1.A study of bone mineral density of lumbar spine by dual energy x-ray absorptiometry (DEXA) in children.
Chur Woo YOU ; Son Moon SHIN ; Yong Hoon PARK ; Son Yong KIM
Yeungnam University Journal of Medicine 1993;10(2):369-379
The bone mineral density(BMD) of the lumbar spine (L2L4) was measured by using dual energy x-ray absorptiometry(Norland M6 DEXA) in 80 children aged between 2months and 15years (group I:2monthlyears, group 2: 1year5years, group3:6years10years, group4*: 11years15years). The correlation coefficient of BMD with age, body weight, height and Tanner stage were 0.696, 0.693, 0.717 and 0.636 respectively. There were sigificant difference. in BMD(g/cm2) between-group 1(BMD : 0.335 0.175) and group 2(BMD : 0.627 0.200), and group 3(BMD : 0.714 0.189) and group.4(BMD : 0. 8730.163) (P<0.05). There was no significant difference of BMD between boys and girls(P<0.05). BMD also increased significantly with development of Tanner stages(Tanner stage 1 : 0.547 0.234, Tanner stage 2 : 0.783 0.136, Tanner stage 3 : 0.998 0.080) (P<0.05). These data indicate that the BMD was correlated with age, body weight, height and Tanner stage significantly and BMD increased significantly during growth spurt occured in 1 to 4years of age and puberty.
Absorptiometry, Photon*
;
Adolescent
;
Body Weight
;
Bone Density*
;
Child*
;
Humans
;
Puberty
;
Spine*
2.The Value of Preoperative Coagulation Screening in Children Undergoing Surgery.
Korean Journal of Hematology 2008;43(2):98-105
BACKGROUND: To evaluate the usefulness of preoperative screening for coagulation disorders in children who have undergone surgery. METHODS: From January 2003 to December 2005, we prospectively evaluated laboratory and bleeding histories in 1,911 children between the ages of one year and 15 years. All of the patients had preoperative coagulation screening with a measurement of complete blood count, prothrombin time and activated partial thromboplastin time. The sensitivity, specificity and positive and negative predictive values following a preoperative coagulation-screening test were evaluated by a comparison of the type of surgery and bleeding complications that occurred during and after surgery. RESULTS: There were no patients with previously proven coagulopathies or suspicious medical histories. Among the 1,911 cases, a subset of 22 patients had persistent abnormalities detected after laboratory testing. In two of the 22 patients, lupus anticoagulant was detected and in one of the 22 patients, a factor VIII deficiency was discovered. There were 46 patients that had postoperative bleeding and required hospitalization extension or readmission for stanching. Among the 46 patients, 44 patients demonstrated normal coagulation after testing and two patients demonstrated abnormal coagulation after testing. Following a preoperative coagulation-screening test, a low sensitivity (0.04) and positive predictive value (0.09) were determined. CONCLUSION: For the prediction of perioperative bleeding, the use of a coagulation-screeningtest showed a very low positive predictive value. Many false positive laboratory tests coupled with the relative rarity of inherited and acquired coagulopathies raises doubt about the overall value of routine preoperative coagulation screening in children.
Blood Cell Count
;
Blood Coagulation Tests
;
Child
;
Hemophilia A
;
Hemorrhage
;
Hospitalization
;
Humans
;
Lupus Coagulation Inhibitor
;
Mass Screening
;
Partial Thromboplastin Time
;
Prospective Studies
;
Prothrombin Time
;
Sensitivity and Specificity
3.The prevalence and risk factors of inhibitor development of FVIII in previously treated patients with hemophilia A
Blood Research 2019;54(3):204-209
BACKGROUND: Risk factors for the development of inhibitors in previously untreated patients (PUPs) have been reported; this is not the case in previously treated patients (PTPs) owing to fewer studies. Risk factors may differ for the development of PTP versus PUP inhibitors. We aimed to identify risk factors for PTP inhibitor development. METHODS: Participants were patients at a hemophilia treatment center in Korea with current or past history of factor VIII or factor IX alloantibodies. Observed inhibitors were classified as PUP or PTP inhibitors based on the cumulative number of exposure days. We compared the type and severity of hemophilia, mutation type, and family history of inhibitor between PUPs and PTPs. Events within 3 months before the first inhibitor detection, such as change of the factor concentrate used, short-term high exposure or continuous infusion of factor concentrate, history of surgery, infection, diagnosis of cancer, use of immunosuppressive or immunomodulator agents, and vaccination were compared between PUPs and PTPs. RESULTS: We observed 5 PUP inhibitors and 5 PTP inhibitors in 115 patients with hemophilia A. Events that might be related to the development of inhibitors within 3 months prior to the first inhibitor detection were observed in all 5 PTPs. On the contrary, no such events were observed in any PUPs. The observed events included a change in the factor concentrate used, subsequent chemotherapy, and short-term high exposure to factor concentrates for controlling hemorrhage and surgeries. CONCLUSION: Our results suggest a greater role of nongenetic factors in PTP inhibitor development.
Diagnosis
;
Drug Therapy
;
Factor IX
;
Factor VIII
;
Hemophilia A
;
Hemorrhage
;
Humans
;
Isoantibodies
;
Korea
;
Prevalence
;
Risk Factors
;
Vaccination
4.A Case of Spigelian Hernia in Upper Abdomen.
Jin Ho KIM ; Seong Taek OH ; Hae Myung JUN ; In Chur KIM
Journal of the Korean Surgical Society 1999;56(3):453-455
Spigelian hernia is an uncommon hernia of the ant. abdominal wall. Because of its insidious nature and nonspecific physical findings, the diagnosis of this hernia is often not made. Typically, the hernia orifice is small, and strangulation of the contents of the hernial sac can occur. Computed tomography permits the distinction between Spigelian hernia and other anterial abdominal wall or intraabdominal masses. Spigelian hernia requires surgical correction to prevent complication of acute abdomen with strangulation or incarceration. The typical site of a Spigelian hernia is at the level of the semicircular fold of Douglas known as the arcuate line. Spigelian hernia can occur above the umbilicus, high Spigelian hernia, but its very unusual site. We report a case of Spigelian hernia on upper abdomen and review the literature.
Abdomen*
;
Abdomen, Acute
;
Abdominal Wall
;
Ants
;
Diagnosis
;
Hernia*
;
Umbilicus
5.The Necessity of Prostate Biopsy for Patient of LUTS/BPH with Elevated Serum Prostate Specific Antigen.
Young Chur CHUNG ; Hyuk Soo CHANG ; Chun Il KIM
Korean Journal of Urology 2005;46(2):112-117
PURPOSE: To determine the criteria that can be used to safely reduce unnecessary biopsies for patient found to be lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) negative on digital rectal examination (DRE) and transrectal ultrasound (TRUS), with a prostate specific antigen (PSA) level over 4.0ng/ml. MATERIALS AND METHODS: A retrospective data analysis of 157 patients, with a raised serum PSA level, over 4.0ng/ml, and negative DRE and TRUS findings was performed. The detection rates of prostate cancer according to the prostate volume were also investigated. All patients with one benign biopsy were followed with PSA determination over a 2 year period, and in the cases of men with a persistently elevated PSA, a re-biopsy was suggested. Patients were also classified according to the results of the first biopsy and the follow up PSA level. RESULTS: Of the 157 patients, the rate of prostate cancer was 14.6% (23 of 157), and that for a benign disease, including BPH, was 85.4% (134 of 157). The rates of prostate cancer according to prostate volume (PV) were 20.6 (22 of 107) and 2.0% (1 of 50) in those with a PV
Biopsy*
;
Digital Rectal Examination
;
Follow-Up Studies
;
Humans
;
Lower Urinary Tract Symptoms
;
Male
;
Prostate*
;
Prostate-Specific Antigen*
;
Prostatectomy
;
Prostatic Hyperplasia
;
Prostatic Neoplasms
;
Retrospective Studies
;
Statistics as Topic
;
Ultrasonography
;
Watchful Waiting
6.A Histologic Study of Urethral Plate with Light and Transmission Electron Microscopy.
Young Chur CHUNG ; Yu Na KANG ; Kwang Sea KIM
Korean Journal of Urology 2005;46(10):1083-1087
PURPOSE: To make a histological study of a urethral plate using light and transmission electron microscopies to find evidence responsible for ventral curvature in hypospadias. MATERIALS AND METHODS: Full thickness biopsies of the urethral plate were obtained from 5 patients with proximal hypospadias; including 4 children and 1 adult. All specimens were examined with light and transmission electron microscopies. RESULTS: With the light microscope, all specimens demonstrated well vascularized connective tissue, comprised of smooth muscle and collagen. With the transmission electron microscope, all specimens demonstrated intact endothelial cells and fibroblasts, with dispersed chromatin distribution, intercellular loose collagen and a regular arrangement of collagen fibrils in intercellular spaces. No histological evidence of fibrous cord could be found in any of the specimens. CONCLUSIONS: No histological evidence of fibrous cord could be historically found that could be considered responsible for ventral penile curvature in hypospadias.
Adult
;
Biopsy
;
Child
;
Chromatin
;
Collagen
;
Connective Tissue
;
Endothelial Cells
;
Extracellular Space
;
Female
;
Fibroblasts
;
Humans
;
Hypospadias
;
Male
;
Microscopy
;
Microscopy, Electron
;
Microscopy, Electron, Transmission*
;
Muscle, Smooth
;
Urethra
7.M-VAC(Methotrexate, Vinblastine, Doxorubicin and Cisplatinum) Chemotherapy for Metastatic Transitional Cell Carcinoma.
Chur Chil SIN ; Sung Goo CHANG ; Jin Il KIM
Korean Journal of Urology 1995;36(5):502-506
We treated 23 patients with metastatic transitional cell carcinoma with methotrexate, vinblastine, doxorubicin and cisplatinum(M-VAC) chemotherapy from March 1989 to June 1994. The mean age of the patients was 60.0 years old and ranged from 49 years old to 75 years old. They were 18 in male and 5 in female. Complete clinical remission was observed in 5 of 23 patients(21.7%) and 6 patients(26.1%) had a partial remission. An overall objective response rate was 47.8%. The median survival was 12.4 months in all 23 patients, and 20.6 months in 5 complete responder, 8.9 months in non-responder. The duration of survival of the patients with complete remission was prolonged significantly compared to the patients with progression. The progression of disease was in 3 of 4 patients with metastatic bone lesion in effect of M-VAC chemotherapy, but complete clinical remission was 1 of 4 patients. After treatment, complete clinical remission was observed in 5 of 18 patients with metastatic lymph node and 5 patients had a partial remission. The progression of disease was in 1 patient with lung and liver metastatic lesions. Toxicity included moderate to severe myelosuppression that resulted in sepsis in 3 patients and mild to moderately anorexia, vomiting, alopecia and renal dysfunction. It was suggested that M-VAC chemotherapy may be effective as treatment for patients with metastatic transitional cell carcinoma.
Aged
;
Alopecia
;
Anorexia
;
Carcinoma, Transitional Cell*
;
Doxorubicin*
;
Drug Therapy*
;
Female
;
Humans
;
Liver
;
Lung
;
Lymph Nodes
;
Male
;
Methotrexate
;
Middle Aged
;
Sepsis
;
Urinary Bladder
;
Vinblastine*
;
Vomiting
8.Serotonin (5-HT) Receptor Subtypes Mediate Regulation of Neuromodulin Secretion in Rat Hypothalamic Neurons.
Genomics & Informatics 2007;5(2):77-82
Serotonin (5-HT), the endogenous nonselective 5-HT receptor agonist, activates the inositol -1,4,5- triphosphate / calcium (InsP3/Ca2+) signaling pathway and exerts both stimulatory and inhibitory actions on cAMP production and neuromodulin secretion in rat hypothalamic neurons. Specific mRNA transcripts for 5-HT1A, 5-HT2C and 5-HT4 were identified in rat hypothalamic neurons. These experiments were supported by combined techniques such as cAMP and a Ca2+ assays in order to elucidate the associated receptors and signaling pathways. The cAMP production and neuromodulin release were profoundly inhibited during the activation of the Gi-coupled 5-HT1A receptor. Treatment with a selective agonist to activate the Gq-coupled 5-HT2C receptor stimulated InsP3 production and caused Ca2+ release from the sarcoplasmic reticulum. Selective activation of the Gs-coupled 5-HT4 receptor also stimulated cAMP production, and caused an increase in neuromodulin secretion. These findings demonstrate the ability of 5-HT receptor subtypes expressed in neurons to induce neuromodulin production. This leads to the activation of single or multiple G-proteins which regulate the InsP3/Ca2+/PLC-gamma and adenyl cyclase / cAMP signaling pathways.
Animals
;
Calcium
;
GAP-43 Protein*
;
GTP-Binding Proteins
;
Inositol
;
Neurons*
;
Rats*
;
Receptor, Serotonin, 5-HT1A
;
Receptor, Serotonin, 5-HT2C
;
Receptors, Serotonin, 5-HT4
;
RNA, Messenger
;
Sarcoplasmic Reticulum
;
Serotonin*
;
Adenylyl Cyclases
9.A Case of Chronic Granulomatous Disease in which Enterococci were Observed in Culture.
Kyung Lae CHO ; Jeong Hee KIM ; Eun Jeong KIM ; Chur Woo YOO ; Chun Soo KIM ; Un Seok NHO ; Chul Kyu KIM
Journal of the Korean Pediatric Society 2000;43(6):846-850
Chronic granulomatous disease(CGD) is a genetically inherited disorder caused by the failure of phagocytic cells to produce superoxide. It is characterized by frequent and uncontrollable infection which often lead to death in early childhood. The first clinical signs may be confined to skin and manifest themselves as abscesses, pyoderma, eczema or draining sinuses. The disease was first reported in 1957 and thereafter the biomolecular mechanism has been found. The first report in Korea was an autopsy case in 1979 and since then there have been a few case reports. This disease is diagnosed by symptoms, such as high fever, cervical lymphadenopathy, skin nodule, lung field infiltration, periumbilical abscess, liver abscess, pyoderma and pericordal abscess. The pathogen here were catalase producing bacteria and fungi. However, we have experienced a case of CGD, in which symptoms were perianal, scrotal abscesses and lung field nodular infiltration. In this case the pathogen was found as a catalase negative Enterococcus. (J Korean Pediatr Soc 2000;43-846-850)
Abscess
;
Autopsy
;
Bacteria
;
Catalase
;
Eczema
;
Enterococcus
;
Fever
;
Fungi
;
Granulomatous Disease, Chronic*
;
Korea
;
Liver Abscess
;
Lung
;
Lymphatic Diseases
;
Phagocytes
;
Pyoderma
;
Skin
;
Superoxides
10.A Case of Deletion 9p Syndrome.
Jeong Hee KIM ; Chun Soo KIM ; Un Seok NHO ; Eun Jeong KIM ; Chur Woo YOO ; Chul Kyu KIM
Journal of the Korean Society of Neonatology 2000;7(1):68-71
Since Alfi et al. first described the 9p deletion syndrome in 1973, approximately 40 cases with deletion of the chromosome 9p have been reported. These patients have multiple anomalies in craniofacies, limbs, and cardiovascular system, and mental retardation. In most cases, the breakpoint is located at the band 9p22 and the deletion is de novo. We report a neonate with 9p deletion syndrome diagnosed by clinical features and chromosomal analysis. He had multiple anomalies such as up slanting of palpebral fissures, epicanthal folds, arched eyebrows, anteverted nares, cleft palate, micrognathia, pectus excavatum, widely spaced nipples, cryptorchidism, atrial septal defect, tricuspid regurgitation (grade : III) and persistent muscle hypotonia.
Cardiovascular System
;
Cleft Palate
;
Cryptorchidism
;
Extremities
;
Eyebrows
;
Funnel Chest
;
Heart Septal Defects, Atrial
;
Humans
;
Infant, Newborn
;
Intellectual Disability
;
Male
;
Muscle Hypotonia
;
Nipples
;
Tricuspid Valve Insufficiency