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Clinical Characteristics of Orbital Cellulitis in Children (소아 안와 연조직염의 임상적 고찰)

  • Lee, Yong Ju;Choi, Kyoung Min;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.178-185
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    • 2005
  • Purpose : Ocular adnexal and orbital infections are broadly divided into preseptal(periorbital) and postseptal(orbital) cellulitis by orbital septum. In this study, we investigated the difference between periorbital and orbital cellulitis regarding their pathogenesis, clinical manifestations, treatments, and prognosis. Methods : We reviewed medical records of 50 cases who were hospitalized in the Severance hospital due to orbital cellulitis from May 1995 to April 2004. Results : There were 32 males and 18 females. The mean age was $3.2{\pm}3.5$ year. According to the result of orbital computerized tomography, 36 cases were periorbital cellulitis, 10 cases orbital cellulitis and 4 cases not diagnosed. The clinical manifestations of periorbital cellulitis are periorbital swelling(100%), fever(19%), orbital pain(6%), and chemosis(22%). On the other hand, those of orbital cellulitis are periorbital swelling(100%), fever(80%), orbital pain(60%), proptosis(20%), chemosis(70%) and limitation of eye movement(20%). The etiologies of periorbital cellulitis are sinusitis(14%), upper respiratory infection(8%), conjunctivitis (19%), skin wound(14%) and unknown(44%). The etiologies of orbital cellulitis are sinusitis (50%), upper respiratory infection(20%), and unknown(30%). The first line antibiotics used in the majority of cases were combinations of cefoxitin+aminoglycoside. 5 patients with orbital cellulitis taking cefoxitin+aminoglycoside had to change the medication into vancomycin or clindamycin. 3 patients with orbital cellulitis underwent operation while 1 patient developed bacterial meningitis. Conclusion : According to invasion of orbit, ocular adnexal and orbital infections are quite different in their pathogenesis, treatment and prognosis. As atypical cases may confound the diagnosis, prompt orbital computerized tomography is required for an accurate diagnosis.

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Analysis of causative microorganisms and choice of antibiotics according to the onset of neonatal sepsis (신생아 패혈증에서 발현시기에 따른 원인균 분석과 항생제 선택)

  • Sung, June Seung;Kim, Dong Yeon;Kim, Sun Hee;Byun, Hyung Suk;Hwang, Tai Ju;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.623-629
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    • 2006
  • Purpose : The mortality rate of neonatal sepsis has been decreased, however, the incidence has not significantly decreased because of increased invasive procedures. This study was designed to make guidelines for choosing antibiotics by analyzing the causative microorganisms and their antibiotics sensitivity test according to the onset of neonatal sepsis. Methods : One hundred seven cases of culture proven sepsis in 89 patients admitted to the NICU of Chonnam University Hospital from Jan. 2000 to Dec. 2004, were enrolled. By reviewing the medical records, clinical data, laboratory findings, causative organisms and their antibiotics sensitivity, and mortality were analyzed. Results : The incidence of neonatal sepsis was 1.7 percent and more prevalent in premature and low birth weight infants. 85.4 percent of neonatal sepsis was late onset. Almost all microorganisms(92.9 percent) were gram-positive in early onset, however, two thirds were gram-positive and one third were gram-negative and Candida in late onset. Gram-negative organisms and Candida were more prevalent in patients who had central line. Gram-positive organisms were sensitive to vancomycin, teicoplanin, and gram-negative were sensitive to imipenem, and cefotaxime. Conclusion : Neonatal sepsis was more prevalent in premature and low birth weight infants. More than 90 percent were gram-positive in early onset, however, one third was gram-negative and Candida in late onset. The first choice of antibiotics were a combination of third generation cephalosporin and clindamycin in early onset, and third generation cephalosporin and glycopeptide in late onset. If there is no response to antibiotics treatment, the use of antifungal agents should be considered.

Association study of polymorphism in leukotriene C4 synthase and cysteinyl leukotriene receptor 1 genes with phenotype of asthma and clinical parameters in Korean children (Leukotrienes C4 synthase와 cysteinyl leukotriene receptor 1 유전자 다형성과 한국 소아 천식 표현형 및 임상 지표와의 연관성 연구)

  • Shim, Jung Yeon;Kim, Byung-Joo;Song, Young Hwa;Kang, Mi-Jin;Lee, So-Yeon;Kim, Hyo-Bin;Yu, Jinho;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.680-688
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    • 2009
  • Purpose : Cysteinyl leukotrienes are important proinflammatory mediators in asthma. Recently, it was suggested that a promoter polymorphism in the genes encoding for leukotriene C4 synthase (LTC4S), a key enzyme in the leukotriene synthetic pathway, and cysteinyl leukotriene receptor 1 (CysLTR1) might be associated with aspirin-intolerant asthma. We investigated whether polymorphisms in LTC4S and CysLTR1 genes or their interactions were associated with the asthma phenotype, lung function, or bronchial hyperreactivity (BHR) in Korean children. Methods : A total of 856 asthmatic children and 254 non-asthmatic controls were enrolled; a skin prick test, lung function test and bronchial provocation test were performed. Of those enrolled, 395 children underwent exercise challenge tests. The LTC4S A(-444)C and CysLTR1 T(+927)C were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis. Results : Of those enrolled, 699 children were classified as having atopic asthma and 277 children, as having exercise-induced asthma (EIA). LTC4S and CysLTR1 polymorphisms were not associated with atopic asthma, EIA, or asthma per se. Lung function and BHR were not significantly different between the wild type (AA or TT) and the variant (AC+CC or TC+CC) genotypes in asthmatics, atopic asthmatics, and EIA (+) asthmatics, while total eosinophil counts were higher in the variant type of LTC4S than in the wild type in atopic asthmatics. There were no associations between the gene-gene interactions of LTC4S and CysLTR1 genotypes and the asthma phenotypes. Conclusion : LTC4S A(-444)C and CysLTR1 T(+927)C polymorphisms and their gene-gene interactions are not associated with asthma phenotype, lung function, or BHR in Korean children.

Pulmonary tuberculosis misdiagnosed as lung Metastasis in childhood cancer patients (소아암 환자에서 암의 전이로 오인된 폐결핵)

  • Lee, Hyun-Jae;Kim, Dong-Whan;Lee, Kang-Min;Park, Kyung-Duk;Lee, Jun-Ah;Cho, Soo-Yeon;Kook, Yoon-Hoh;Kim, Hee-Youn;Kim, Dong-Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.904-909
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    • 2009
  • Purpose : The differential diagnosis for a pulmonary nodule is intriguing in cancer patients. Metastasis might be a preferential diagnosis, and yet possibilities of other medical conditions still exist. Pulmonary tuberculosis should be enlisted in the differential diagnosis for a pulmonary nodule in cancer patients in Korea. This study was aimed at analyzing the incidence and clinical features of pulmonary tuberculosis that were misdiagnosed as pulmonary metastasis during radiologic follow-up in pediatric cancer patients. Methods : We retrospectively studied 422 cancer patients less than 18 years old in the Korea Cancer Center Hospital from January 2001 to June 2007. We collected episodes of lung metastasis of primary tumor and tuberculosis during treatment or follow-up, and analyzed medical records. Results : There were 5 cases of tuberculosis confirmed after surgery which were initially regarded as cancer. Two patients had respiratory symptoms such as cough and sputum but the other 3 patients did not. One patient had a family history of tuberculosis. Acid-fast M. tuberculosis was found in one case upon tissue specimen analysis. Two cases were Mantoux positive and the sputum examination was negative in all cases. The polymerase chain reaction for tuberculosis on a pathologic specimen was used to differentiate M. tuberculosis from non-tuberculosis mycobacterium (NTM). It was positive in one case. Lung lesions in one case showed a concurrence of tuberculosis along with lung metastasis. One of these patients died after cancer recurrence. Conclusion : It is necessary to consider the possibility of tuberculosis when a lung mass is newly detected during treatment or follow-up in patients with childhood cancer.

The Development of a Cryotherapy System (한냉물리치료기의 개발)

  • Kim, Yeong-Ho;Yang, Gil-Tae;Jang, Yun-Hui;Park, Si-Bok;Ryu, Jin-Sang
    • Journal of Biomedical Engineering Research
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    • v.19 no.6
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    • pp.617-622
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    • 1998
  • A cryotherapy system using cold air was developed. The developed system had superior low-temperature characteristics with various flow rates and nozzle sizes, and used R-404A, as a coolant, which has no destructive effects of Ozone layers. Flow rates and the treatment time can be easily altered during the operation. In addition, and alarm system was designed for the overload, overheat, and over-charge of the machine. For clinical applications, skin temperatures, intra-articular temperatures of the knee joint and intra-muscluar temperatures of the gluteal muscles were measured during and after the cryotherapy. After a 5-minute therapy, skin and intra-articular temperatures decreased by $23.3{\pm}4.7 and 4.1 {\pm}1.0^{circ}C$, respectively. A 5-minute cryotherapy was good enough to maintain low intra-articular temperatures for 2-3 hours. Resting intra-muscular temperatures in 2, 4, and 6cm deep in the gluteal muscle were $36.5{\pm}1.2, 36.9{\pm}0.2, 37.1{\pm}0.2^{circ}C$, respectively (p<0.05). Lowest temperatures in 2, 4, and 6cm depth were $35.1{\pm}0.7, 36.2{\pm}0.4, 36.9{\pm}0.3^{circ}C$, respectively (p<0.05). Temperatures after a 2-hour cold air application on the skin and in the muscle in dept도 of 2, 4, and 6cm were $32.2{\pm}1.1, 36.2{\pm}0.5, 36.6{\pm}0.3, 36.9{\pm}0.3^{circ}C$respectively (p<0.05). Temperatures on the skin and in the muscle significantly decreased after 2 hours, compared with before cold air application (p<0.05). The intra-muscular temperature was changed more slowly than the skin temperature, and the deeper the muscle, the lesser temperature changes. The effect of a 5-minute cold air application lasts up to 2 hours, and it seems that the rebound-rise of the temperature dut to the reactive vasodilatation does not occur in the gluteal muscle.

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Studies on the Storage Stability of Traditional Andong sikhe using Lactobacillus delbreuckii (Lactobacillus delbreuckii를 이용한 전통안동식혜의 저장 안정성)

  • Choi, Cheong;Son, Gyu-Mok;Woo, He-Sob
    • Journal of the Korean Society of Food Culture
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    • v.7 no.4
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    • pp.329-338
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    • 1992
  • This study was attempted aimed to prepare of Andong sikhe by pure culture inoculation and to improve storage stability by the addition of stabilizers to the product. Lactobacillus delbreuckii was selected for pure culture inoculation in the fermentation. The effect of stabilizers on the sedimentation, sensory evaluation and viscosity of Sikhe were investigated during the fermentation of traditional Andong Sikhe stored at $4^{\circ}C$ Morphological characteristics of Sikhe were determined by scanning electromicrograpy. Among the stabilizers added to the traditional Andong sikhe Na-alginate was found to be best stabilizers. When the product was evaluated by the sensory panel, the addition of stabilizers up to 0.1% level actually increased the acceptability of the product, while the concentration of more than 0.2% stabilizers affected the acceptability of the negatively. Sikhe added Na-carboxymethyl cellulose and Na-alginate showed highest viscosity on the 2nd day of fermentation, while homogenized Andong sikhe with Carrageenan showed the highest peak in viscosity on the first day of fermentation. Lactic acid bacterial count reached to $3.2{\times}10^8/ml$ after 20 days of storage. The surface and cross section of rice was observed by scanning electron microscope. As the fermentation proceeded holes on the surface increased, and nearly empty cell wall remained at the later stage of fermentation. Use of pure cultured inoculum of L. delbreuckii supported the rapid build up of the lactic acid bacteria and consequently the whole process of the fermentation was shortened. The acceptability and product quality were improved by use of L. delbreuckii inoculum.

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A Comparison of Illness Behavior among Patients with Somatoform Disorders, Depressive Disorders and Psychosomatic Disorders (신체형장애, 우울장애 및 정신신체장애 환자들간의 질병행동의 비교)

  • Koh, Kyung-Bong;Ki, Sun-Wan
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.2
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    • pp.185-194
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    • 1997
  • A comparison was made regarding illness behavior among patients with somatoform disorders, depressive disorders and psychosomatic disorders. The subjects consisted of out-patients with somatoform disorders(N=52), depressive disorders(N=52) and psychosomatic disorders(N=51). illness behavior was assessed by illness Behavior Assessment Schedule and the questionnaire about help-seeking behavior. The patients with somatoform disorders and psychosomatic disorders more often affirmed the presence of somatic disease, were more likely to have phobia of disease, had more preoccupation with ideas of disease and more frequently shopped around oriental clinics than the patients with depressive disorders. The patients with somatoform disorders more often attributed its cause to physical factors, less often attributed the origin of affective disturbance to psychological causes, showed Less depression and irritability, and were less likely to accept psychiatric treatment recommended by other physicians than depressive patients. The patients with somatoform disorders were more likely to report having been told that they suffered from a mild illness than those with psychosomatic disorders. The patients with somatoform disorders with psychological problems tended to inhibit expression of their emotion. Female patients with somatoform disorders more often affirmed the presence of psychological disorder and attributed its cause to psychological factors than male ones. These results suggest that in illness behavior, patients with somatoform disorders are different from depressive patients, whereas the former patients are similar to psychosomatic patients except the discrepancy between therapists and patients regarding evaluation of their symptoms. Thus, it is emphasized that first, therapists need to approach patients with somatoform disorders somatically with understanding of their underlying need to deny psychological problems, followed by either psychological or biopsychosocial approach.

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Clinical and Laboratory Features of Korean Mucopolysaccharidoses (MPSs) (한국 뮤코 다당체 침착증 환자에 대한 임상적 고찰)

  • Sohn, Woo Yun;Lee, Jee Hyun;Paik, Kyung Hoon;Kwon, Eun Kyoung;Kim, Ahn Hee;Jin, Dong Kyu
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1132-1138
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    • 2005
  • Purpose : The mucopolysaccharidoses (MPSs) are a heterogeneous group of lysosomal storage disorders. They are caused by a deficiency of the enzymes involved in the degradation of glycosaminoglycans. Early recognition is important because recombinant enzyme replacement therapy is now available for MPS. We studied the clinical characteristics of 80 MPS children with the object of determining the epidemiological, clinical and radiological features in Korean MPS children. Methods : Diagnosis of MPS was confirmed by skin fibroblast enzyme analysis in 80 patients between February 1995 and December 2004. Charts were retrospectively reviewed for clinical and radiological findings, as well as for intelligence and speech evaluations. Results : Hunter syndrome (MPS type II) was the most prevalent type, appearing in 51/80 cases (64 %), followed by Sanfilippo syndrome (MPS III-18%), Hurler syndrome (MPS I-15%), and Morquio syndrome (MPS IV-4%). The average age at diagnosis was 5.5 years (range 1 to 20), and the male-to-female ratio was 4.7 : 1. Typical radiographic changes were observed in 45/54 cases (83%). Mitral regurgitation was the most common cardiac defect. Moderate to profound mental retardation and hearing loss were present in 14/35 cases (56%) and 33/38 cases (82%), respectively. Four MPS II patients had bone marrow transplantation, with mixed outcomes. Five MPS I patients are currently on enzyme replacement therapy. Conclusion : Our study showed a high proportion of MPS II cases (64%), which may represent population variability. By studying the clinical features of these patients, we hope to alert pediatricians of the warning signs of MPS.

The Etiologic Diseases and Diagnostic Usefulness of Color Doppler Ultrasonography in Children with Chronic Coughs (소아 만성 기침의 원인 질환과 컬러 도플러 초음파 검사의 진단적 유용성)

  • Park, Sun Young;Lee, Joon Sung
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.489-497
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    • 2002
  • Purpose : The objectives of this study were to investigate the causes of chronic cough and to establish the appropriate diagnostic approach to chronic cough in children. Methods : One hundred and thirty two cases of chronic cough were prospectively evaluated. They visitors to pediatric chronic cough clinics at Kang-nam saint Mary's Hospital of Catholic University from August 2000 to July 2001 for 12 months. Careful history taking by questionnaire, physical examination, radiologic studies of chest and sinus, hematologic and immunologic studies, allergic skin tests, and methacholine challenge tests were performed. Color doppler(CD) ultrasonography were performed and compared with simultaneous 24 Hr. esophageal pH monitoring to diagnose gastroesophageal reflux disease(GERD). Results : Age distributions were demonstrated that nine in infants, 82 in early childhood, 38 in late childhood, and three in adolescence. Common causes of chronic cough were bronchial asthma in 40 cases, chronic sinusitis in 22 cases, GERD in seven cases, bronchial asthma combined with sinusitis in 28 cases, bronchial asthma combined with GERD in 14 cases, psychogenic cough in two. cases, foreign body in one case, chronic bronchitis in one case, and bronchiolitis in one case. Comparing with 24 Hr. pH monitoring, sensitivity, specificity, positive predictive value and negative predictive values of CD ultrasonography were 88%, 69%, 85 %, and 73% respectively. Conclusion : The most common causes of chronic cough in children were bronchial asthma, sinusitis and GERD in order. We suggest that CD ultrasonography can be used as a good, convenient screening method for patients with suspected GERD in outpatient settings.

Anti-oxidative Activities of Castanea crenata Leaf Extract/Fractions and Application on Cosmetics (밤나무 잎 추출물의 항노화 활성 및 화장품에의 응용( I ))

  • Kim, Jin-Young;Park, Soo-Nam
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.34 no.4
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    • pp.259-268
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    • 2008
  • In this study, the antioxidative effects, inhibitory effects on tyrosinase and elastase and components of Castanea crenata leaf were investigated. The free radical (1,1-diphenyl-2-picrylhydrazyl radical, DPPH) scavenging activity ($FSC_{50}$) of extract / fractions of Castanea crenata left was in the order: 50% ethanol extract ($13.6{\mu}g/mL$) < ethyl acetate fraction (6.2) < aglycone fraction (2.1). Reactive oxygen species (ROS) scavenging activities ($OSC_{50}$ of extract / fractions from Castanea crenata leaf extract / fractions on ROS generated in $Fe^{3+}$-EDTA/$H_2O_2$ system were investigated using the luminol-dependent chemiluminescence assay. The order of ROS scavenging activity was in the order: aglycone fraction (0.8) < 50% ethanol extract (0.5) < ethyl acetate fraction (0.3). The scavenging activity ($IC_{50}$ for ${O_2}^{{\cdot}\;-}$ (superoxide anion radical) generated by NBT method was in the order: ethyl acetate fraction (145.5) < aglycone fraction (65.5). The protective effects on the rose-bengal sensitized photohemolysis of human erythrocytes were investigated. The ethyl acetate fraction exhibited the most prominent cellular protective effect (${\tau}_{50}$, $191.9{\pm}12.2\;min$ at $10{\mu}g/mL$). The inhibitory effect of aglycone fraction ($9.1{\mu}g/mL$) on elastase was higher than oleanolic and ($13.7{\mu}g/mL$). And the inhibitory effect of aglycone fraction ($21.6{\mu}g/mL$) on tyrosinase was higher than arbutin ($226.2{\mu}g/mL$). But 50% ethanol extract rarely exhibited the inhibitory activity on tryosinase and elastase. Flavonoids were contained in Castanea crenata left (96.3 mg / 100 g dried Castanea crenata leaf). And flavonoids contained in ethyl acetate fraction were kaempferol, quercetin, quercitrin, and so on. Quercitrin is the most abundant component. These results indicate that extract / fractions of Castanea crenata can function as antioxidants in biological systems, particularly skin exposed to UV radiation by scavenging free radical and ROS, Castanea crenata leaf extract/ fractions could be used as new cosmeceutical for whitening and anti-wrinkle products.