• Title/Summary/Keyword: 위장성

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EARLY DETECTION OF BEHCET'S DISEASE (베체트병의 조기 진단)

  • Kim, Seung-Hye;Song, Je-Seon;Choi, Hyung-Jun;Son, Heung-Kyu;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.575-579
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    • 2009
  • Behcet's disease(BD) is a multisystem vasculitis that almost any organ in the body may be involved. Its diagnosis bases on clinical criteria in the absence of any specific laboratory test to confirm it. The clinical criteria proposed for the diagnosis for BD include recurrent oral and genital ulceration, skin lesion, ocular changes, and positive response to pathergy test. Besides these essential features, BD may manifest itself on the gastrointestinal tract, central nervous system, and other systemic involvements. Among these clinical features, recurrent oral ulcers are present in most BD patients, often as the initial symptom, preceding other manifestations by many years. Therefore, dentists are in the important position for the early detection and diagnosis of BD. In this case report, we are presenting a case of 6 year-old girl, who came to the pediatric dentistry department for evaluation and treatment of pain and dysphagia caused by severe recurrent oral ulcers. Through taking detailed dental and medical history and clinical examination, we reported the possibility of BD to the medical team and prescribed topical lidocaine to relief pain during swallowing. The medical team, which involved pediatrics, ophthalmology, dermatology, and gastroenterology, finally confirmed BD through various examinations. Detection of the possibility of BD in the dental field helped early diagnosis and proper management by the medical team.

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A case of acquired acrodermatitis enteropathica with a normal serum zinc level but a low level in the hair (혈중 아연 농도는 정상이나 모발 검사에서는 감소된 아연 농도를 보인 일과성 장병성 선단 피부염 1례)

  • Oh, Kyung Il;Kim, Jung Hee;Lee, Ji Eun;Lim, Dae Hyun;Son, Byong Kwan
    • Clinical and Experimental Pediatrics
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    • v.50 no.2
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    • pp.209-212
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    • 2007
  • Acrodermatitis enteropathica (AE) is a rare autosomal recessive disorder of early infancy, and is characterized by periorificial dermatitis, alopecia, and intractable diarrhea. Serum zinc levels are usually low in untreated patients and the oral administration of zinc sulfate can clear skin lesions and other symptoms. Although premature and cow's milk-fed infants are at particular risk of developing AE, there have been a few reports about AE in term and breast-fed infants. We report a case of transient AE in a 4-month-old breast-fed infant. This patient suffered from diarrhea and dermatitis for more than a month. Her skin lesions were erythematous, scaly, crusted, psoriasiform, eczematous, with an eruption at the chin, and a periorificial disposition with involvement of the flexural areas of lower extremities. Her serum zinc level was almost normal at $129{\mu}g/dL$ (reference range: $60-121{\mu}g/dL$), but the zinc level in her hair was low: 8 mg percent (reference range: 10-21 mg percent). Skin biopsy findings were consistent with AE. Seven days after zinc supplementation, the skin lesions and diarrhea improved. The authors recommend that a clinical trial of zinc supplementation be considered in cases where there are suspicious of AE, even when the serum zinc level is normal.

Comparison of Clinical Manifestations of Rotaviral Gastroenteritis between Neonates and Infants (신생아와 영유아 로타바이러스 위장염의 임상 경과에 대한 비교)

  • Park, Min Kyoung;Park, Jae Ock;Kim, Chang Hwi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.153-161
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    • 2006
  • Purpose: This study was designed to investigate rotavirus infection by comparing the clinical characteristics in neonates and infants. Methods: We enrolled 104 neonates and 250 infants wiht gastroenteritis and a rotazyme test positive reaction at the Soonchunhyang University Bucheon Hospital from February 2001 to January 2003. Results: The seasonal peaks of infection in infants occurred from February to June. However, in neonates, it occurred from October to December due to nursery outbreaks. Diarrhea, vomiting, fever and convulsions were significant symptoms in infants; however, metabolic acidosis with dehydration, jaundice, irritability, apnea, bloody stool, gastric residual, grunting, poor oral intake, lethargy as well as fever and diarrhea were more common in the neonates. Upper respiratory infection, pneumonia and bronchitis were present in the infants; however, necrotizing enterocolitis was more commonly observed in the in neonates. Among the patients with rotaviral infection, formula feeding was more popular than breast milk feeding in both the neonates and infants; however, this finding was not statistically significant. Conclusion: Rotavirus can be a significant pathogen in neonates as well as infants. Neonates suffering from fever, poor oral intake, lethargy and apnea should be investigated for rotaviral infection. A new vaccine, rotaviral specific immunoglobulin and treatment guidelines are needed for eradicating rotavirus infection. Further studies on isolation, infection pathway, immune response and treatment of rotavirus are needed.

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A Clinical Study of Congenital Duodenal Obstruction (선천성 십이지장 폐쇄증의 임상적 고찰)

  • Huh, Young-Soo;Suh, Bo-Yang;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.39-48
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    • 1990
  • Congenital duodenal obstruction in the newborn infant may be due to a variety of causes. Duodenal obstruction often presents with bilious vomiting and upper abdominal distention. Diagnosis is usually established on plain x-ray of the abdomen by the classic finding of the double-bubble. In the period July 1986 to June 1990, 16 patients with congenital duodenal obstruction were operated and the following results were obtained. 1. Sixteen patients were comprised of 11 males and 5 females, the ratio of male and female was 2.2:1. 2. Thirteen patients(81%) had been admitted to our hospital during one month of life. 3. Congenital duodenal obstruction was in 16 cases; malrotation in eight(50%), annular pancreas in six(38%), type 1 atresia in one(6%), and wind-sock anomaly in one(6%). 4. There were two premature patients and six patients of small for gestational age. 5. Overall, bilious vomiting, occurring in three fourths, was the single most frequent presenting complaint. 6. Polyhydramnios occurred in two of the patients. 7. Diagnosis was possible with clinical symptom and simple abdomen. 8. The operative procedures performed were ; duodenoduodenostomy in five, duodenojejunostomy in two, excision of wind-sock membrane in one, and Ladd's procedure in eight. 9. A total of ten asociated congenital anomalies were found in six patients. 10. Postoperative complications occurred in five cases(31%).

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Genetic analysis of Campylobacter jejuni isolates from diarrhea patients in Gyeonggi-do (경기도에서 분리된 Campylobacter jejuni의 유전자 패턴 분석 연구)

  • Kim, Woon-Ho;Choi, Ok-Kyung;Jeong, Jin-A;Park, Sung-Hee;Lee, Yea-Eun;Park, Gwang-Hee;Yoon, Mi-Hye
    • Korean Journal of Microbiology
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    • v.54 no.1
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    • pp.31-37
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    • 2018
  • Campylobacter jejuni is an important food-borne pathogen causing gastroenteritis in human. We isolated 208 strains of Campylobacter jejuni from 430 diarrhea patients and food employees with 17 food-poisoning outbreaks between 2014 and 2016 in Gyeonggi area. The strains were tested for genetic relationship and the genotype distribution using PFGE and multiplex-PCR typing. Among the 47 Penner-serotypes known for C. jejuni, it was identified as a genotype consisting of 35 genotypes by multiplex-PCR typing and represented 7 genotypes (HS2, HS4A, HS8, HS15, HS29, HS41, and HS53) in the selected strain. From the PFGE analysis of 11 food-poisoning outbreaks, 5 group of PFGE profile were obtained, and genetic similarity in these clusters ranged from 61.8 to 66.6%. This study examines the genetic diversity of C. jejuni that have been separated in the Gyeonggi area through various genetic analysis methods and identifies the correlation between strains in patients who have been infected with the disease in the future.

Screening of Domoic Acid, a Marine Neurotoxin, in Korean Shellfishes (국내산 패류의 신경독소 domoic acid 검색)

  • Koh, Eun-Mi;Kwon, Hoon-Jeong
    • Korean Journal of Food Science and Technology
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    • v.34 no.6
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    • pp.1130-1133
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    • 2002
  • Domoic acid, and amnesic shellfish poison, is a neurotoxin frequently found in shellfishes. Guidance level for the consumable shellfish has been established as $20\;{\mu}g$ domoic acid/g by Health and Welfare Canada and U.S. FDA. Domoic acid is produced by pennate diatom, a Nitzschia pungens f. multiseries ingested by the shellfish. Content of domoic acid in shellfish samples collected along the Korean shoreline from May to December of 1999 was analyzed. The collection included 1 Gastropoda (Murex shell) and 11 Bivalvias (oyster, little neck clam, orient hard clam, venus clam, surf clam, ark shell, hard-shelled mussel, pen shell, jack-knife clam, pink butterfly shell, and granulated ark shell). Samples were homogenized, extracted with 50% methanol, filtered, and analyzed by reversed-phase liquid chromatography at 242 nm with mobile phase consisting of 10% acetonitrile and 0.1% trifluoroacetic acid. Recovery of the HPLC analysis was 95.80% (${\pm}1.09$). All tested samples showed no domoic acid at the detection limit of 50 ng/g.

Methylenetetrahydrofolate Reductase C677T Polymorphism in Gastric Cancer (위암에서 Methylenetetrahydrofolate Reductase C677T의 유전자 다형성)

  • Seo Won;Park Won Cheol;Lee Jeong Kyun;Kim Jeong Jung
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.10-15
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    • 2005
  • Purpose: Recently the role of vitamins, folate in particular, has been emphasized in the maintenance of health. Folate deficiency is known to give rise to developmental delay, immature vascular disease, neural tube defect, acute leukemia, atherosclerotic vascular disease, delivery defects, breast cancer, and particularly gastrointestinal neoplasia. Methylenetetrahydrofolate reductase (MTHFR) is an essential enzyme in folate metaboism, and influences DNA synthesis and DNA methylation. Generally, folate deficiency is associated with gastrointestinal neoplasms. The amino-acid- changing and enzyme-activity-reducing nucleotide polymorphism (766C$\rightarrow$T/ Ala222Val) has been described in the MTHFR polymorphism and leads to low enzyme activity that may reduce the capacity of DNA methylation and possibly uracil mis-incorporation into DNA. These processes may be critical in the oncogenic transformation of human cells, especially in colorectal carcinomas. We investigated the relationship between the MTHFR polymorphism in gastric cancer and the tumor site, the smoking history, and the alcoholic history. Materials and Methods: Ninety-six (96) individuals with gastric cancer and 287 healthy persons were analyzed. Blood sampling was performed, PCR-RFLP was analyzed, and MTHFR polymorphism genotypes of C/C, C/T, and T/T were obtained and analyzed statistically for their correlation. Results: In the gastric cancer group there were 69 ($72\%$) males and 27 ($28\%$) females. There were also 58 cases ($60\%$) involving the gastric lower body, 20 cases ($21\%$) the gastric mid-body, and 18 cases ($19\%$) the gastric upper body. In the control group there were 169 ($59\%$) males and 118 ($41\%$) females. Among the gastric cancer, 56 ($61\%$) smoking patients, 40 ($39\%$) non-smoking patients, 45($47\%$) alcoholic patients, 51 ($53\%$) non-alcoholic patients. In the gastric cancer group, MTHER polymorphisms were C/C in 18 ($19\%$) cases, C/T in 59 ($61\%$) cases, T/T in 19 ($20\%$) cases. In the control group polymorphisms were C/C 116 ($40\%$) cases, C/T 103 ($36\%$) cases, and T/T 68 ($24\%$) cases (P=0.045). In cases of lower gastric body cancer, polymorphisms were C/C in 16 ($24\%$) C/C in 16 ($24\%$) cases and C/T or T/T in 42 ($72\%$) cases. In cases of upper and mid-body cancer, polymorphisms were C/C in 2 ($5\%$) cases and C/T or T/T 36 ($95\%$) cases (P=0.006). In the non-smoking patient group, polymorphisms were C/C in 5 (12%) cases and C/T or T/T in 35 ($88\%$) cases. In the smoking patient group, C/C in 13 ($23\%$) cases and C/T or T/T in 43 ($77\%$) cases (P=0.189). In the non-alcoholic patient group, polymorphisms were C/C in 6 ($12\%$) cases and C/T or T/T in 45 ($88\%$) cases. In the alcoholic patient group, polymorphisms were C/C in 12 ($26\%$) cases and C/T or T/T in 33 ($74\%$) cases (P=0.063) Conclusion: MTHFR polymorphisms are associated with gastric cancer and tumor site, but not with smoking and alcohol drinking.

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Dose Response Relationship in Local Radiotherapy for Hepatocellular Carcinoma (원발성 간암의 국소 방사선치료 시 선량반응 관계)

  • Park Hee Chul;Seong Jinsil;Han Kwang Hyub;Chon Chae Yoon;Moon Young Myoung;Song Jae Seok;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.118-126
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    • 2001
  • Purpose : In this study, it was investigated whether dose response relation existed or not in local radiotherapy for primary hepatocellular carcinoma. Materials and Methods : From January 1992 to March 2000, 158 patients were included in present study. Exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child's class C, tumors occupying more than two thirds of the entire liver, and performance status on the ECOG scale of more than 3. Radiotherapy was given to the field including tumor with generous margin using 6, 10-MV X-ray. Mean tumor dose was $48.2{\pm}7.9\;Gy$ in daily 1.8 Gy fractions. Tumor response was based on diagnostic radiologic examinations such as CT scan, MR imaging, hepatic artery angiography at $4\~8$ weeks following completion of treatment. Statistical analysis was done to investigate the existence of dose response relationship of local radiotherapy when it was applied to the treatment of primary hepatocellular carcinoma. Results : An objective response was observed in 106 of 158 patients, giving a response rate of $67.1\%$. Statistical analysis revealed that total dose was the most significant factor in relation to tumor response when local radiotherapy was applied to the treatment of primary hepatocellular carcinoma. Only $29.2\%$ showed objective response in patients treated with dose less than 40 Gy, while $68.6\%\;and\;77.1\%$ showed major response in patients with $40\~50\;Gy$ and more than 50 Gy, respectively. Child-Pugh classification was significant factor in the development of ascites, overt radiation induced liver disease and gastroenteritis. Radiation dose was an important factor for development of radiation induced gastroduodenal ulcer. Conclusion : Present study showed the existence of dose response relationship in local radiotherapy for primary hepatocellular carcinoma. Only radiotherapy dose was a significant factor to predict the objective response. Further study is required to predict the maximal tolerance dose in consideration of liver function and non-irradiated liver volume.

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Lead Concentrations of Pigeon's Tissue as Indicator of Lead pollution in Air and Soil (대기 및 토양 오염의 지표로서 비둘기 조직의 연농도)

  • Byun, Yung-Woo;Hwang, Tae-Yoon;Lee, Jung-Jeung;Kim, Chang-Yoon;Chung, Jong-Hak
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.1 s.52
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    • pp.15-26
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    • 1996
  • It has been studied that a variety of fauna and flora are sensitive biological indicators which reflect the severity of regional pollution of heavy metals, but in the center of part of Taegu City the controversial issue of lead poisoning attributable to the atmosphere which contains an increased concentrations of lead has been raised recently, it is usually hard to find suitable plants or animal in the areas with heavy traffic. Pigeons are ubiquitous in and around Taegu City area, inhabiting even the most densely populated areas with heavy traffic. With its small body size, high metabolic turnover, and rather limited mobility, a pigeon, as a biological indicator is expected. This study was conducted to monitor lead pollution in the Taegu and Kyongju City in Korea. We measured the lead content of the various tissue of three groups of feral pigeon(Columba livia) and soil and atmospheric lead concentration. First group was obtained in heavy traffic area in Taegu City, the second group was obtained a park in Taegu City and the third group was obtained light traffic area in Kyongju City. The air and soil lead concentration of heavy traffic area in Taegu City was $0.11{\mu}g/m^3,\;4.96{\mu}g/g$, that of park in Taegu City was $0.05{\mu}g/m^3,\;2.65{\mu}g/g$ and that of light traffic area in Kyongju City was $0.03{\mu}g/m^3,\;0.01{\mu}g/g$. The lead content of lung, blood, kidney, femur and liver of feral pigeons in heavy traffic area in Taegu City was significantly higher than pigeons obtained in a park in Taegu City and low traffic density area in Kyongju City(p<0.01). But stomach lead content of three group did not reflect a significant difference. In this study positive correlation was found between atmospheric lead concentrations and the concentration of lead in the pigeon's lung(r=0.5040, p<0.001), blood(r=0.3322, p<0.01), kidney(r=0.4824, p<0.001), femur(r=0.7214, p<0.001) and liver(r=0.4836, p<0.01). We can also found positive correlation between soil lead concentrations and the concentration of lead in the pigeon's femur(r=0.4850, p<0.001), kidney(r=0.4850, p<0.001) and liver(r=0.4386, p<0.01). In the pigeon's tissue there were significant correlations between concentration of lead in the blood and kidney(r=4818, p<0.001), femur(r=0.6157, p<0.001) and liver(r=0.3889, p<0.001). In conclusion, at the heavy traffic area in Taegu City, lead concentrations found in the atmosphere and soil are reflected in the lead concentrations of different tissue of urban pigeons. It is suggested that the tissue of pigeons can be good biological indicators of environmental lead pollution.

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A Case of Pulmonary Langerhans Cell Histiocytosis associated with Central Diabetes Insipidus in Adult -A case report - (성인에서 발견된 중추성 요붕증이 합병된 폐 랑게르한스 세포 조직구증 -1예 보고-)

  • Yoo Byung Su;Lee Jae Woong;Jo Tae Jun;Hong Ki Woo;Kim Kun Il;Lee Weon Yong;Kim Dong Gyu;Jun Sun Young
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.866-869
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    • 2005
  • Langerhans Cell Histiocytosis (LCH) is a pathologic proliferation and infiltration of various organs by Langerhans' cells of unknown cause. Incidence rate of one million parties 3$\∼$4 is seen in young child but the incidence is not sure in adult. Organ systems involved by LCH may include skin, ear, bone marrow, liver, spleen, lung, pituitary gland - hypothalamus and Gl tracts. In case pituitary-hypothalamus axis are involved, diabetes insipidus happened. Primary Pulmonary Langerhans Cell Histiocytosis(PLCH) with uninvolvement of other organs is rare and accompanied diabetes insipidus is more rare. There are many cases of LCH with diabetes insipidus involve such as central nervous system except lung. PLCH accompany central diabetes insipidus is only 1 case. We report a case of PLCH that accompany central diabetes insipidus with literature investigation in Department of Thoracic and Cardiovascular Surgery, Hallym University.