• Title/Summary/Keyword: Clinical Manifestation

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A Case of Pulmonary Paragonimiasis with Recurrent Pleural Effusion and Cured by Four Cycles of Chemotherapy (세 차례 재발하여 4회 약물 요법으로 치료한 폐흡충증 1예)

  • Cho, Gye Jung;Lim, Jung Hwan;Chae, Dong Ryeol;Chi, Su Young;Ban, Hee Jung;Yoon, Byeong Kab;Kwon, Yong Soo;Oh, In Jae;Kim, Kyu Sik;Kim, Yu Il;Lim, Sung Chul;Kim, Young Chul
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.6
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    • pp.451-456
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    • 2009
  • Paragonimiasis is a parasitic infection that occurs following the ingestion of infectious Paragonimus metacercariae, which occurs as a result of eating raw or undercooked freshwater crabs or crayfish. Pulmonary paragonimiasis is the most common clinical manifestation of this infection. Human paragonimiasis occurs sporadically. We experienced a case of pulmonary paragonimiasis in a 35-year-old woman with left lower chest pain. The patient had hypereosinophilia and a pleural effusion. The diagnosis was confirmed by positive ELISA (Enzyme-linked immunosorbent assay) that detected Paragonimiasis westermani antibody in the serum. We treated the patient with praziquantel for two days at a daily dosage of 75 mg/kg. Left pleuritic pain and pleural effusion improved after treatment. However, similar symptoms and pleural effusion developed recurrently for the first 3 courses of treatment with praziquantel. Upon the fourth round of treatment, the patient made a full recovery.

Role of the Nuclear Transcription Factor NF-κB Caused by Acute Hypoxia in the Heart (급성 저산소증 상태에서 심장 내 전사인자 NF-κB의 기능)

  • Joo, Chan Uhng;Juhng, Woo Suk;Kim, Jae Cheol;Yi, Ho Keun
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1106-1113
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    • 2002
  • Purpose : Nuclear ($factor-{\kappa}BNF-{\kappa}B$) is now recognized as playing a potential role in programmed cell death and the adaptive response to various stress. Cellular hypoxia is a primary manifestation of many cardiovascular diseases. It seems that vascular endothelial growth factor (VEGF) and insulin like growth factor-I(IGF-I) have a function as a protective molecule in the heart against several stress including hypoxia. In this study, the role of $NF-{\kappa}B$ to the cellular response and regulation of protective molecules against the acute hypoxia in the heart was studied. Methods : To cause acute hypoxic stress to the heart, Sprague Dawley rats were exposed to hypoxic chamer($N_2$ 92% and $O_2$ 8%). After the hypoxic exposure, nuclear proteins, total proteins and mRNA were isolated from heart. Translocation of the transcription factors $NF-{\kappa}B$, NF-ATc, AP-1 and NKX-2.5 were evaluated by electrophoretic mobility shift assay(EMSA). The expression of IGF-I and VEGF were studied before and after the hypoxic stress by competitive-PCR, Northern hybridization and Western hybridization. To confirm the role of the $NF-{\kappa}B$ in the heart, the rats also were pretreated with diethyl-dithiocarbamic acid(DDTC) into peritoneal cavity to block $NF-{\kappa}B$ translocation into nucleus. Results : The expression of $NF-{\kappa}B$, AP-1 and NF-ATc were increased by the hypoxic stress. Increased expression of the VEGF and IGF-I were also observed by the hypoxic stress. However, the blocking of the $NF-{\kappa}B$ translocation reduced those expressions of VEGF and IGF-I. Conclusion : These results suggest that $NF-{\kappa}B$ has a protective role against the acute hypoxia through several gene expression, especially VEGF and IGF-I in heart muscle.

A STUDY ON COMORBID DISORDERS AND ASSOCIATED SYMPTOMS OF PERVASIVE DEVELOPMENTAL DISORDER CHILDREN (전반적 발달장애 아동들의 공존질환 및 동반증상에 대한 연구)

  • Kwak, Young-Sook;Kang, Kyung-Mee;Cho, Seong-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.64-75
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    • 1999
  • Objective:The purpose of this study was to investigate the prevalence and characteristics of comorbid disorders and associated symptoms in pervasive developmental disorder(PDD) and to examine the correlation between associated symptoms and developmental characteristics in PDD children. Method:The sample consisted of 209 cases of PDD and 143 cases of developmental language disorder(DLD)(control group) who were treated at the Seoul National Mental Hospital from Jan. 1996 to Mar. 1999. The diagnostic work based on DSM-IV criteria was performed by one or two child psychiatrists, while the clinical feature was evaluated by doctors’s notes, occupational/speech therapy reports, and results of social maturity scale(SMS), childhood autism rating scale(CARS), and psycho-educational profile(PEP). Two groups were compared on a wide range of measures including comorbid disorders, associated symptoms, treatment drugs, and PEP. The relation between associated symptom & PEP was investigated in total(106 cases) and in each dignostic group. Sixty-four cases of PDD were divided into three groups by CARS and then compared on associated symptoms. Result:The prevalence of comorbid disorder was 19.6% in PDD, 41.2% in DLD. The rate of manifestation of 13 associated symptoms was 31.47% in PDD, 22.13% in DLD on the average. Associated symptoms significantly high in PDD were preoccupation, obsession, self-mutilation, stereotypy, sleep problems, and odd response. In total patient group, associated symptoms that significantly influenced PEP were preoccupation, self-stimulation, stereotypy, inappropriate affect, sleep problems, and odd response. But, in each diagnostic group, no associated symptom influenced PEP. Associated symptoms significantly different between the 3 groups of CARS were stereotypy, anxiety, and sleep problems. Conclusion:These preliminary results suggest that developmental characteristics may influence associated symptoms in PDD children and a realistic approach considering minute diagnosis by associated symptoms and comorbid disorders is required.

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Mutational Analysis of Mitochondria DNA in Children with IgA Nephropathy (소아 IgA 신병증 환자에서 미토콘드리아 DNA 돌연변이 분석)

  • Eom, Tae Min;Jang, Chang-Han;Kim, Hyoung Kyu;Kim, Nari;Chung, Yun Seo;Han, Jin;Chung, Woo Yeong
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.73-79
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    • 2012
  • Purpose: The association of mitochondrial DNA (mtDNA) mutations, deletions and copy number with progressive changes in patients with some glomerular disease and end-stage renal disease have been reported. In this study, we performed mtDNA mutation analysis in children with IgA nephropathy to investigate its role in progressive clinical course. Methods: Seven children with IgA nephropathy were involved in this study. MtDNA isolated from platelet was amplified by PCR and sequenced entirely. Results: The mean age at renal biopsy was $11.5{\pm}2.2$ year and the mean age at latest evaluation was $17.9{\pm}3.2$ year. The mean follow-up period were $7.8{\pm}3.1$ years. Patients was divided into 2 groups according to the amount of proteinuria at presenting manifestation. Group 2 patients were nephrotic syndrome. Renal function reveals within normal range in all patients. In group 2 patients, the mean serum albumin level was significantly lower than those of group 1 ($3.7{\pm}0.6g/dL$ vs. $4.7{\pm}0.2g/dL$, P=0.0241) and the mean total cholesterol level was significantly higher than those of group 1 ($222.7{\pm}35.7mg/dL$ vs. $148.3{\pm}29.1mg/dL$, P=0.0283). In Group 2 patients, total amount of protein of 24 hour collected urine also significantly higher than those of group 1 ($1,466.0{\pm}742.5mg$ vs. $122.5{\pm}48.1mg$, P=0.0135). Pr/Cr ratio in random urine sample was also higher in group 2 than those of group 1 but the statistical significance was not noted ($1.8{\pm}1.6$ vs. $0.2{\pm}0.2$, P=0.0961). Deletion of mtDNA nt 8272-8281 were observed in two patients, one patient in each groups, respectively. This is noncoding lesion. No patients demonstrated the mtDNA mutations. Conclusions: We have identified a deletion of mtDNA nt 8272-8281 in two children with IgA nephropathy. Further studies are needed to clarify the role of mitochondrial function in the progressive change of IgA nephropathy.

Search for the Meaning of Social Support in Korean Society (Social Support의 한국적 의미)

  • 오가실;서미혜;이선옥;김정아;오경옥;정추자;김희순
    • Journal of Korean Academy of Nursing
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    • v.24 no.2
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    • pp.264-277
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    • 1994
  • In Korea the concept of social support was first used as a research concept in nursing and has not had much application in the clinical field. Another problem is that research on social support has used a direct translation of the words “social support” into Korean as “sawhejuk jiji”. Three questions were posed to direct the re-search. 1) Is there a concept of social support in Korean society? 2) if so, what words or expressions are used to de-scribe it? 3) further, if so, how is social support structured and how does it function? In order to answer the research questions a three-step research methodology was used : The first step consisted of a literature review on re-search related to social support and on information on the background of, and the way of thinking re-lated to interpersonal relations among Korean people. The second step, which was done to identify whether there is a concept of social support in korean society, involved interviewing a sample of the population. The third step involved a panel discussion that included the members of the research team and three consultants, a sociologist, a philosopher and a scholor in korean literature. A review of the literature on interpersonal relationships in traditional korean society identified a four cirole structure that explains interpersonal relationships. The first circle with “me” at the center is the family but here “me” disappears into the “we” that is essential for a cooperative agricultural society. In the second circle are those close to “me” but outside the family. The third circle includes those with whom “I ” have infrequent but regular contact and with whom correct conduct is important. The last circle is all the people with whom “I” have nothing in common. They are excluded in interpersonal relationships. The literature on interpersonal relationships showed that within the traditional Korean society people lived in villages where most people were very familiar with each other. “Yun”, the social network established the connection and “Jung”, the feeling of affection increased with time as the connection was strengthened. In the traditional village psychological support was provided through “Mallaniki”, “Pumashi” and “Kae” with the latter two also providing material support. In modern Korea there are more informal and formal social networks, like social services and community activities on the formal level and cultural and leisure groups along with “kae’s on the informal level. But even with this modern variety of groups, most social support comes from informal networks that resemble the traditiorlal “Pumashi”, “Kai” md “Mallaniki”. The six member research team interviewed 65 people in order to identify whether there is a concept of social support and then analysed their responses. There were 20 different words describing the reception of the social support and these could be grouped into seven major categories : virtuous, fortunate, helped, supported, blessed, attached(receiving affection) and receiving (grace) benevolence. there were 27 words describing the act of social support which could be categorized into seven major categories : love, looking after, affection(attachment), kindness(goodness), faith, psychological help and material help. for the meaning of social support translated as “sawhe juk jiji” there were a total of 14 different answers which could be categorized into 3 major categories : help, agreement, and faith. In third step, the results of the literature review and the answers to the questions were discussed in a pannel. The results of the discussion led to the following definition of social support in Korea which is shaped like a the four sided pyramid on a base. Social support is the apex of the pyramid and four sides are made up of : “do-oom” (both emotional and material help), “jung” (connectedness, or relationship bound by affection, regard or shared common experience ), “midum” (faith or belief in), “eunhae” (kindness or benevolence). The research team identified “Yun”( the basic network of relationships) as the base of the pyramid and as such the foundation for the components of social support in Korean culture. On “Yun” rest the other four components of social support : “Jung”, “Midum”, “Do-oom”, and “Eunhae”, For social support to take place there must be “Yun”. This is an important factor in social support. In private social network “Jung” is an essential factor in social support. But not in the public social network. “Yun” is a condition for “Jung” and “Jung” is the manifestation of support.

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Temporal Transcriptome Analysis of SARS-CoV-2-Infected Lung and Spleen in Human ACE2-Transgenic Mice

  • Jung Ah, Kim;Sung-Hee, Kim;Jung Seon, Seo;Hyuna, Noh;Haengdueng, Jeong;Jiseon, Kim;Donghun, Jeon;Jeong Jin, Kim;Dain, On;Suhyeon, Yoon;Sang Gyu, Lee;Youn Woo, Lee;Hui Jeong, Jang;In Ho, Park;Jooyeon, Oh;Sang-Hyuk, Seok;Yu Jin, Lee;Seung-Min, Hong;Se-Hee, An;Joon-Yong, Bae;Jung-ah, Choi;Seo Yeon, Kim;Young Been, Kim;Ji-Yeon, Hwang;Hyo-Jung, Lee;Hong Bin, Kim;Dae Gwin, Jeong;Daesub, Song;Manki, Song;Man-Seong, Park;Kang-Seuk, Choi;Jun Won, Park;Jun-Won, Yun;Jeon-Soo, Shin;Ho-Young, Lee;Jun-Young, Seo;Ki Taek, Nam;Heon Yung, Gee;Je Kyung, Seong
    • Molecules and Cells
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    • v.45 no.12
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    • pp.896-910
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    • 2022
  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible and potentially fatal virus. So far, most comprehensive analyses encompassing clinical and transcriptional manifestation have concentrated on the lungs. Here, we confirmed evident signs of viral infection in the lungs and spleen of SARS-CoV-2-infected K18-hACE2 mice, which replicate the phenotype and infection symptoms in hospitalized humans. Seven days post viral detection in organs, infected mice showed decreased vital signs, leading to death. Bronchopneumonia due to infiltration of leukocytes in the lungs and reduction in the spleen lymphocyte region were observed. Transcriptome profiling implicated the meticulous regulation of distress and recovery from cytokine-mediated immunity by distinct immune cell types in a time-dependent manner. In lungs, the chemokine-driven response to viral invasion was highly elevated at 2 days post infection (dpi). In late infection, diseased lungs, post the innate immune process, showed recovery signs. The spleen established an even more immediate line of defense than the lungs, and the cytokine expression profile dropped at 7 dpi. At 5 dpi, spleen samples diverged into two distinct groups with different transcriptome profile and pathophysiology. Inhibition of consecutive host cell viral entry and massive immunoglobulin production and proteolysis inhibition seemed that one group endeavored to survive, while the other group struggled with developmental regeneration against consistent viral intrusion through the replication cycle. Our results may contribute to improved understanding of the longitudinal response to viral infection and development of potential therapeutics for hospitalized patients affected by SARS-CoV-2.

The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.