1 Ag, TAT and the possibility of local production of PAI-1 antigen is present.

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Cross-Sectional Relations of Arterial Stiffness and Inflammatory Markers in Korean Adults Aged 50 Years and Older (지역사회 거주 50세 이상 성인의 동맥경직도와 염증반응인자와의 관련성)

  • Ryu, So-Yeon;Shin, Min-Ho;Lee, Young-Hoon;Rhee, Jung-Ae;Choi, Jin-Su;Park, Kyeong-Soo;Nam, Hae-Sung;Jeong, Seul-Ki;Kweon, Sun-Seog
    • Journal of agricultural medicine and community health
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    • v.36 no.2
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    • pp.101-112
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    • 2011
  • Objectives: The aim of this study is to determine arterial stiffness levels as measured by brachial-ankle pulse wave velocity (baPWV) and to identify the association between arterial stiffness and inflammatory markers, in healthy adults over 50 years old. Methods: The study population consisted of 4617 persons over the age of 50 years who participated in the baseline survey of the Dong-gu Study, which was conducted in 2007 and 2008. Arterial stiffness was measured using baPWV. A multiple regression analysis was performed to assess the relationship between conventional cardiovascular risk factors and inflammatory markers, including white blood cell (WBC) counts, high-sensitive C-reactive protein (hs-CRP), and gamma glutamyltransferase (GGT). Results: After adjustment for conventional cardiovascular risk factors including sex, age, smoking status, body mass index, systolic blood pressure, fasting glucose, hypertension or diabetic medication, total cholesterol, triglycerides, uric acid, and alanine aminotransferase, baPWV was significantly associated with WBC counts (${\beta}$=0.158, p<0.0001), hs-CRP (${\beta}$=0.244, p=0.026), and GGT (${\beta}$=0.003, p<0.0001). Conclusion: This study shows that arterial stiffness correlates with inflammatory markers. Arterial stiffness may be used as a composite risk factor to identify persons with higher risk for cardiovascular disease. Additionally, arterial stiffness may be a marker for future cardiovascular disease and a target for prevention.