• Title/Summary/Keyword: 수액

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The Correlation between the Severity of Hypoxic Ischemic Encephalopathy and the Development of Acute Renal Failure in Asphyxiated Neonates (신생아 질식 환아에서 저산소성 허혈 뇌증의 정도와 급성신부전 발생과의 연관성)

  • Park, Sung-Shin;Chung, Sung-Hoon;Song, Jun-Hyuk;Kim, Sun-Kyoung;Cho, Byoung-Soo;Kim, Sung-Do
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.32-40
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    • 2007
  • Purpose : We performed this study to determine the incidence of acute renal failure(ARF) in birth asphyxia and to correlate the severity of asphyxia and hypoxic-ischemic encephalopathy (HIE) and ARF in asphyxiated neonates. Methods : Data was retrospectively collected from the medical records of 33 patients with neonatal asphyxia and of 33 neonates with no asphyxia. On the basis the 5-minute Apgar score, the asphyxiated neonates were further grouped into mild(6 or 7), moderate(4 or 5), and severe asphyxia(3 or less). Asphyxiated neonates with HIE were staged by the Sarnat and Sarnat scoring system. We compared serum creatinine, blood urea nitrogen, electrolytes, and urine output on day 3 of life and the incidence and severity of intraventricular hemorrhage(IVH) between each group. Results : ARF occurred in 8(24.2%) asphyxiated neonates. Of these, 3(37.5%) were oliguric, while 1(10.0%) patient with mild asphyxia, 2(18.2%) of moderate asphyxia, and 5(41.7%) with of severe asphyxia had ARF(P>0.05). One(25%) patient with stage I HIE, 4(50%) with stage II HIE, and 3(75%) of HIE with stage III HIE developed ARF(P<0.01). There was no statistical correlation between the severity of asphyxia and HIE stage. One(7.7%) patient with grade 1 IVE, 0(0.0%) with grade 2 IVH, 2(66.7%) with grade 3 IVH, and 2(100.0%) with grade 4 IVH had ARF(P<0.01). Mortality was higher in asphyxiated neonates with ARF(P<0.05). There was no significant difference between the oliguric and non-oliguric renal failure. Conclusion : We found that the greater the degree of HIE, the higher was the incidence of ARF. Asphyxiated neonates with ARF had a poorer prognosis.

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Purification of cystic fluid antigen of Taenia solium metacestodes by affinity chromatography using monoclonal antibody and its antigenic characterization (단세포군항체에 의한 유구낭미충 낭액 특이항원의 순수분리 및 항원특성 관찰)

  • Kim, Suk-Il;Kang, Shin-Yong;Cho, Seung-Yull;Hwang, Eung-Soo;Cha, Chang-Yong
    • Parasites, Hosts and Diseases
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    • v.24 no.2
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    • pp.145-158
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    • 1986
  • This study was undertaken to purify cystic fluid (CF) antigen of Taenia solium metacestodes by affinity chromatogaphy using specific monoclonal antibody(McAb) and to characterize the antigenicity of the purified antigen. The hybridoma cell lines, prepared by fusion between mouse plasmacytoma and spleen cells from BALB/c mice immunized with CF, secreted antibodies reacting to various helminthic antigens. Majority of cell lines reacted to CF only but some also reacted to parenchymal antigen of T. solium metacestodes, adult T. saginata, sparganum, hydatid cystic fluid, Paragonimus westermani and Clonorchis sinensis, either in combination with CF, other antigens or independently. Cloned cells derived from monoclonal lines also produced antibodies reacting either to CF only or to other helminthes in combination or independently. These results indicated that CF of T. solium metacestodes contained proteins which possessed antigenic determinants not only specific to CF but also cross reactive with the afore-mentioned helminthes. CF of T. solium metacestodes was purified by affinity chromatography using the McAb which reacted to CF and parenchymal antigens. The affinity-purified antigen (A-Ag) and unbound pool CF (U-Ag) were separated. A-Ag showed 2 protein bands by disc-PAGE whereas CF exhibited 6 bands and U-Ag consisted of all bands CF had. The diagnostic significance of A-Ag was evaluated by ELISA in human neurocysticercosis and other helminthic and neurologic diseases. By A-Ag, the levels of the specific IgG antibody, as shown by absorbance in sera and CSF, were lower than those of CF and U-Ag. Accordingly, the sensitivity was about 70% of CF and U-Ag. However, the nonspecific positive reactions to CF and U-Ag, observed in sparganosis, T. saginata infection and paragonimiasis did not occur when A-Ag was used. These results indicated that the affinity-purified A-Ag had the higher specificity but the lower sensitivity as a diagnostic antigen in cysticercosis, probably because it only detected a single or limited numbers of monospecific antibodies among the diverse polyclonal antibodies produced in the patients with neurocysticercosis.

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Effects of Cotton Balls of Alcohol and Povidone for Disinfectoin of Skin in Newborns (신생아에서 알코올 솜 및 포비돈 솜의 피부 소독효과 비교)

  • Park, Kyu Chang;Kim, Chang Ryul;Kim, Eun A;Oh, Jae Won;Yum, Myung Kul;Oh, Sung Hee;Moon, Soo Jee;Kang, Jung Oak
    • Pediatric Infection and Vaccine
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    • v.6 no.1
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    • pp.116-122
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    • 1999
  • Purpose : Despite of development of neonatal intensive care, infections, especially catheter-related infection, have been a major problem in newborns on intensive care. Catheter-related infection is closely related to skin colonization so that skin disinfection is crucial to protect newborns from the infection. Cotton balls of seventy percent alcohol made by hospital frequently open to air so that composition of alcohol may be easily evaporated. We hypothesized that 10% povidone would have better disinfection compared to 70% alcohol and normal saline. Methods : The effect of skin disinfection was evaluated in newborn infants who were admitted to the neonatal intensive care unit(NICU) of Hanyang University Kuri Hospital by a skin swab culture before and after disinfectant exposure. Before skin disinfective preparation, the peripheral intravenous catheter insertion sites were swabbed for culture with sterile cotton moistened with normal saline. Cotton balls of 70% alcohol(Alcohol group, n=20) or 10% povidone and 70% alcohol(povidone group, n=20) were randomly selected. Normal saline swabs were used for controls(n=10). After swabbing, the skin swab culture was done on same sites with same procedure. Results : Before skin disinfection, culture-positivity was shown in 9 of 20 leases of alcohol and povidone groups, respectively and in 8 of 10 cases of the controls. After skin disinfection, culture-positivity was still shown in 3 of 9 cases of the Alcohol group, in 2 of 9 of the Povidone group, and in 6 of 8 cases of the controls. Disinfective effect was significantly different among the 3 groups(p=0.0387). The povidone group had significantly better disinfection than the controls(p=0.0156), but the alcohol group was not significantly different from the controls. Conclusion : The cotton balls of povidone had similar effect of disinfection compared to those of alcohol, but better disinfection than the controls. A disinfective effect of the cotton balls of alcohol was not, however, significantly different from the controls. We suggest that purity of alcohol, quality control of cotton balls of alcohol, and disinfection method should be reevaluated.

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Therapeutic Effect of Anti-Rotavirus Chicken Egg Yolk Immunoglobulin(IgY) on Diarrhea by Infection of Rotavirus (로타바이러스 감염성 설사에 대한 항-로타바이러스 난황항체의 치료 효과)

  • Lim, In Seok;Lee, Ho Seok;Kim, Wonyong;Choi, Eung Sang;Jung, Dong Hyuk;Jung, Hoo Kil;Yun, Sung Seob;Chun, Ho Nam
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1354-1361
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    • 2005
  • Purpose : Rotavirus is an enteric pathogen that affects millions of children globally each year. But no specific therapy is available for the management of rotavirus diarrhea. Due to the clear need to define improved modality for treatment of rotavirus diarrhea, we evaluated the efficacy of antirotavirus IgY in the treatment of infants and children with gastroenteritis. Methods : First, the amount of viral particle in the stools of thirteen patients(seven were given IgY, 6 placebo) infected by rotavirus were evaluated for 3 days with the quantitative RT-PCR method. Second, 36 children with known rotavirus infection identified by ELISA or semi-quantitative RT-PCR were evaluated. We gave 5 g anti-rotavirus egg yolk daily in two equally divided doses for 3 days to two groups(an 18 IgY group and an 18 placebo group), respectively after parenteral consent. Daily vomiting frequency, stool frequency, oral intake and urine output were monitored for 3 days, and electrolyte and blood chemistry were checked at the first and third days. Results : First, in the placebo group, the amount of virus particles increased daily, but in the IgY group it decreased daily. Second, when IgY and placebos were given to children infected with rotavirus, diarrhea on the third day decreased significantly in the IgY group, compared with the placebo group. Conclusion : Treatment with antirotavirus immunoglobulin from immunized chicken's egg resulted in a decrease in the amount of viral particles in stools and diarrhea frequency in children. These results suggest that anti-rotavirus IgY is effective in the treatment of rotavirus gastroenteritis.

Study on the Mobility of Cd Ion Using Extraction by Solutions in Stem Wood of Pinus densiflora L. (용매추출(溶媒抽出)에 의한 소나무(Pinus densiflora L.) 수간부(樹幹部)에서의 Cd 이동성(移動性)에 관(關한) 연구(硏究))

  • Shin, Kyungwon;Cho, Namhoon;Kim, Jeong-Gyu
    • Journal of Korean Society of Forest Science
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    • v.89 no.1
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    • pp.77-84
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    • 2000
  • In order to understand the chemical binding forms of Cd in terms of its binding strength in wood, the radial distribution of it through dendroanalysis and its different chemical fractions in trunk wood of mature red pine(Pinus densiflora L.) trees grown in a relatively unpolluted area, in Kangwon-Province, were examined. Total Cd concentration in stem wood was determined by dry digestion and $H_2O$ and 0.01 M solutions of citric acid, malic acid, $CaCl_2$, $MgCl_2$, $Na_2EDTA$ were used as extracting solutions for Cd. Extracting efficiencies of applied solutions were expressed as % of Cd concentration extracted by $Na_2EDTA$ which extracted all Cd instead of Cd total concentration. Total concentration of Cd decreased from the innermost rings near pith towards the the outermost rings near cambium. Especially through the transition zone this tendency was observed clearly. $H_2O$ was the least effective extractant of Cd, then extracting efficiency increased in the order $MgCl_2$ < $CaCl_2$ $Na_2EDTA$ (extracted all Cd). According to the radial position, extracting efficiency of Cd was ranging from 7 to 30% by $H_2O$ and even from 60 to 95% by citric acid. The Cd extracting efficiencies of $H_2O$ and organic acids increased continuously from the stem center to outermost annual rings, whereas salts showed somewhat different tendency, suddenly decreasing near the outermost ring. The results are discussed with regard to the different chemical binding forms of Cd and the mobility of Cd in wood and comparable with ones in previous studies on Pinus sylvestris and Quercus patraea. According to the results, usefulness of radial distribution pattern of Cd in pine tree trunks for retrosective biomonitoring is questioned.

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Gastric Dilatation and Volvulus in Shih-tzu (시츄에서 발견된 위확대염전)

  • Moon, Joon Ho;Kim, Hyun Ah;Ryu, Minok;Jang, Min;Ji, Seoyeon;Lee, Inhyung;Yoon, Junghee;Choi, Mincheol;Youn, Hwayoung;Lee, Byeong Chun;Jang, Goo
    • Journal of Veterinary Clinics
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    • v.32 no.3
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    • pp.255-258
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    • 2015
  • Gastric dilatation and volvulus (GDV) is an acute and life-threatening disease most commonly affecting large- and giant-breed dogs. However a 17-year-old Shih-tzu (4 kg, spayed female) was hospitalized for acute GDV. Repeated unproductive retching, lethargy, and excessively enlarged abdomen were observed. Physical examination indicated that the patient had suffered from hypothermia ($36.5^{\circ}C$), tachycardia (240 bpm), slowed capillary refill time (> 2 sec.), and pale mucous membrane. Grade III murmur with normal lung sound was auscultated. Abdominal palpation revealed that tympanic regions existed in both the left and right sides. Systolic blood pressure decreased gradually from 220 to 40 mmHg within 4 hours. In blood analysis, slight azotemia was observed by blood urea nitrogen (BUN; 29.1 mg/dl) and creatinine (1.6 mg/dl). Blood lactate concentration (8.13 mmol/l) was severely elevated. Additionally, dilatation and volvulus of the stomach was observed by radiograph. Supportive oxygen, heat, fluid, and drugs were administered with gastric decompressions (e.g., gastrocentesis and nasogastric tube). However the patient entered into comatose status with uncontrollable systolic blood pressure, despite the administration of dobutamine intravenously. The case was closed by euthanasia, considering welfare and age. We finally diagnosed the patient as a GDV, thus this is the first GDV case report in small-breed dog such as Shih-tzu.

The Study of Intravenous-gammaglobulin Therapy in Acute phase of Measles (급성기 홍역 환자의 정주용 인면역글로부린 치료 효과에 대한 연구)

  • Kim, Min Shik;Cha, Yoon Hwa
    • Pediatric Infection and Vaccine
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    • v.8 no.1
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    • pp.101-106
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    • 2001
  • Purpose : The outbreaks of measles in infants and school children have been reported recently, but there are no specific treatment of these patients except symptomatic therapy. This study was performed to evaluate the effectiveness of intravenous gammaglobulin(IVGG) therapy in acute febrile phase of measles. Methods : The 68 cases in measles were treated with single dose of IVGG(400~500 mg/kg), and 44 cases were treated with only symptomatic treatment during the periods of 14 months from Jan. 2000 to Feb. 2001. They were compared to duration of fever, rash, the levels of CRP and days of admission on both groups after treatment. Results : The results obtained follows. The average of age was $7.9{\pm}3.6$ year old, and male to female was 1.0 : 1.6. The duration of fever after admission was $2.4{\pm}1.2$ days in treated group and $5.7{\pm}2.4$ days in control group. The period of disappearance of systemic erythematous maculopapular rash was $4.5{\pm}1.3$ days in treated group, and $6.9{\pm}2.4$ days in control group. The durations of admission day were also shown significantly shorter duration of period in treated group(P<0.05). The levels of CRP were no significant difference between two groups before treatment. However, treated group was significantly shown by improved within 5 days after IVGG therapy(P<0.05). Conclusions : The single dose of IVGG(400~500 mg/kg) therapy is one of rapid and effective therapy for clinical symptoms and signs in acute high febrile phase of measles.

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Epidemics of Aseptic Meningitis in Kyoungsangnamdo from March to October, 1997 (1997년 경상남도 중부지방에서 유행한 무균성 뇌막염의 임상적 고찰)

  • Park, Sun Young;Kwon, Oh Su;Kim, Won Youb;Jung, Won Jo;Ma, Sang Hyouk;Kim, Sang Ki;Nam, Sung Jin;Jo, Sung Rae;Gu, Bon Chun;Lee, Kyu Man
    • Pediatric Infection and Vaccine
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    • v.5 no.1
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    • pp.104-114
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    • 1998
  • Purpose : Enteroviruses are the most common cause of aseptic meningitis. The epidemics of aseptic meningitis in 1993 and 1996 were mostly caused by echovirus type 9. Identification of the causative virus of aseptic meningitis in epidemics, is very important not only for diagnosis but also for epidemiologic purpose. The purpose of this study was to identify the causative virus and investigate the relationship between aseptic meningitis, prevailed in Masan and surrounding areas in Kyoungsangnamdo in 1997, and its clinical manifestations. Methods : One hundred twenty eight cerebrospinal fluid(CSF) and 239 stool specimens were obtained from 239 patients(213 children and 26 adult patients) with aseptic meningitis were admitted to Masan Fatima Hospitals from March to October 1997. Viral isolation and serotype identification was performed by cell culture and immunofluorescent test. Enteroviruses not typed by immunofluorescent test was confirmed by reverse transcription-polymerase chain reaction(RT-PCR). Results : 1) The peak incidence was noted in June. 2) The age of 239 patients(pediatrics-213 cases, internal medicine-26 cases) that were diagnosed ranged from neonate to 35 years, the age of the patients of pediatrics ranged from neonate to 15years(mean 4.9 years), the age of the patients of internal medicine (above 16 years) ranged from 16 years to 35 years(mean 24.2 years). 3) Fifty-three(41.4%) of 128 CSF specimens were positive for enteroviruses, and 163(68.2%) of 239 stool specimens were positive for enteroviruses respectively. 4) Serotypes of 53 enteroviruses isolated from CSF were 16(30.2%) of echovirus type 30, 6(11.3%) of echovirus type 6, 1 of echovirus type 4, 4 of untyped echovirus, 1 of coxsackievirus type B5, and 24 isolates of untyped enteroviruses. Of 163 enterovirus isolated from stool were 72(44.2%) of echovirus type 30, 21(12.9%) of echovirus type 6, 1 of echovirus type 4, 17(10.4%) of undetermined subtyped echovirus, 1 of coxsackievirus type B5, 2 of A24, 3 of undetermined subtyped coxsackievirus type B, and 46 isolates of untyped enterovirus. Conclusion : There were epidemics of aseptic meningitis in the central areas of Kyoungsangnamdo from March to October 1997. The main causative organism was thought to be the echovirus type 30, and echovirus type 4, 6, coxsackievirus B5 and A24 were also thought to contribute to the epidemics.

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Comparative Analysis of Signal Intensity and Apparent Diffusion Coefficient at Varying b-values in the Brain : Diffusion Weighted-Echo Planar Image ($T_2^*$ and FLAIR) Sequence (뇌의 확산강조 영상에서 b-value의 변화에 따른 신호강도, 현성확산계수에 관한 비교 분석 : 확산강조 에코평면영상($T_2^*$ 및 FLAIR)기법 중심으로)

  • Oh, Jong-Kap;Im, Jung-Yeol
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.313-323
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    • 2009
  • Diffusion-weighted imaging (DWI) has been demonstrated to be a practical method for the diagnosis of various brain diseases such as acute infarction, brain tumor, and white matter disease. In this study, we used two techniques to examine the average signal intensity (SI) and apparent diffusion coefficient (ADC) of the brains of patients who ranged in age from 10 to 60 years. Our results indicated that the average SI was the highest in amygdala (as derived from DWI), whereas that in the cerebrospinal fluid was the lowest. The average ADC was the highest in the cerebrospinal fluid, whereas the lowest measurement was derived from the pons. The average SI and ADC were higher in $T_2^*$-DW-EPI than in FLAIR-DW-EPI. The higher the b-value, the smaller the average difference in both imaging techniques; the lower the b-value, the greater the average difference. Also, comparative analysis of the brains of patients who had experienced cerebral infarction showed no distinct lesion in the general MR image over time. However, there was a high SI in apparent weighted images. Analysis of other brain diseases (e.g., bleeding, acute, subacute, chronic infarction) indicated SI variance in accordance with characteristics of the two techniques. The higher the SI, the lower the ADC. Taken together, the value of SI and ADC in accordance with frequently occurring areas and various brain disease varies based on the b-value and imaging technique. Because they provide additional useful information in the diagnosis and treatment of patients with various brain diseases through signal recognition, the proper imaging technique and b-value are important for the detection and interpretation of subacute stroke and other brain diseases.

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A Clinical Study of Aseptic Meningitis in the Northern Area of Seoul in 2002 (2002년 서울 북부지역에서 유행한 무균성 수막염의 임상적 고찰)

  • Song, Myoung Hak;Chung, Ju Young;Kwon, Ji Won;Kim, Sang Woo
    • Pediatric Infection and Vaccine
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    • v.11 no.2
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    • pp.176-182
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    • 2004
  • Purpose : The etiologic agents of aseptic meningitis remain mostly unknown due to difficulty of viral culture and identification. There was an outbreak of aseptic meningitis in northern area of Seoul from June to August, 2002. We report the clinical features, laboratory data and causative viruses on 196 children with aseptic meningitis during this period. Methods : We retrospectively studied about clinical manifestations and laboratory findings 196 patients diagnosed as aseptic meningitis at Sanggye-Paik hospital. Virus isolation and serotype identification were performed by cell culture and reverse transcription polymerase chain reaction(RT-PCR) of the cerebrospinal fluid. Results : The male to female ratio was 1.39 : 1 and the mean age was 5.8+3 years. The clinical manifestations were fever, headache and vomiting. It occurred mostly in June, July and August. The numbers of peripheral blood leukocytes were $4,800{\sim}24,360/mm^3$. On cerebrospinal fluid examinations, leukocytes were in range of 10~2,000(mean 105)/$mm^3$, protein level in range of 15~171(mean 41.4) mg/dL and glucose level from 16~97(mean 57.9) mg/dL. Viral culture of cerebrospinal fluid showed 3 cases of Echovirus 9, 1 case of 25 and 30. In stool culture, 2 cases of Echovirus 6, 2 cases of Echovirus 13 and 1 case of Echovirus 30 were isolated. Conclusion : The etiologic viruses of the aseptic meningitis in northern area of Seoul in 2002 are presumed to be Echovirus 6, 9, 13, 25, 30.

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