• Journal of Veterinary Clinics
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• v.28 no.3
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• pp.314-317
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• 2011

A 16-year-old, spayed female, Maltese dog weighing 4.3 kg was presented with a 2-week history of yellowish nose-and oral-discharge, anorexia and lethargy. In physical examination, indefinite ulcerative mass about $3{\times}3$ cm in size in the left sublingual region, severe gingivoperiodontitis, halitosis, moderate dental calculus, fever and swelling of mandible soft tissue were noted. In radiographic view, periodontitis and bone lysis findings on the left rostral part of maxilla and mandible were observed. In complete blood count and blood chemistry test, thrombocytosis, increased levels of serum $NH_3$, AST and ALP were obtained. Urinalysis revealed hematuria and proteinuria. In histological examination, squamous cell carcinoma was diagnosed. No surgery was performed, but combined treatment with carboplatin and piroxicam was initiated. Five days after initiation of medication, because of insistent vomiting, piroxicam was substituted to meloxicam. Although the therapeutic efficacy of meloxicam could not be known; administration of meloxicam might be less potential to gastrointestinal side-effects than piroxicam. The dog totally received 3 times of carboplatin infusion. Five days after third infusion of carboplatin, the dog was hospitalized with severe lethargy, vomiting and bloody diarrhea. In examination, severe renal failure signs were noted, and the dog was euthanized.

• Journal of Veterinary Clinics
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• v.24 no.2
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• pp.82-87
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• 2007

Five dogs with renal failure were referred to the Veterinary Medical Teaching Hospital at Kangwon National University. These dogs had the common history of consumption of Pedigree dry dog food produced in Thailand plant for over 1 month. The dogs showed anorexia, emaciation, vomiting, and polydipsia/polyuria. And in one severely affected dog, bloody diarrhea and hypothermia were seen. The remarkable clinicopathological signs were high value of BUN and creatinine. In some dogs, GGT, phosphorus and lipase were increased. However, no significant changes of complete blood count were found. In urinalysis, hematuria, low specific gravity urine, proteinuria, and calcium oxalate-like crystals were observed. Two severely affected dogs were died. The remained dogs were recovered gradually after change of dog food and supportive therapy. Pathological findings were seen typically in kidneys. Renal atrophy, congestion of the glomerular capillary, and diffuse degeneration, necrosis, dystrophic calcification and regeneration in the tubular epithelium were seen. Yellowish brown fluorolucent laminated materials or particles were quite often found in the lumina of the necrotizing renal tubules of cortex and medulla. Proliferation of fibrous tissue in the interstitium was also seen. By the mycotoxin analysis of the Pedigree dry dog food, ochratoxin A (OTA) and citrinin were detected as much as the concentration of 372.8 ppb and 8.3 ppb, respectively. The final diagnosis of renal failure caused by OTA and citrinin toxicosis was made on the basis of history takings, clinical signs, clinicopathological and pathological findings, and analysis of mycotoxins.

• Food Science of Animal Resources
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• v.30 no.2
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• pp.179-184
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• 2010

Escherichia coli O157:H7 is a food-borne pathogen that causes bloody diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS). We compared three selective media and evaluated the performance of immunomagnetic separation (IMS) for the detection of low levels of E. coli O157:H7 in ground beef and radish sprouts with different levels of background flora. Bulk food samples (500 g for each trial) were artificially inoculated with nalidixic acid-resistant E. coli O157:H7 at the lowest dose that would generate 20 partial-positive samples of 25 g each. All samples were homogenized in mTSB (225 mL) and incubated overnight at $37^{\circ}C$. IMS was performed using the enriched mTSB samples (1 mL) along with conventional spreads plated onto three different selective media: Sorbitol MacConkey agar (SMAC), Sorbitol MacConkey agar with cefixime and tellulite (CT-SMAC), and Sorbitol MacConkey agar with nalidixic acid (NAL-SMAC) as the gold standard. Two suspicious colonies from each medium were selected and confirmed usinga serological test after transfer to tryptic soy broth with yeast extract (TSAYE). CT-SMAC was better than SMAC for detecting E. coli O157:H7 in all food types. Although there was no statistical difference in the number of positive samples when using IMS vs. non-IMS techniques, more positive samples were detected when IMS was used in both ground beef and radish sprouts. It appears that the improvement was more significant in radish sprouts, which had a higher level of background flora than ground beef. The results also suggest that the combination of CT-SMAC and IMS is sufficient to recover low levels of E. coli O157:H7 in high background flora food samples.

• The Journal of the Convergence on Culture Technology
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• v.5 no.3
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• pp.317-326
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• 2019

The present study aimed to investigate the comparative evaluation of pharmacological efficacy between sulfasalazine alone and combination with herbal medicine on dextran sodium sulfate (DSS)-induced UC in mice. Balb/c mice received 5% DSS in drinking water for 7 days to induce colitis. Animals were divided into five groups (n = 9): group I-normal group, group II-DSS control group, group III-DSS + sulfasalazine (30 mg/kg), group IV-DSS + sulfasalazine (60 mg/kg), group V-DSS + sulfasalazine (30 mg/kg) + Radish Extract mixture (30 mg /kg) (SRE). DSS-treated mice developed symptoms similar to those of human UC, such as severe bloody diarrhea and weight loss. SRE supplementation, as well as sulfasalazine, suppressed colonic length and mucosal inflammatory infiltration. In addition, SRE treatment significantly reduced the expression of pro-inflammatory signaling molecules through suppression both MAPK) and nuclear factor-kappa B (NF-${\kappa}B$) signaling pathways, and prevented the apoptosis of colon. Moreover, SRE administration significantly led to the up-regulation of anti-oxidant enzyme including SOD and Catalase. This is the first report that Radish extract mixture combined with sulfasalazine protects against experimental UC via the inhibition of both inflammation and apoptosis, very similar to the standard-of-care sulfasalazin.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.27-43
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• 1970

This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.184-189
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• 2010

Purpose : Pseudomembranous colitis (PMC) occurs rarely in children, but its incidences are increasing due to frequent antibiotic use. We investigated the incidence and clinical characteristics of PMC accompanied by bacterial enteritis-like symptoms in children. Methods : Between November 2003 and July 2007 at the Department of Pediatrics, Dongsan Medical Center, we analyzed the medical records of consecutive patients who received antibiotics in the past 1 month, developed bacterial enteritis-like symptoms, and were diagnosed with PMC based on sigmoidoscopy examination and histological findings. Results : Among 22 patients who underwent sigmoidoscopy and biopsy examinations, 11 (50%) were diagnosed with PMC. These 11 patients were aged 2 months-12 years, among whom 5 patients (45.5%) were less than 1 year old. The clinical symptoms were bloody diarrhea (28.6%), abdominal pain or colic (28.6%), watery or mucoid diarrhea (23.8%), vomiting (9.5%), and fever (9.5%). The antibiotics used were penicillins (55.6%), macrolides (27.8%), cephalosporins (11.1%), and aminoglycosides (5.6%). The period of antibiotic use was 3-14 days. The interval between the initial antibiotic exposure and the onset of symptoms was 5-21 days. The results of stool examination of all patients were negative for Clostridium difficile toxin A. Patient distribution according to the degree of PMC was as follows: grade I, 18.2% (2 cases); grade II, 27.3% (3); grade III, 36.4% (4); and grade IV, 18.2% (2). PMC did not recur in any case.Conclusion : PMC is not a rare disease in children. If pediatric patients receiving antibiotics manifest symptoms like bacterial enteritis, PMC should be suspected. Endoscopy and biopsy should be applied as aggressive diagnostic approaches to detect this condition.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.63-67
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• 2005

Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis, characterized by cutaneous palpable purpura, gastrointestinal(GI) symptoms, arthritis and renal involvement. In general, the prognosis is determined by GI complication as well as the severity of nephritis. In this study, we analyzed the statistical relationship between the GI symptom and other clinical findings for assessing the prognosis, and evaluated abdominal ultrasonographic findings for early diagnosis of this disease with atypical clinical presentation and early detection of serious GI complications. Methods : One hundred seventy seven patients with HSP in the Department of Pediatrics, Wonkwang University Hospital from January 1994 to June 2004, were enrolled. We retrospectively analyzed charts about clinical and abdominal ultrasonographic findings, and classified our patients into two groups(GI-Sx(-), GI-Sx(+)) for statistical analysis. Results : The ratio of female to male is 1.5 : 1. The peak age incidence was five to eight years in 95 cases(53%). The GI symptoms appeared in 117 cases(66%), which include abdominal pain 115 (98 %), tenderness 45(38%), nausea and vomiting 35(30%), bloody stool 10(8.5%), diarrhea four(3.4%), rebound tenderness four(3.4%), and also intussusception and appendicitis were complicated in five and two cases respectively. GI-Sx(+) group had an increased risk of renal involvement and relapse than the GI-Sx(-) group. But there were no relationships about sex and age incidence, or other clinical and laboratory findings between two groups. Ultrasonographic findings in 98 patients with GI symptoms included small bowel thickening in 70 cases(71%) in which duodenum, jejunum and ileum were involved in 71%, 45.7%, 40% respectively, small bowel dilatation in 41 cases(42%), lymph node swelling in 46 cases(47%), and ascites in 25 cases(25.5%). Conclusion : GI symptoms in patients with HSP suggested increased risk of renal involvement and relapse. Abdominal ultrasonography could be helpful in the early diagnosis on atypical clinical presentation and early detection of serious GI complication in these patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.16-23
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• 2004

Purpose: In this study, we tried to evaluate the clinical characteristics or circumstances that lead to unintentionally the delay in the diagnosis of intussusception or to the wrong direction that prevent the proper management early. Methods: All the patients of intussusception with delayed diagnosis in the department of pediatrics or emergency room at Gyeongsang National University Hospital from 1990 to 2003 were enrolled and reviewed retrospectively. Results: There were 8 boys and 6 girls and their median age was 8 months (range 2 months to 10 years). Their initial symptoms and signs were vomiting, seizure, diarrhea, lethargy, irritability, bloody stool, palpable abdominal mass, foul odor of urine and tachycardia. Clinical diagnosis or impressions at admission consisted of acute gastroenteritis, shigellosis and toxic encephalopathy, convulsive disorders, urinary tract infections, sepsis, abdominal mass and intestinal obstruction. Eight patients were luckily diagnosed due to the delayed manifestations of cyclic irritability or currant jelly stool. Six patients were not paid attentions for the possibilities of intussusception and diagnosed serendipitiously by the abdominal sonography or CT during the evaluation of the abdominal mass or distension. Only five of 14 cases (35.7%) were successfully managed by barium or air reductions. The other 9 cases needed surgical operations. Conclusion: Delayed diagnosis of intussusception arise when doctors initially diagnose the patients incorrectly due to the unusual presentations or when they overlook the newly arising symptoms or signs suggestive intussusception after the admission because they are ardently attached to the first impressions or initial clinical diagnosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.199-206
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• 2009

Purpose: To analyze the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after liver transplantation in children. Methods: From January 1988 to June 2009, we retrospectively reviewed the medical records of 8 PTLD cases among 148 pediatric patients underwent liver transplantation. The age at transplantation, time of presentation after transplantation, clinical manifestations, histologic diagnosis, results of EBV (Epstein-Barr virus) assessments, managements and outcomes of PTLD were investigated. Results: The prevalence of PTLD in liver transplant pediatric recipients was 5.4% (8 of 148). The mean age of patients was 25.4${\pm}$21.3 months (range 10 to 67 months). Seven of 8 patients (87.5%) underwent liver transplantation before 1 year of age. The common clinical presentations were persistent fever (8 of 8, 100%) and bloody diarrhea (6 of 8, 75%). PTLD was diagnosed with gastrointestinal endoscopic biopsies in five patients and surgical biopsies in three. Histologic findings showed early lesion in three patients, polymorphic in two, and monomorphic in three. Burkitt lymphoma and lymphoblastic lymphoma were found in two of 3 monomorphic patients. Seven of 8 patients were found with EBV-positive. Eight patients were treated with dose reduction of immunosuppressants and infusion of ganciclovir. Rituximab was added to four patients. PTLD were successfully managed in all patients except one who died of sepsis during chemotherapy. Conclusion: Major risk factor of PTLD was to undergo liver transplantation before 1 year of age. Continuous monitoring for EBV viral load and gastrointestinal endoscopic biopsy may be useful to early detection of PTLD.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.211-217
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• 2000

Purpose : Salmonellosis including typhoid fever is still prevalent in Korea. Recently it has been reported that the incidence of salmonella gastroenteritis is increasing with a reduction of typhoid fever. We studied the clinical and laboratory features of salmonellosis. Methods : We evaluated the clinical records of 83 patients with salmonellosis who had been confirmed by stool culture from 1994 to 1999. Results : Annual incidence of salmonellosis showed an increasing tendency during recent 4 years. Seasonally, summer(45.8%) was the most prevalent, followed by fall(32.5%). Male to female ratio was 1.4 : 1. In age distribution, 64 cases(77.1%) were under 5 year-old, and 18 cases(21.7%) were younger than 1 year-old. Clinical features included diarrhea(96.4%), fever(91.6%), vomiting(49.4%), bloody stool(42.1%), abdominal pain(40.1%) and tenesmus(12.0%). In serogroups, there was no group A and group B, group C, group D(including 2 cases of S.typhi) and group E were in 41.0%(34 cases), 3.6%(3 csaes), 51.8%(43cases) and 3.6%(3 cases), respectively. In Widal test, 5 cases(13.5%) and 1 case(2.7%) of group B, C and E(total 37 cases) were observed the O titer above 1 : 80 and 1 : 320, respectively. However, in 36 cases of group D, 19 cases(52.7%) and 9 cases(25.0%) were above the O titer 1 : 80 and 1 : 320, respectively. Antibiotics resistant rates to ampicillin, trimethoprim/sulfamethoxazole and chloramphenicol were 23.2%, 10.1% and 51.4%, respectively. Conclusion : Salmonellosis has become a common cause of gastroenteritis in children, especially under the pre-school age. Isolation of salmonella is neccessary for accurate diagnosis of gastroenteritis and typhoid fever. A careful attention of the use of antibiotics is needed to reduce the muilti-drug resistant strains.