• Clinical and Experimental Pediatrics
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• v.51 no.2
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• pp.156-161
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• 2008

Purpose : Neutropenic enterocolitis is an acute, life-threatening inflammation of the small and large bowel, often seen in children with malignancies during periods of prolonged or severe neutropenia. The optimal management for typhlitis in pediatric oncology patients has been debateful between operative and nonoperative approaches. The purpose of this study was to review the outcome of medical management of patients who were diagnosed as typhlitis. Methods : The records of 207 pediatric cancer patients who were diagnosed and treated at the pediatric department of Yeungnam University Hospital for cancer between August, 2002 and July, 2007 were reviewed. Results : Among 207 patients, 12 (5.7%) children aged 9 to 14 years, were diagnosed clinically to have typhlitis. Clinical symptoms and signs of patients were fever, abdominal pain and tenderness, diarrhea, vomiting and rebound tenderness. Bowel-wall thickening (> 4mm) was seen on CT or ultrasonography. All patients were treated with antibiotics combinations of teicoplanin, carbapenem, aminoglycoside, or other third generation cephalosporin and metronidazole or clindamycin. Eight patients were treated with additional antifungal agents. Other supportive management included bowel rest, total parenteral nutrition, and G-CSF administration. All patients recovered completely and did not need any surgical management. Conclusion : Early diagnosis and aggressive supportive treatment appears to be important for complete recovery and survival of typhlitis.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.2
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• pp.205-209
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• 1995

A desmoid tumor is a locally aggressive growth of connective tissue origin which infiltrates the surrounding tissue and has a marked tendency for recurrence. And so it was also called as an aggressive fibromatosis, musculofascial fibromatosis or fibrosarcoma etc. Thirteen cases of desmoid tumor was treated since 1980, and their retrospective study was done with 79 months of follow-up after initial surgical excision. The female was involved in 12 cases(one male) with the age ranged from 7-50 years, average 28 years, and seven patients in third decade. A slowly growing mass was excised on average 4 months after first notice of the mass, but their margins are not demarcated clearly in most cases. Wide excision in 12 cases was done, but wide excision and saphenous vein graft was performed in one case because of invasion of posterior tibial artery by tumor mass. The tumor was found on extraabdominal region in 8 cases(61.5%) but 5 cases in abdominal wall(38.5%). The recurrence rate was high(6/13, 46.2%), and 11 times in 6 patients were recurred(average 1.8 times), within 27 months of initial excision. Six cases of recurrence were treated with wide excision again in 3 cases, wide excision combined with radiotherapy(4,000-6,000cGy) in 4 cases and wide excision with chemotherapy in one case. During the follow-up for average 21 months after treatment, no recurrences are found. Tumor remission periods without recurrence are average 67 months in all, and 11 years in longest case. Histologically it was very mimic with fibrosarcoma but could be differentiated with Trichrome stain, and their findings are not changed after recurrence.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.80-84
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• 2011

Empyema necessitatis refers to empyema that extends into the extrapleural space through a defect in the pleural surface. Tuberculous empyema necessitatis is a rare complication of tuberculosis. We experienced a 21-month-old boy with tuberculous empyema necessitatis with osteomyelitis in the right $7^{th}$ rib. He presented with a mass on the right lateral chest wall, which was soft and nontender, enlarging for one month. He also had mild fever. The plain radiograph of his chest revealed soft tissue swelling and calcified lymph node on the left axilla, and his PPD skin test was positive. CT scan of the chest showed empyema necessitatis at the right lower chest and upper abdominal walls with osteomyelitis of the right $7^{th}$ rib. He did not have concurrent pulmonary tuberculosis. Surgery was performed for diagnosis and treatment. In histopathologic findings, chronic granulomatous inflammation with caseation necrosis was shown and was positive for acid fast bacilli stain. In addition, M. tuberculosis complex was found as etiology by polymerase chain reaction. The patient has been treated with anti-tuberculous medication without any specific complication.

• Journal of Trauma and Injury
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• v.24 no.1
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• pp.12-17
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• 2011

Purpose: A rib fracture secondary to blunt thoracic trauma continues to be an important injury with significant complications. Unfortunately, there are no definite treatment guidelines for severe multiple rib fractures. The purpose of this study was to evaluate the result of early operative stabilization and to find the risk factors of surgical fixation in patients with bilateral multiple rib fractures or flail segments. Methods: From December 2005 to December 2008, the medical records of all patients who underwent operative stabilization of ribs for severe multiple rib fractures were reviewed. We investigated patients' demographics, preoperative comorbidities, underlying lung disease, chest trauma, other associated injuries, number of surgical rib fixation, combined operations, perioperative ventilator support, and postoperative complications to find the factors affecting the mortality after surgical treatment. Results: The mean age of the 96 patients who underwent surgical stabilization for bilateral multiple rib fractures or flail segments was 56.7 years (range: 22 to 82 years), and the male-to-female ratio was 3.6:1. Among the 96 patients, 16 patients (16.7%) underwent reoperation under general or epidural anesthesia due to remaining fracture with severe displacement. The surgical mortality of severe multiple rib fractures was 8.3% (8/96), 7 of those 8 patients (87.5%) dying from acute respiratory distress syndrome or sepsis. And the other one patient expired from acute myocardial infarction. The risk factors affecting mortality were liver cirrhosis, chronic obstructive pulmonary disease, concomitant severe head or abdominal injuries, perioperative ventilator care, postoperative bleeding or pneumonia, and tracheostomy. However, age, number of fractured ribs, lung parenchymal injury, pulmonary contusion and combined operations were not significantly related to mortality. Conclusion: In the present study, surgical fixation of ribs could be carried out as a first-line therapeutic option for bilateral rib fractures or flail segments without significant complications if the risk factors associated with mortality were carefully considered. Furthermore, with a view of restoring pulmonary function, as well as chest wall configuration, early operative stabilization of the ribs is more helpful than conventional treatment for patients with severe multiple rib fractures.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.261-267
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• 1986

Development of supervoltage treatment machine may minimize skin reaction by skin-sparing effect, but skin damage is still one of "the dose limiting factor" in radiation therapy. In spite of these importance, systemic histopathologic studies of skin in similar conditions which used in clinical treatment has not been performed so far. 60mice were irradiated with conventional fraction ($200{\times}5/wk$) and whole abdominal field ($2{\times}3cm$, from symphysis pubis to xyphoid process). Used machine was 250KV, 24mA, orthovoltage x-ray machine. Histopathological changes of acute skin reaction at the level of total irradiation dose were analyzed and the possible mechanism of later chronic changes were investigated. Obtained results are as follows: 1. In 1,000 rad irradiated group, only mild epidermal edema is noted. 2. In 2,000 rad irradiated group, slightly decreased number and size of hair follicles and appendages, dermal edema and scanty infiltration of inflammatory cells are visible. 3. In 3,000 rad irradiated group, marked increased capillary congestion and prominant infiltration of inflammatory cells are observed. 4. In 4,000 rad irradiated group, vascular wall thickening with proliferation of endothelial cells are prominant. Dermal thinning and hyalinization are newly developed. 5. In 5,000 rad irradiated group, complete desquamation of epidermis is not seen, despite of acceleration of all above mentioned changes.

• Neonatal Medicine
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• v.17 no.2
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• pp.262-264
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• 2010

A case of bladder prolapse through a patent urachus is reported in a female infant born with a large, red, tubular mass inferior to the umbilical cord. A cystic mass communicating with fetal bladder was detected by prenatal ultrasound performed at $20^{+2}$ weeks of gestation. A fetal MRI was also performed to confirm the diagnosis and to exclude associated fetal anomalies. At $40^{+4}$ weeks, the cystic mass was no longer present and a new small solid mass was noted at the fetal abdominal wall. After birth, a protruded mucosal mass inferior to the umbilical cord was noted, and catheterization confirmed communication between the protruded mass and the urinary bladder. On the second day of life, reduction of the bladder and partial resection of the urachus was performed. A voiding cystourethrogram showed good bladder capacity and no vesicoureteral reflux. The patient voided well and was discharged after 10 days. Here, we present a case of urinary bladder prolapse through a patent urachus, diagnosed by fetal sonography and this is the first case reported that was treated by simple excision without complication.

• Parasites, Hosts and Diseases
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• v.22 no.2
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• pp.181-189
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• 1984

The metacercariae of Echinostoma cineterchis (Trematoda: Echinostomatidae) were found infected in the loaches (Misgurnus anguillicaudatus) purchased from two local markets in Korea. Identification of the metacercariae was done after obtaining adult worms from experimentally infected albino rats. Brief course of worm development in rats was also observed up to 28th post-infection day. The results are as follows: 1. The metacercariae of E. cinetorchis were detected from 5 (10.9%) out of 46 loaches examined and the average metacercarial burden per infected loach was 34.4. They were always found from the posterior abdominal wall. 2. The worm recovery rate from 8 rats was 24.6% in average. It was observed that the rate decreased according to age of infection; from 40.7% after 6 days to 15.0% after 28 days. 3. The adult worms were morphologically characterized by the presence of head crown with derfally uninterrupted collar spines, 37-38 in number, and the tendency of migration or disappearance of testes. So that they were identified as Echinostoma cinetorchis Ando et Ozaki, 1923. 4. The development of worm was very rapid during 6-10 days after infection and became much slower thereafter. During the rapid worm growth the development of genital organs was more prominent than that of non-genital organs. From the results it is concluded that the loach is involved in the life cycle of E. cinetorchis in this country and may take a role for infection source to animals and man. It is also confirmed that migration or loss of testes is the distinct specific character of this echinostomatid fluke.

• Journal of Veterinary Clinics
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• v.32 no.3
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• pp.247-250
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• 2015

A 10-year-old spayed female Pomeranian dog weighing 3.65 kg was presented with a 7-month history of urinary incontinence, stranguria and hematuria. The patient had mass lesions at left prescapular region ($3cm{\times}3cm$) and left axillary region ($5cm{\times}4cm$). Diagnosis of transitional cell carcinoma (TCC) with multiple cutaneous metastasis was made. Dog was treated with chemotherapy using mitoxantrone and piroxicam for 5 months. Although TCC size of urinary bladder was decreased during chemotherapy, there was no change of subcutaneous tumor size and mild relief of clinical signs. Partial anorexia for 3 weeks and multiple masses were noted at left caudal abdominal wall and left medial thigh (203 days after first presentation) and assessed as chronic kidney disease and additional subcutaneous metastasis of urinary bladder TCC by post-mortem and histopathological findings.

• The Korean Journal of Nuclear Medicine
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• v.23 no.2
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• pp.219-223
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• 1989

Inflammation scan using radiolabelled leukocytes has high sensitivity and specificity. Several methods for labelling leukocytes have been evaluated using P-32 diisopropyl fluorophosphate (DFP-32), H-3 thymidine, Cr-51 chromate, Ga-67 citrate and Tc-99m-sulfur colloid. In-111-oxine has proved so far to be the most reliable agent for labelling leukocytes. In-111-oxine is, however, expensive, not easily available when needed, and its radiation dose to leukocytes is relatively high. Moreover, resolution of the resultant image is relatively poor. Tc-99m is still the agent of choice because of, as compared with the indium, its favorable physical characteristics, lower cost and availability. Now the technique for labelling the leukocytes with technetium is successfully obtained using the lipophilic HAPAO with higher efficiency for granulocytes than for other cells. With this technique it is possible to label leukocytes in plasma to improve the viability of the leukocytes. Inflammation scan using Tc-99m-HMPAO has been evaluated in several laboratories, and difference in methods for separation and labelling accounts for difference in efficiency, viability and biodistribution of the labelled leukocytes. We performed inflammation scan using leukocytes labelled with Tc-99m-HMPAO in three dogs 24 hours after inoculation of live E. Coli and A. Aureus in their right abdominal wall. We separated mixed leukocytes by simple sedimentation using 6% hetastarch (HES) and labelled the leukocytes with Tc-99m-HMPAO in 20% cell free plama diluted with phosphate buffer solution(Fig. 1). Uptake was high in the liver and spleen but is was minimal in the lungs on whole body scan. Kidneys and intestine showed minimal activity although it was high in the urinary bladder(Fig. 2). Uptake of labelled leukocytes in the inflammation site was do(mite on 2 hour-postinjection scan and abscess was clearly delineated on 24 hour-delayed scan with high target-to-nontarget ratio(Fig. 3, 4). Inflammation scan using mixed leukocytes labelled with Tc-99m-HMPAO is very sensitive and specific in early detection of inflammation.

• Biomolecules & Therapeutics
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• v.4 no.2
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• pp.127-137
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• 1996

This study was performed to investigate the toxicity of DA-125 in beagle dogs, an anthracycline antitumor antibiotic. The dogs were administered DA-125 i.v. at 0.0023, 0.0375, 0.15 and 0.6 mg/kg/day, 6 days/week for 26 weeks. At 0.6 mg/kg, all male and female dogs were either sacrificed moribundly or dead during the 26-week treatment. The dogs revealed inactivity, salivation, dark bloody discharge, swelling of the subcutaneous injection site, abscess, and ulceration in the abdominal wall and legs. At 0.15 mg/kg, anorexia, salivation, and swelling of the injection site were observed. The food consumption was decreased with a statistical significance at 6 and 12 weeks treatment in males of 7.6 mg/kg. At 0.0375, 0.15 and 0.6 mg/kg, body weights were decreased significantly in a dose-related fashion after 17 weeks treatment. Total white blood cell counts for male dogs at 0.6 mg/kg were lower than those of control dogs after 13 weeks treatment, which appeared mainly due to decreased neutrophils. At 0.15 mg/kg, testicular atrophy was found in all males by gross pathology and the testicular weights were significantly decreased when compared to those of control males. Microscopically, the testis showed moderate atrophy of the seminiferous tubules and marked decrease in number of spermatozoa in the epididymal tubules. At 0.6 mg/kg, petechia or echymotic hemorrhage was observed in gastrointestinal tract, heart, lungs, and other organs at the necropsy, Marked atrophy of thymus were observed in both males and females. In addition, severe testicular atrophy was noted in all males. Microscopically, gastrointestinal tract showed hemorrhage, epithelial denudation, hypermucus secretion, and atrophy of intestinal villi. Seminiferous tubules of the atrophic testis were lined with Sertoli cells only and devoid of germ cells. Severe oligospermia or aspermia was present in the epididymal tubules. Bone marrow showed marked depletion of hemopoietic cells. In addition, marked atrophy was found in the lymphoid tissue of gastrointestinal tract, various Iymph nodes, and thymus. Injection sites showed marked inflammatory response with necrosis, necrotizing vasculitis, thrombus formation, and ulceration in the skin. According to the present results, no observed effect level appeared to be 0.0375 mg/kg. At 0.15 mg/kg, testis was a target organ, while at 0.6 mg/kg hemopoietic tissue, gastrointestinal tract, and testis were considered to be target organs. At 0.6 mg/kg the test compound seems to inflict a damage on the blood vessels causing hemorrhage in the various organs and tissues.