Purpose: To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is knwon as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management. Methods: A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions. Results: 1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms. Conclusions: Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.
Han Byong-Mu;Cho Jin-Youl;Chuon Ko-Woon;NamGoong Mee-Kyung
Childhood Kidney Diseases
/
v.7
no.2
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pp.150-156
/
2003
Purpose : Efforts to predict the clinicopathological outcome of IgA nephropathy have been made but have yielded conflicting results and have not helped in deciding the appropriate timing of the renal biopsy. In this study, we reviewed the predictive factors of clinicopathological outcome for finding out the criteria of renal biopsy timing of IgA nephropathy. Methods : Forty children diagnosed with biopsy proven IgA nephropathy at Wonju Christian Hospital were studied retrospectively, based on medical records. Results : Among 39 patients, 2 children progressed to higher serum creatinine level. One of them reached to the end stage renal disease within 2 year 7 months. According to WHO histopathological classification, there were 15 cases of class I, 14 cases of class II, 7 cases of class III, and 3 cases of class IV. In the mild histological classes(class I, II), gross hematuria was shown in 23 out of 29 children(P=0.02). In the severe histological classes(class III, IV), gross hematuria was noted in 4 out of 10(P>0.05). The tubulointerstitial changes were grade 1 in 24 cases, grade 2 in 4 cases, grade 3 in 8 cases, and grade 4 in 3 cases. With an increase in the tubulointerstitial grade, the 24 hour urine protein/albumin ratio increased. Serum creatinine less than 0.79 mg/dL could predict the lower grade(grade 1 and 2) of tubulointerstitial changes. But serum creatinine greater than 1.13 mg/dL could predict the higher grade(grade 3 and 4) of tubulointerstitial changes. In children with gross hematuria(n=27), serum creatinine was lower(0.78 vs 1.09 mg/dL, P=0.027), serum IgA was higher(316.3 vs 198.8 mg/dL), and the cases of lower WHO classification(I and II) were more common(23 vs 4, P=0.029) than the children with microscopic hematuria. Conclusion : Serum creatinine less than 0.79 mg/dL, macroscopic hematuria, and higher 24 hour urine protein/albumin ratio would predict the lower grade glomerulo tubulointerstitial lesion in IgA nephropathy and could be used as the criteria delaying the renal biopsy.
The non-ionic surfactant (NIS) Tween 80 was evaluated for its ability to influence invitro cumulative gas production, dry matter digestibility, cellulolytic enzyme activities, anaerobic microbial growth rates, and adhesion to substrates by mixed rumen microorganisms on rice straw, alfalfa hay, cellulose filter paper and tall fescue hay. The addition of NIS Tween 80 at a level of 0.05% increased significantly (P<0.05) in vitro DM digestibility, cumulative gas production, microbial growth rate and cellulolytic enzyme activity from all of substrates used in this study. In vitro cumulative gas production from the NIS-treated substrates; rice straw, alfalfa hay, filter paper and tall fescue hay was significantly (P<0.05) improved by 274.8, 235.2, 231.1 and 719.5% compared with the control, when substrates were incubated for 48 hr in vitro. The addition of 0.05% NIS Tween 80 to cultures growing on alfalfa hay resulted in a significant increase in CMCase (38.1%), xylanase (121.4%), Avicelase (not changed) and amylase (38.2%) activities after 36 h incubation. These results indicated that the addition of 0.05% Tween 80 could greatly stimulate the release of some kinds of cellulolytic enzymes without decreasing cell growth rate in contrast to trends reported with aerobic microorganism. Our SEM observation showed that NIS Tween. 80 did not influence the microbial adhesion to substrates used in the study. Present data clearly show that improved gas production, DM digestibility and cellulolytic enzyme activity by Tween 80 is not due to increased bacterial adhesion on the substrates.
To investigate the molecular mechanism of the airway inflammation by Pseudomonas fluorescens, effects on the inflammatory mediators such as interleukin-8 (IL-8), cyclooxygenase-2 (COX-2), macophage inhibitory cytokine 1 (MIC-1) were assessed in the human alveolar epithelial cells. Exposure to P. fluorescens and its recombinant bacteria suppressed cellular viability in the A549 epithelial cells and pro-inflammatory cytokine interleukin-8 production. However, pro-inflammatory prostaglandin-producing COX-2 protein was not altered by P. fluorescens though its mRNA was slightly elevated. As the inhibitory cytokine for the pro-inflammatory mediators, MIC-1 expression was monitored in A549 cells. MIC-1 gene induction was not significantly enhanced but the protein processing was changed by exposure to P. fluorescens. Pro-protein form of MIC-1 (${\sim}40\;kD$) was cleaved into active form mature MIC-1 (${\sim}15\;kD$) and propeptide (${\sim}28\;kD$) by the bacteria exposure. MIC-1 activation can contribute to the suppression of cellular viability by P. fluorescens and can retard IL-8-induced monocyte recruitment. However, sustained activation of MIC-1 can mediate the tissue injury by P. fluorescens exposure.
Purpose: The purpose of this study is to evaluate migration of technetium-99m hexamethylpropylene amine oxime ($^{99m}Tc$-HMPAO) labeled immature and mature dendritic cells (DC) in the mouse. Methods: DC were collected from bone marrow (BM) of tibiae and femurs of mice. Immature and mature DC from BM cells were radiolabeled with $^{99m}Tc$-HMPAO. To evaluate the functional and phenotypic changes of DC from radiolabeling, the allogeneic mixed lymphocyte reaction (MLR) and fluorescence-activated cell sorting (FACS) analysis were performed before and after labeling with $^{99m}Tc$-HMPAO. Migration of intravenously injected DC (iv-DC) was assessed by serial gamma camera images of mice with or without subcutaneous tumor. Percent injected dose per gram (%ID/g) was calculated in lungs, liver, spleen, kidneys, and tumor through dissection of each mice after 24 hours of injection. Results: Labeling efficiency of immature and mature DC were $60.4{\pm}5.4%\;and\;61.8{\pm}6.7%$, respectively. Iv-DC initially appeared in the lungs, then redistributed mainly to liver and spleen. Migration of mature DC to spleen was significantly higher than that of immature DC ($38.3{\pm}4.0%\;vs.\;32.2{\pm}4.1%$ in control group, $40.4{\pm}4.1%\;vs.\;35.9{\pm}3.8%$ in tumor group; p<0.05). Migration to tumor was also significantly higher in mature DC than in immature DC ($2.4{\pm}0.3%\;vs\;1.7{\pm}0.2%$; p=0.034). Conclusion: Assessment of migration pattern of DC in mice was possible using $^{99m}Tc$-HMPAO labeled immature and mature DC. Migration of mature DC to spleen and tumor was higher than that of immature DC when they were i.v. injected.
Purpose: The purpose of this study was to evaluate and compare the scintigraphic findings and diagnostic accuracy of double-phase Tc-99m sestamibi scan in primary and secondary hyperparathyroidism (HPT). Materials and Methods: We retrospectively reviewed 16 cases of primary (18 lesions) and 11 cases of secondary HPT (44 lesions) who underwent Tc-99m-sestamibi scan before the surgical intervention. Scan was performed using LEM camera (Siemens, Germany) after the injection of 740MBq of Tc-99m sestamibi. Routine image consisted of baseline and 3-hour delayed images and each image was obtained using both parallel and pine hole collimator. The study population was 27 patients (male/female=5/22, age: $49.1{\pm}10.8$). Results: Eighteen lesions of primary HPT consisted of 13 adenomas and S hyperplasias, while all lesions of secondary HPT were hyperplasias. Among the case of primary HPT, we could detect all the lesions of 13 adenomas but only 2 lesions of 5 hyperplasias (40%) could be detected by double phase scintigraphy. Three cases of primary lesion showed decreased uptake in delayed images compared with baseline. The sensitivity, specificity, positive predictive value and accuracy of primary and secondary HPT were 58.8% (10/17), 83.3% (10/12), 83.3% (10/12), 75.9% (22/29), and 37.5% (15/40), 50% (2/4), 88.2% (15/17), 38.6% (17/44), respectively. Overall sensitivity, specificity, positive predictive value and accuracy were 43.9% (25/57), 75% (12/16), 86.2% (25/29), and 53.4% (39/73). There were no statistical difference between the weight of primary and secondary HPT lesion (p>0.05). Conclusion: Tc-99m sestamibi scan is fairly good modality to detect parathyroid lesion in patient with primary HPT before the surgical intervention. However, since some of cases may reveal decreased uptake in delayed image, a careful attention to the findings of baseline images may be helpful. Still the low accuracy of sestamibi scan in diagnosis of secondary HPT prohibits routine use of it for this disease.
Kim, Joo-Yeon;Lee, Han-Wool;Kwon, O-Jun;Kim, Jung-Yul;Park, Min-Soo;Cho, Seok-Won;Kang, Chun-Goo;Kim, Jae-Sam
The Korean Journal of Nuclear Medicine Technology
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v.19
no.1
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pp.37-43
/
2015
Purpose $^{99m}Tc-DMSA$ renal scintigraphy serves as location, size and shape of kidney, so it has been used for diagnosis and passage observation after the operation or treatment. There are 3 methods of calculating the relative renal uptake ratio such as geometric mean of the counts from the anterior and posterior views, arithmetical mean from the only posterior view and posterior view which applied the renal depths. In this study, we seek to correlation between the change of total relative uptake ratio according to different inspection methods of obtaining the renal count rate. Materials and Methods The phantom experiments proceeded 5 times depending on each renal depth with the kidney phantom and tissue equivalent materials. In the clinical research, we investigated 36 adult patients who had visited our hospital from february to october, 2014 and received $^{99m}Tc-DMSA$ renal scan. The equipment was used as a gamma camera named INFINIA (General Electric Healthcare, milwaukee, USA) and we drew the region of interests through semiautomatic method by using Xeleris Ver. 2.1220 of GE. In addition, we obtained the lateral view of kidney to measure the renal depth of each patient. Then the results were compared with 3 methods of calculating relative renal uptake ratio. Results The phantom studies show when the difference between the left ant right kidney depth were less than 1 cm, there were no statistically significant difference among values calculated through anterior and posterior views and only posterior view (P>0.05), while the excess of 1cm, the results showed a statistically significant change in the value (P<0.05). In case of clinical research, the correlation between total relative uptake ratio by obtaining both sides of image and posterior view applied the kidney depth (r=0.999) was higher than by obtaining only posterior view and applying the kidney depth to one side image (r=0.988). Conclusion This study has found that, the difference of calculating total relative uptake ratio compared with obtaining anterior and posterior views and only posterior view. In order to reduce the error, we recommend the method of obtaining anterior and posterior views and is considered to be useful, particularly the patients have similar uptake ratio of left and right kidney and difficulties of measurements of kidney depth.
The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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v.8
no.4
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pp.401-410
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2003
Three beaches of the Seogwang-ri coast in the western part of Wu Island, Jeju-do, are solely composed of rhodoliths (red algal nodules). The beach sediments are coarse sand to granule in size and they show the banded distribution according to size. Commonly the larger pebble-sized rhodoliths are concentrated near the rocky coast, resulting from the transportation of the nodules from shallow marine environments by intermittent typhoons. Based on the internal texture of the rhodoliths, it appears that crustose red algae, Lithophyllum sp., is the main contributor for the formation of the rhodolith. The coarse sand to granule-sized grains show that they started to grow from the nucleus as rhodoliths, but the surface was severely eroded by waves. However, the pebble to cobble-sized grains exhibit the complete growth pattern of rhodoliths and sometimes contain other calcareous skeletons. It is common that encrusting red algae are intergrown with encrusting bryozoan. The surface morphology of rhodolith tends to change from the concentric to domal shape towards the outer part. This suggests that the rhodolith grew to a certain stage by rolling, but it grew in more quiet condition without rolling as it became larger. Aragonite and calcite cements can be found in the pores within rhodoliths (conceptacle, intraskeletal pore in bryozoan, and boring), and this means that shallow marine cementation has occurred during their growth. Growth of numerous rhodoliths in shallow marine environment near the Seogwang-ri coast indicates that this area has suitable oceanographic conditions for their growth such as warm water temperature (about 19$^{\circ}C$ in average) and clear water condition due to the lack of terrestrial input of volcanoclastic sediments. Fast tidal current and high wave energy in the shallow water setting can provide suitable conditions enough for their rolling and growth. Typhoons passing this area every summer also influence on the growth of rhodoliths.
This study was performed to investigate the reduction in bitter taste and quality characteristics by pretreatments (brining; 1, 5% and blanching; 1, 3 min) in pickled bitter melon, respectively. We prepared picked bitter melon samples at 1%-1 min, 1%-3 min, 5%-1 min, 5%-3 min. Total polyphenol and total flavonoid contents were found to be the highest in 5%-1 min at $14.23{\pm}0.40mg\;CE/g$ (dry) and $4.46{\pm}0.10mg\;RE/g$ (dry), respectively. L-ascorbic acid level was the highest in control samples. Arginine and glutamic acid were increased by brining and blanching. ABTS and DPPH radical scavenging activity were found to be the highest at $43.60{\pm}0.40$ and $44.88{\pm}0.20%$ at 5%-1 min, respectively. ${\alpha}-glucosidase$ inhibitory activity was the highest at 5%-1 min. The a value was statistically different, whereas L and b values were similar among different pretreatments. Hardness in pretreated samples was decreased as compared to that in the control. Among sensory evaluations, 'color' did not indicate any statistical difference, while 'texture', 'bitterness preference' and 'overall preference' increased with pretreatments, and 'bitter intensity' decreased.
This study mainly focused on to investigate the effects of Schizandra chinensis on the growth of a bacterium, CS6 which was isolated from kimchi. CS6 was final]y identified to lactobacillus plantarum that caused acidification of kimchi. The ethanolic extract of Schizandra chinensis(EES) inhibited the growth of L. plantarum. Minimum inhibition concentration of crude EES on L. plantarum was 62.5mg/$m\ell$. In broth culture, 5$\mu\textrm{g}$/$m\ell$ of EES completely inhibited the growth of L. plantarum during fermentation. The addition of 0.4% of EES has no apparent effect on quality including the taste and color on kimchi. It was expected that EES-containing kimchi could extend the period of preservation. Analysis of organic acids in water fractions of EES was carried out by HPLC. It is apparent that antimicrobial active fractions contained the highest concentration of succinic acid, a little tartaric acid and malic acid. Among these organic acids, succinic acid showed the strong inhibitory effect against L. plantarum CS6 in vitro. Succinic acid-containing kimchi with a concentration of 0.4 and 0.5% had the inhibitory effect on growth of L. plantarum. Inhibitory effect of EES on amylase, cellulase and pectinase was also tested. In conclusion, the present experiment demonstrated that EES inhibited the growth of L. plantarum, and various enzyme activity. EES-containing kimchi was sustained the hardness, and initial acidity during fermentation. EES was considered as the possible additive of kimchi process and EES added in kimchi increase the quality, and storage period of kimchi.
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