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A Clinical Observation on Children with Corrosive Esophagitis (소아 부식성 식도염의 임상적 고찰)

  • Choi, Dong-Hyeon;Cho, Moon-Gi;Ju, Hyo-Geun;Kim, Byung-Ju;Ma, Jae-Sook
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.1-8
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    • 2000
  • Purpose: This study was undertaken to evaluate the clinical features and complication such as esophageal stricture in children with corrosive esophagitis. Methods: We retrospectively reviewed medical records of 31 children who accidentally ingested corrosive materials and visited to emergency room of Chonnam National University Hospital from Jan. 1992 to Dec. 1999. Twenty-one children were examined by upper gastrointestinal (UGI) endoscopy to evaluate location and severity of caustic injury. Results: 1) Among 31 patients, there were 20 males and 11 females and the ratio of male to female was 2:1. Average age at diagnosis was 2.3 years (12 months to 9.8 years). Twenty-seven (87.1%) patients were accidentally ingested vinegar. 2) Initial presenting symptoms were dysphagia (54.8%), vomiting (48.3%), chemical burn on lips and skin (45.2%), excessive salivation (45.2%), coughing and respiratory grunting (32.3%) and aspiration pneumonia (9.8%). 3) UGI endoscopic examination showed caustic injury in 17 children: grade I in 8, grade II in 7 and grade III in 2. The region of caustic injury was proximal esophagus in 5, distal esophagus in 3, entire esophagus in 9 and stomach in 6. 4) Corrosive esophageal strictures developed in 6 children (19.4%) and gastric outlet stricture in 1 (3.2%). All of them showed grade II or III caustic injury on endoscopic examination. Conclusion: The development of esophageal stricture was related to the severity of the caustic injury. Early UGI endoscopic examination in caustic ingestion seems to be useful for prediction of development of caustic stricture.

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Experimental Studies on Lead Toxicity in Domestic II. Histopathology (고양이의 납중독에 관한 실험적 연구 2. 조직병리학적 소견)

  • Hong Soon-Ho;Han Hong Ryul
    • Journal of Veterinary Clinics
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    • v.11 no.1
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    • pp.485-505
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    • 1994
  • Lead toxicity was evaluated in forty-five cats on a balanced diet, treated with 0(control), 10, 100(low), 1, 000, 2, 000 and 4, 000(high)ppm of lead acetate orally on a body weight basis. The objectives were to describe the gross and histopathologic changes and to demonstrate what tissue lead concentrations correlate with the known dosages of lead. In subclinical lead toxicity, greater than 80% of the absorbed lead was deposited in the bone, whereas in more acute lead toxicity, 42% of absorbed lead was deposited in the bone and 36% and 20% of absorbed lead was deposited in the kidneys and in the liver, respectively. No gross lesions were found in the nervous system. Yellow-brown colored livers appear to be associated with lead toxicity. Neuronal necrosis in the cerebrum was the most predominant histopathologic finding. Astrocytic proliferation in the cerebral gray matter was observed in 1 high dose cat. Gliosis was noted in the cerebral cortex of 6 high dose cats. Two high dose cats had demyelination in the deepest layer of the cortical gray matter of the cerebrum. Extravasation of red cells and cavitation around the vessels were found in the cerebrum of 1 high dose cat. Six high dose cats had degeneration of Purkinje cells in the cerebellum. The microscopic findings in the peripheral nerves were ambiguous. In more acute toxicity, the cats had lead inclusions in the epithelial cells of proximal tubules of the kidneys of 7 cats and hepatocytes of the liver of S cats. These inclusions could be seen wlth H&E, but were more prominent with orcein staining. Two high dose cats had granulomas and connective tissue hyperplasia between tubules of the kidneys. Periportal hepatocyte vacuolization was observed in the liver of 22 cats. Vacuolization of seminiferous tubules and a reduced number of spermatogonia(indicative of reduced spermatogenesis) were found in the testis of 5 treated cats. Cystic ovaries were observed in 3 high dose cats and poor development of oogonia was found in 2 cats. The diagnosis of lead toxicity in cats can be suspected on the basis of the histopathologic lesions described, and can be of value in contributing to a diagnosis. A reliable diagnosis of lead poisoning can be helped utilizing tissue lead analysis(post molten)

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Change of Regional Myocardial Blood Flow After Transmyocardial Laser Revascularization in Porcine Model of Chronic Myocardial Ischemia (돼지 만성 심근허혈 모델에서 경심근레이저혈류재건술 후 국소 심근 혈류량의 변화)

  • Park, Kay-Hyun;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.662-671
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    • 2001
  • Background: This study was aimed to assess improvement in myocardial perfusion after TMR by measuring regional myocardial blood flow(RMBF) in porcine model of chronic myocardial ischemia. Material and Method: Ameroid ring was placed around the proximal left circumflex coronary artery in fourteen pigs. After 4 weeks, the control group(7 pigs) underwent rethoracotomy only, and the TMR group(7 pigs) underwent Ho:YAG laser TMR at the circumflex territory. After another 4 weeks, the animals were sacrificed for the measurement of RMBF using colored microspheres. The ratio of RMBF between the circumflex territory and the interventricular septum was calculated and compared. Result: At 4 weeks after ameroid constriction, RMBF of the circumflex territory decreased to 46∼89% of RMBF of the interventricular septum. In five of six animals in the TMR group, RMBF of the circumflex territory at 8 weeks after ameroid constriction was higher compared with RMBF at 4 weeks after ameroid constriction. However, the improvement was statistically significant only in two animals. In three of the four animals in the control group, RMBF of the circumflex territory also increased at 8 weeks compared with RMBF at 4 weeks. The degree of increase in RMBF was not different between the control and the TMR groups. Conclusion: In porcine model of chronic myocardial ischemia, the degree of increase in RMBF of the ischemic area after Ho:YAG TMR was not different from the increase by development of native collateral circulation. Perfusion of ischemic myocardium after TMR is not thought to improve to the degree that can be demonstrated by currently available method of assessment such as radioisotope myocardial scintigraphy.

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Effect of Oyster Shell Powder on Quality Properties and Storage Stability of Emulsion-type Pork Sausages (굴패각 첨가가 유화형 돈육 소시지의 품질 및 저장안정성에 미치는 효과)

  • Lee, Jae-Joon;Park, Sung-Hyun;Choi, Jung-Soek;Kim, Jong-Hee;Lee, Sang-Hwa;Choi, Suk-Hyun;Choi, Yang-Il;Jung, Dong-Soon
    • Food Science of Animal Resources
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    • v.31 no.3
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    • pp.469-476
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    • 2011
  • This study was conducted to evaluate the functional effects of adding oyster shell powder on the quality properties and storage stability of emulsion-type pork sausages to substitute phosphates as a curing agent. Seven treatments were prepared: T1 (Control), T2 (0.3% STPP), T3 (1.5% NaCl), T4 (1.5% NaCl + 0.5% whey protein), T5 (1.5% NaCl + 0.5% whey protein + 0.15% oyster shell powder), T6 (1.5% NaCl + 0.5% whey protein + 0.3% oyster shell powder), and T7 (1.5% NaCl + 0.5% whey protein + 0.5% oyster shell powder). Significant differences were observed for ash in the proximal analysis. Adding 0.5% oyster shell powder significantly increased pH values when compared to the other treatments. Pork sausages with 0.3% oyster shell powder had significantly improved water holding capacity and cooking loss. Adding oyster shell powder (0.15, 0.3, and 0.5%) resulted in significantly higher hardness, cohesiveness, springiness, and chewiness values than those in the other treatments. No significant differences were observed among treatments during 14 d of cold storage at $4^{\circ}C$.

Histomorphometric study of machined titanium implants and calcium phosphate coated titanium implants (Machined 티타늄 임플란트와 calcium phosphate coated 티타늄 임플란트의 조직형태계측학적 연구)

  • Kang, Hyun-Joo;Yang, Jae-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.2
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    • pp.122-127
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    • 2010
  • Purpose: The objective of this study was to investigate the effects of calcium phosphate coated titanium implant surface on bone response and implant stability at early stage of healing period of 3 weeks and later healing period of 6 weeks. Material and methods: A total of 24 machined, screw-shaped implants (Dentium Co., Ltd., Seoul, Korea) which dimensions were 3.3 mm in diameter and 5.0 mm in length, were used in this research. All implants (n = 24), made of commercially pure (grade IV) titanium, were divided into 2 groups. Twelve implants (n = 12) were machined without any surface modification (control). The test implants (n = 12) were anodized and coated with thin film (150nm) of calcium phosphate by electron-beam deposition. The implants were placed on the proximal surface of the rabbit tibiae. The bone to implant contact (BIC) ratios was evaluated after 3 and 6 weeks of implant insertion. Results: The BIC percentage of calcium phosphate coated implants ($70.8{\pm}18.9%$) was significantly higher than that of machined implants ($44.1{\pm}16.5%$) 3 weeks after implant insertion (P = 0.0264). However, there was no significant difference between the groups after 6 weeks of healing (P > .05). Conclusion: The histomorphometric evaluation of implant surface revealed that; 1. After 3 weeks early healing period, bone to implant contact (BIC) percentage of calcium phosphate coated implants (70.8%) was much greater than that of surface untreated machined implants (44.1%) with P = 0.0264. 2. After 6 weeks healing period, however, BIC percentage of calcium phosphate coated implants group (79.0%) was similar to the machined only implant group (78.6%). There was no statistical difference between two groups (P = 0.8074). 3. We found the significant deference between the control group and experimental group during the early healing period of 3 weeks. But no statistical difference was found between two groups during the later of 6 weeks.

Expected Values for the Analysis of Accommodation and Vergence Dysfunction of Young Adluts (젊은 성인의 조절 및 이향운동 기능장애 분석을 위한 표준 값)

  • Baarg, Saang-Bai
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.4
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    • pp.127-134
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    • 2008
  • Purpose: The purpose of this study was to determine the expected values of accommodation and vergence system for analysis of binocular vision. Methods: Seventy three healty subjects without past history of eye disease were selected for this study, Patients showing clinical binocular anomalies including manifest squint and intermittent heterotropia were excluded and data was collected on 54 patients(mean age, 25.3${\pm}$2.7 year). Near point of convergence, distance and near phoiras were measured based on objective deviation angle. And then AC/ A ratio, relative accommodation were measured and all of the data were compared with the Morgan's expected values. Results: The values of distance and near heterophoria were 1.24${\pm}$2.72${\Delta}$ and 2.70${\pm}$4.91${\Delta}$ respectively and the gradient AC/A ratio was 3.92${\pm}$2.17${\Delta}$/D which were all about the same compared with the Morgan's expected values. The values of distance negative fusional convergence was same, however, distance positive fusional convergence was 7${\Delta}$ greater than the Morgan's one. There were no significant differences in the range values of both near vergences while the range of distance vergence was relatively larger than the Morgan's one. Positive relative accommodation was +0.37D greater and negative relative accommodation was -0.63D greater than the Morgan's values. Conclusions: The findings in this study appear that the Morgan's expected values have a possibilities of including considerable proximal convergence value. In comparison with Morgan's values, Korean's normal expected values have much different values of especially BO limit, so if the Morgan's values are directly applied to binocular vision analysis for Korean people, it may lead to an inaccurate binocular vision diagnosis. This results can be used to diagnose the accommodation and vergence system of Korean normal young adults.

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Colon Perforation during Air Enema Reduction of Intussusception (소아 장중첩증에서 공기 주입 정복술 시행 도중 발생한 장천공)

  • Kim, Yong Kuk;Im, Hae Ra;Lee, Gwang Hoon;Han, Soo Jin;Sun, Yong Han;Ryoo, Eell;Cho, Kang Ho;Tchah, Hann;Lee, Hak Soo
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.37-41
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    • 2003
  • Purpose : Although air enema reduction has been known as a good method of diagnosis and treatment of intussusception, it could develop colon perforation. However, there have been few studies about this complication. So we analyzed the risk factors of colon perforation during air enema reduction in patients with intussusception. Methods : We reviewed the charts of 12 colon perforation patients during air enema reduction of intussusception, who were admitted to Gil Medical Center from Jan. 1990 to Dec. 2001. Their age, sex, major symptoms, length of time till hospital visit, types of intussusception, operative findings and pathologic reports were reviewed. Results : Among 657 cases, 596 patients(90.7%) were successfully treated, but 12 patients(1.83%) failed in air enema reduction and had colon perforation. In patients with colon perforation the male to female ratio was 11 : 1, and average age was 5.3 months. The most common symptom at the time of hospital visit was vomiting(91.7%). Cyclic irritability(75.0%), bloody stool(75.0%) and abdominal mass(41.7%) were also noted. The average length of time between symptom onset and hospital visit was 44.7 hours. Types of intussusception were predominantly ileocolic, ileocecal, and ileoileocolic. The site of perforation was most commonly found at the proximal part of intussusception including ascending colon(50%) and transverse colon(50%). Most cases were uncomplicated, and had a single perforation. Pathologic reports showed hemorrhagic necrosis and mesenteric laceration at the site of colon perforation. Complications of colon perforation were tension pneumoperitonium(58.3%), requiring immediate decompression. Conclusion : The chance of colon perforation during air enema reduction increases in cases with small bowel obstruction on simple abdominal x-ray of a patient younger than 6 months, delay in time till hospital visit and higher air pressure during reduction. Therefore more careful investigation is needed in these cases.

Clinical Results of ACL Reconstruction in the Immature Adolescent via Transphyseal Approach in Tibia Based on a New Indication Paradigm (새로운 수술적응증에 의한 골 미성숙 전방십자인대 손상 환자에서의 성장판을 통과하는 전방십자인대 재건술의 결과)

  • Lee, Dong Chul;Shon, Oog Jin;Park, Chul-Hyun;Kwon, Moon Soo
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.1-8
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    • 2012
  • Purpose: To evaluate clinical and radiologic outcomes of transphyseal anterior cruciate ligament (ACL) reconstruction in patients with open physes who were selected with authors' new operative indications. Materials and Methods: We evaluated 15 patients with open physes who underwent a transtibial ACL reconstruction and were followed up for 4~6 years after surgery. Our operative indications involved 1) choronologic age of ${\geq}$ 16 in male and ${\geq}$ 14 in female, 2) open physes of ${\leq}$ 2 mm width, and 3) Risser sign and Tanner stage of ${\geq}$ 3. Tibialis anterior tendon allograft was used in all patients, and endobutton and bioscrew were used for femoral and tibial fixations, respectively. Functional outcomes were evaluated using Lysholm Knee Scoring scale, Tegner activity scale, and International Knee Documentation Committee (IKDC) 2000 subjective score. Physical examinations to evaluate stability involved Lachman and pivot shift tests. For radiographic results, we evaluated side to side differences of anterior displacement in stress views. In addition, with use of scannograms taken at last follow-up, we examined side to side differences of femorotibial angles, anatomical and mechanical lateral distal femoral angles, mechanical medial proximal tibial angles and leg lengths. Results: The mean Lysholm Knee score was 51(40-61) points preoperatively and 97(94-100) points at last follow up. The mean Tegner activity score was 2.6 points preoperatively and 7.1 points at last follow up. The mean IKDC score was 32.6 points preoperatively and 88.3 points at last follow up. The mean anterior displacement of the tibia was improved from 6.7(${\pm}1.0$) mm to 1.9(${\pm}0.9$) mm. There were no leg length discrepancies over 5 mm and no statistically significant differences in all the radiographic variables representing growth disturbance. Conclusion: This study suggests that patients with open physes who selected by authors' new indication would safely undergo transphyseal ACL reconstruction with successful outcomes.

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Influence of Intracerebroventricular Yohimbine on the Renal Function of the Rabbit (가토 신장기능에 미치는 측뇌실내 Yohimbine의 영향)

  • Kook, Young-Johng;Kim, Kyung-Keun;Kim, Sei-Jong
    • The Korean Journal of Pharmacology
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    • v.21 no.2
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    • pp.119-127
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    • 1985
  • The renal function is under regulatory influence of the central nervous system, mainly through activation of sympathetic nerve to the kidney, and it was recently reported that clonidine, an agonist to ${\alpha}_2$-adrenoceptors, induces diuresis and natriuresis when injected directly into a lateral ventricle of the rabbit brain (i.c.v.). This study was undertaken, therefore, to obtain further information as to the role of the central ${\alpha}_2$-adrenoceptors in regulating renal function, by observing the effects of i.c.v. yohimbine, a specific antagonist of adrenoceptors of ${\alpha}_2$-type, on the rabbit renal function, and to elucidate the mechanism involved in it. With 10 ${\mu}g/kg$ i.c.v. of yohimbine sodium excretion transiently increased along with increasing tendency of urine flow, renal plasma flow and glomerular filtration rate. These responses decreased with increasing doses. With 100 and 300 ${\mu}g/kg$ i.c.v. marked antidiuresis and antinatriuresis as well as profound decreases of renal perfusion and glomerular filtration were noted. Systemic blood pressure transiently increased. In reserpinized rabbits, 100 ${\mu}g/kg$ yohimbine i.c.v. did not produce any significant changes in urine flow, sodium excretion as well as in renal hemodynamics. The pressor response was also abolished. In preparations in which one kidney was denervated and the other left intact as control, i.c.v. yohimbine elicited typical antidiuretic antinatriuretic response in the innervated control kidney, whereas the denervated experimental kidney responded with marked diuresis and increases in excretory rates of sodium and potassium and in osmolar clearance in spite of absence of increased filtration and perfusion . Systemic blood pressure responded as in the normal rabbits. These observations indicate that i.c.v. yohimbine affects renal function in dual ways in opposite directions, the first being the antidiuretic antinatriuretic effects which results from decreased renal perfusion and glomerular filtration due to sympathetic activation and which is predominantly expressed in the normal rabbits, and the second less apparent effect being the diuretic and natriuretic action which is not mediated by nerve pathway but brought about by some humoral mechanism and which is effected by decreased sodium reabsorption in the tubules, possibly of the proximal portion.

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Analysis of Postoperative Coronary Angiography in Symptomatic Patients (관상동맥 우회술 시행 후 증상이 있는 환자에서 시행한 관상동맥 조영술의 분석)

  • Kim Young-Hak;Han San-Woong;Kang Jeong-Ho;Kim Hyuck;Lee Chul-Burm;Chon Soon-Ho;Nam Seung-Hyuk;Chung Won-Sang
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.759-764
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    • 2006
  • Background: We analyzed post-operative angiography performed in symptomatic patients to evaluate the patency rates and the roles of grafts. Material and Method: We reviewed 52 (15%) coronary angiograms performed for recurrent angina after prior coronary artery bypass surgery from January 1995 to June 2005. A total of 345 patients underwent coronary artery bypass surgery during this period. There were 41 men and 11 women and the mean age was $64.07{\pm}15.58$ years. The median period from operation to re-angiogram was 68.5 months (range, 1 to 126 months). The numbers of grafts and peripheral anastomoses were 42 and 43 for internal thoracic artery (ITA), 14 and 20 for radial artery (RA), and 49 and 89 for saphenous vein. The mean number of anastomosis was 2.9 per patient, Result: The patency rates of ITA, RA and saphenous vein graft (SVG) were 37/43 (86%), 17/20 (85%) and 34/89 (38.2%). The patency rate of arterial grafts was significantly higher than that of SVG (p< 0.001) and the patency rate of the RA was comparable to that of ITA (p=0.942). The patency rate of sequential SVGs was higher than that of single SVG (40.3% vs 31.8%, p=0.478) and the patency rate of proximal segments in sequential anastomosis was higher than that in single anastomsis (55.6% vs 31.8%, p=0.097), but statistically not significant. Conclusion: Arterial grafts have markedly superior patency rates than SVGs, so consideration should be given to the vigorous use of arterial grafts. The patency rate of the RA was comparable to that of ITA.