• Pediatric Infection and Vaccine
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• v.15 no.1
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• pp.59-67
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• 2008

Purpose : According to the 2008 WHO report, incidence, prevalence, and mortality of tuberculosis are decreasing globally. The 7th National Tuberculosis Survey of 1995 in Korea showed that the prevalence of tuberculosis was also decreasing. This study was performed to review the hospitalized childhood tuberculosis in a children's hospital over a 20 year period. Methods : Medical records of children <16 years of age hospitalized with the diagnosis of tuberculosis at the Seoul National University Children's Hospital between 1988 and 2007 were reviewed retrospectively. Changes in number of patients and involved sites were also analyzed by four 5-year periods. Results : Out of the 186 hospitalized patients, 59.1% were male. Median age at diagnosis was 5.5 years old (range, 10 days-15 years). The main involved sites included the lung (n=54, 29%) or pleura (n=12, 6.5%), central nervous system (n=49, 26.3%), lymph node (n=15, 8.1 %), bone and joint (n=9, 4.8%), gastrointestinal tract (n=5, 2.7%) or peritoneum (n=5, 2.7%), pericardium (n=2, 1.1%) and others (n=3, 1.6%). Total 32 patients (17.2%) showed miliary pattern. The proportion of hospitalization with newly diagnosed tuberculosis among all cause hospitalization decreased from 0.61% to 0.09%, comparing the period of 1988-1992 and 2003-2007 (P<0.001) and the incidence of hospitalized tuberculosis of any involved organs also decreased with a statistical significance. Conclusion : The data from a single children's hospital suggest that the number of hospitalized childhood patients with tuberculosis has decreased over a 20 year period in Korea.

• Radiation Oncology Journal
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• v.15 no.2
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• pp.113-119
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• 1997

Purpose : Radical gastrectomy is main treatment of gastric cancer. But the result is not satisfactory with surgery alone. Most of pattern of failure remain locoregional recurrence. To improve 5 year survival postoperative chemotherapy with or without radiotherapy has been used. We analyzed patients with stage III and IV stomach cancer who had radical operation and received postoperative radiation therapy combined with or without chemotherapy retrospectively. Material and Method : From March 1985 to June 1993, 68 patients treated with curative resection and received postoperative adiuvant radiotherapy with 36Gy or more were evaluated. Median age was 60 years(range 28-66 yrs) . Patients were followed from 3 to 133 months with median follow up of 48 months. Thirty seven patients had non signet ring adenocarcinoma, 29 signet ring cell, 2 other cell. Patients with stage IIIA, IIIB, IV disease were 19, 25 and 24 respectively Chemotherapy was given to all patients except two. Results : Five-year overall survival and disease-free survival rate were 36.6% and 33.6%, respectively. Prognostic factor affecting survival were assessed. High ratio of jnvolved/dissected Iymph node, signet ring histology showed Poor Prognosis with statistical significance. Presence of residual tumor after surgery, stageIV. split course of radiation therapy, age, number of involved Iymph node, number of Iymph node dissection and grade of tumor affected survival without statistical significance, Type of chemotherapy did not affect survival. Recurrence was documented in 34 patients. High recurrence was seen in omentum and peritoneum with 23.5%, and remnant stomach, anastomosis site, A-loop and I-loop had also high recurrence with 13.2%. In field locoregional recurrence was 20.7% and total distant metastases were 39.7%. Total intraabdominal failure was 47.1% and extraabdominal failure was 13.2%. Treatment toxicity was considered to be acceptable. 22.1% of patients had grade 3 and only 1 patient had grade 4 leukopenia. Six Patients(8.8%) had weigh loss more than 10%. Conclusion : Treatment toxicity was acceptable with combined treatment with chemotherapy and radiotherapy. Locoregional recurrence was relatively low compared to distant failure with addition of irradiation. Peritoneal and omental seeding was high Five-rear surival was increased with combined modality. Radiation may eradicate minimal residual disease and improve survival, To evaluate role of radiation Prospective randomized study employing chemotherapy alone and chemotherapy plus radiation is necessary. Futhermore to reduce intraabdominal failure, role of intraabdominal chemotherapy in addition to combined chemotherapy plus radiation has to be explored.

• Pediatric Infection and Vaccine
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• v.25 no.2
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• pp.82-90
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• 2018

Purpose: Survival after liver transplantation (LT) has improved over the years, but infection is still a major complication. We aimed to identify the characteristics of bacterial infections in pediatric LT recipients. Methods: This study is a retrospective review of 189 consecutive children undergoing LT between 2000 and 2015 at a single center. In this study, the incidence of infection was determined for the following periods: within 1 month, between 1-5 months, and between 6-12 months. Patients who underwent liver transplants more than once or multiple organ transplants were excluded. Results: All patients had received postoperative antibiotic for 3 days. Only the maintenance immunosuppression with oral tacrolimus and steroids were performed. As a result, 132 bacterial infections developed in 87 (46.0%) patients (0.70 events per person-year). Bacterial infections occurred most frequently within the first month (n=84, 63.6%) after LT. In the pathogens, Staphylococcus aureus (15.2%), Enterococcus species (15.2%), and Klebsiella species (13.6%) were most common. Regarding the organ infected, bloodstream was most common (n=39, 29.5%), followed by peritoneum (n=28, 21.2%), urinary tract (n=25, 18.9%), and lungs (n=20, 15.2%). We changed prophylactic antibiotics from ampicillin-sulbactam to piperacillin-tazobactam at 2011, October, there were no significant effects in the prevalence of antibiotics resistant bacterial infections. The 1-year mortality was 9.0% (n=17), in which 41.2% (n=7) was attributable to bacterial infection; septicemia (n=4), pneumonia (n=2), and peritonitis (n=1). Conclusions: The incidence and type of bacterial infectious complications after LT in pediatric patients were similar to those of previous studies. Bacterial complications affecting mortality occur within 6 months after transplantation, so proper prophylaxis and treatment in this period may improve the prognosis of LT.

• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.91-103
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• 2003

Background : Histamine is widely distributed in the lung. It increases capillary permeability and the P-selectin expression on vascular endothelial cell surfaces. We studied the role of endogenous histamine on the pathogenesis of endotoxin-induced acute lung injury (ALI) in rats. Methods: We instilled either normal saline (control group) or lipopolysaccharide (3 mg/Kg, LPS group) to tracheas of Sprague-Dawley rats. H1-receptor blocker (mepyramine, 10 mg/Kg, H1RB group), H2-receptor blocker (ranitidine, 10 mg/Kg, H2RB group), and H3-receptor blocker (thioperamide, 2 mg/Kg, H3RB group) were administered through vein or peritoneum along with intratracheal LPS administration. Statistical significance was accepted at p<0.05. Results : LPS increases the histamine level in BAL fluid significantly at 2 h after the treatment compared with control group. LPS significantly increases protein concentration, PMN cell count in bronchoalveolar lavage (BAL) fluid, and myeloperoxidase (MPO) activity in the lung tissue at 6 h compared to control group. PMN cell count in BAL fluid and MPO activity in lung tissue were significantly lower in H2RB-group compared to LPS-group. However, protein concentration in BAL fluid showed no significant differences between the LPS alone and LPS with histamine receptor blockade. Conclusions : Endogenous histamine might be involved in the recruitment of PMNs in LPS-induced ALI via H2 receptor. However, its role in ALI would not be significant in this model.

• The Journal of Korean Obstetrics and Gynecology
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• v.23 no.3
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• pp.56-77
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• 2010

Purpose: This study was performed to investigate effects of Boyanghwano-Tang on the development of experimentally-induced endometriosis in rats. Methods: Endometriosis was induced in rats by autotransplanting uterine tissue to the peritoneum and divided them into three groups: (1) sham-operated group(n=8), (2) surgically induced endometriosis and untreated control group (n=8), (3) surgically induced endometriosis and Boyanghwano-Tang treated group. Boyanghwano-Tang was orally administrated for 15 days after operation. Then we measured the body weight, the volume of endometriotic implants, the weight of uterus and ovary, and investigated the concentration of cytokines (MCP-1, TNF-$\alpha$, IL-$1{\beta}$, IL-6) in peritoneal fluids. Histopathology, immunohistochemistry for COX-2 and VEGF, and histochemistry for mast cell in transplanted uterine tissue were performed. Results: - The volume($mm^3$) of endometriotic implants in Boyanghwano-Tang treated group ($122.3{\pm}45.0$) was significantly decreased(p<0.05) compared with control group($222.1{\pm}109.1$). - The concentration(pg/$m{\ell}$) of MCP-1 in peritoneal fluids in Boyanghwano-Tang treated group($1026.3{\pm}196.5$) was significantly decreased(p<0.05) compared with control group($1412.5{\pm}345.7$). - The concentration(pg/$m{\ell}$) of TNF-$\alpha$ in peritoneal fluids in Boyanghwano-Tang treated group($936.5{\pm}94.3$) was significantly decreased(p<0.01) compared with control group($1126.2{\pm}139.9$). - The concentration(pg/$m{\ell}$) of IL-$1{\beta}$ in peritoneal fluids in Boyanghwano-Tang treated group($78.5{\pm}13.3$) was significantly decreased(p<0.01) compared with control group($105.3{\pm}17.6$). - The concentration(pg/$m{\ell}$) of IL-6 in peritoneal fluids in Boyanghwano-Tang treated group($107.4{\pm}15.8$) was decreased compared with control group($122.8{\pm}19.3$). - Histopathologically, proliferation of endometriotic epithelia, infiltration of inflammatory cells and angiogenesis in transplanted uterine tissue of Boyanghwano-Tang treated group were weakly observed than those of control group. - The percentage of positive epithelial layers for COX-2 in Boyanghwano-Tang treated group($51.5{\pm}14.1$) was significantly decreased(p<0.01) compared with control group($75.1{\pm}16.3$). - The VEGF expression of endometriotic epithelia, neovascular endothelia and stromal cells in transplanted uterine tissue of Boyanghwano-Tang treated group were weakly observed than those of control group. - The number of mast cells in adjacent tissue of transplanted uterine tissue in Boyanghwano-Tang treated group($75.9{\pm}13.1$) was decreased compared with control group($91.0{\pm}28.3$). Conclusion: On the basis of these results, we concluded that Boyanghwano-Tang have inhibiting effects on the development of transplanted uterine tissue. And these effects may be related with decreased production of MCP-1, TNF-$\alpha$, IL-$1{\beta}$ and decreased expression of COX-2 and VEGF by administration of Boyanghwano-Tang.

• Journal of Veterinary Clinics
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• v.20 no.1
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• pp.42-48
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• 2003

This study was performed to compare the effect of hyaluronic acid(HA), vitamin I and their combinations for the prevention of postoperative intraperitioneal adhesion in dogs. Twelve mongrel dogs were divided into four groups; HA- (HA Group), vitamin E 800IU- (E8 Group), HA + vitamin E 800IU- (HA+E8 Group) and HA + vitamin E 1600IU-treated group(HA+E16 Group) with three dogs in each group. After celiotomy, five abrasions of 1$\times$1 cm area were made on the antimesenteric serosal surface of the anterior ileocecum with a No. 10 scalpel blade. The five abrasions and peritoneal cavity were coated with 25 of 0.l% HA. Oral supplements of vitamin E were given from the fifth day before the operation to the fourteenth day after the operation. Hematologic values were evaluated before the operation and on the 1st, 4th, 7th and 14th day after the operation. The locations and scores of adhesion were assessed through the second operation on the 21st day after the first operation. The adhesions were located on serosa to mesentary(43.3%)), serosa to serosa(20%), serosa to omentum(5%) and serosa to parietal peritoneum(1.7%). The incidences of adhesion in HA, E8, HA+E8 and HA+E16 groups were 80%, 100%, 47% and 53%, respectively. The scores of adhesion in HA+E8 group(p < 0.05) were lower than those in other groups. This study showed that the combination of HA and vitamin E 800IU was significantly effective in reducing the intraperitoneal adhesion in dogs.

• Korean Journal of Ichthyology
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• v.6 no.2
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• pp.237-243
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• 1994

This work was conducted to study sex differentiation in the black sea bream, Acanthopagrus schlegeli (Bleeker), using a histological method for the appearance of primordial germ cell, formation of primitive gonads, differentiation of female and male from newly hatched larva to the ovotestis stage of fish. The 3~4 primordial germ cells of $6.8{\sim}7.2\;{\mu}m$ in size, which were buried under fibrous mesenchymal tissue between gut duct and notochord of pre-larva with a total length (T.L.) of 2.4 mm at 3 days after hatching. The proto-gonial cells were located in the epithelium of the coelom attached with pigment cells of juvenile with 6.4 mm in T.L. at 21 days after hatching. In juvenile of 20.8 mm in T.L. at 59 days after hatching, the proto-gonial cells were migrated to the retro-peritoneum through the lineshaped primitive gonad composed of fibrous mesenchymal tissue. In juvenile of 7.8 em in T.L. at 186 days after hatching, the mitotic division of proto-gonial cell appeared in the lineshaped primitive gonad having many eosinophilic granule cells and abundant fibrous connective tissue. In juvenile of 9.5 em in T.L. at 254 days after hatching, the gonad was occupied by abundant fibrous connective tissue, bundles of spermatocyte and spermatid. In juvenile of 10.5 cm in T.L. at 13 months after hatching, the gonad was divided into cortical layer and medullary layer. The former was composed of bundles of a few spermatocytes and proto-gonial cells, the latter was filled with the fibrous mesenchymal tissue and a few proto-gonial cells. In juvenile of 14.7 em in T.L. at 16 months after hatching, the gonad was separated into ovarian part and testicular part by the fibrous connective tissue. The ovarian part is consisted of ovarian cavity and oocytes of perinucleolus stage. The testicular part was occupied by spermatogonia in the cyst.

• Radiation Oncology Journal
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• v.28 no.2
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• pp.79-84
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• 2010

Purpose: We retrospectively analyzed the long-term results of radical surgery and intraoperative radiation therapy (IORT) in patients with stomach cancer. Materials and Methods: From 1988 to 1994, 51 patients were treated with curative surgery and IORT. Postoperative external beam radiotherapy (EBRT) was administered to 30 patients, while adjuvant chemotherapy was administered to 35 patients. A dose of 15 Gy was irradiated with a 9 MeV electron beam as the IORT and a median dose of EBRT was 43.2 Gy (range, 7.2 to 45 Gy). The follow-up period ranged from 1~254 months, with a median follow-up period of 64 months. Results: The median age of all the patients was 58 years (range, 30 to 71 years). The distribution of pathologic stage (American Joint Committee on Cancer [AJCC] 2002 tumor-note-metastasis [TNM]) was as follows: 13 stage I (25.5%), 10 stage II (19.6%), 25 stage III (49.0%), and 3 stage IV (5.9%). Distant metastases occurred in 11 patients (10 in the peritoneum and 1 in bone), including one patient with concurrent local recurrence (anastomosis site). The 5-year locoregional control, disease free survival and overall survival rates were 94.7%, 66.5%, and 51.7%, respectively. For the multivariate analysis, age, TNM stage, and EBRT were significant prognostic factors for overall survival, and only TNM stage for disease free survival. Conclusion: We could have achieved a high loco-regional control rate in patients with locally advanced stomach cancer by adding IORT to radical surgery. However, the benefit of IORT on survival remains to be elucidated.

• The Journal of Korean Obstetrics and Gynecology
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• v.21 no.3
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• pp.34-59
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• 2008

Purpose: This study was performed to investigate the inhibiting effects of Gungguijohyeoleum on the development of experimentally-induced endometriosis in rats. Methods: Endometriosis was induced in rats by autotransplanting uterine tissue to the peritoneum and we divided them into three groups: (1) sham-operated group(n=8), (2) surgically induced endometriosis and untreated control group(n=8), (3) surgically induced endometriosis and Gungguijohyeoleum treated group(n=8), Gungguijohyeoleum was orally administrated for 15 days after operation. Then we measured the body weight, the volumes of endometriotic implants, the weight of uterus and ovary, and investigated the concentrations of cytokines(MCP-1, $TNF-{\alpha}$, $IL-1{\beta}$, IL-6) in peritoneal fluids. Histopathology, immunohistochemistry for COX-2 and VEGF, and histochemistry for mast cell in transplanted uterine tissue were performed. Results: - The volume ($mm^3$) of endometriotic implants in Gungguijohyeoleum treated group ($76.4{\pm}24.5$) was significantly decreased(p<0.05) compared with control group($222.1{\pm}109.1$). - The concentration (pg/ml) of MCP-1 in peritoneal fluids in Gungguijohyeoleum treated group ($1060.8{\pm}280.8$) was significantly decreased(p<0.05) compared with control group($1412.5{\pm}345.7$). - The concentration (pg/ml) of $TNF-{\alpha}$ in peritoneal fluids in Gungguijohyeoleum treated group ($827.5{\pm}219.9$) was significantly decreased(p<0.01) compared with control group($1126.2{\pm}139.9$). - The concentration (pg/ml) of $IL-1{\beta}$ in peritoneal fluids in Gungguijohyeoleum treated group($83.4{\pm}9.0$) was significantly decreased(p<0.01) compared with control group($105.3{\pm}17.6$). - The concentration (pg/ml) of IL-6 in peritoneal fluids in Gungguijohyeoleum treated group($108.9{\pm}15.7$) was decreased compared with control group($122.8{\pm}19.3$). - Histopathologically, proliferation of endometriotic epithelia, infiltration of inflammatory cells and angiogenesis in transplanted uterine tissue of Gungguijohyeoleum treated group were weakly observed than those of control group. - The percentage(%) of positive epithelial layers for COX-2 in Gungguijohyeoleum treated group($56.8{\pm}12.8$) was significantly decreased(p<0.01) compared with control group($75.1{\pm}16.3$). -The VEGF expression of endometriotic epithelia, neovascular endothelia and stromal cells in transplanted uterine tissue of Gungguijohyeoleum treated group was weakly observed than that of control group. - The numbers of mast cells in transplanted uterine tissue in Gungguijohyeoleum treated group($35.4{\pm}18.4$) were significantly decreased(p<0.01) compared with control group ($91.0{\pm}28.3$). Conclusion: On the basis of these results, we concluded that Gungguijohyeoleum has inhibiting effects on the development of transplanted uterine tissue. And these effects may be related with decreased production of MCP-1, $TNF-{\alpha}$, $IL-1{\beta}$, COX-2, VEGF and mast cells by administration of Gungguijohyeoleum.