A 6 year 6month-old boy was admitted with complains of severe spontaneou epistaxis and easy brusability. He was one of five siblings, and two of them died of recurred severe epistaxis at their age of six years. There was no history of bleeding tendency to his antecedents and parents, whose marriage was unrelated. Platelet count and partial thromboplastin time were noraml with prolonged bleeding time, but clot retraction was poor. Platelet adhesion(Salzman method) was decreased and platelet aggregation test showed flat curve with no response to epinephrine and ADP. These tests of other were normal. Diagnosis of thrombasthenia was made with the above history and laboratory results.
Adenosine Diphosphate ; Bleeding Time ; Blood Platelets ; Clot Retraction ; Diagnosis ; Epinephrine ; Epistaxis ; Hemorrhage ; Humans ; Male ; Marriage ; Parents ; Partial Thromboplastin Time ; Platelet Aggregation ; Platelet Count ; Siblings ; Thrombasthenia*

A 6 year 6month-old boy was admitted with complains of severe spontaneou epistaxis and easy brusability. He was one of five siblings, and two of them died of recurred severe epistaxis at their age of six years. There was no history of bleeding tendency to his antecedents and parents, whose marriage was unrelated. Platelet count and partial thromboplastin time were noraml with prolonged bleeding time, but clot retraction was poor. Platelet adhesion(Salzman method) was decreased and platelet aggregation test showed flat curve with no response to epinephrine and ADP. These tests of other were normal. Diagnosis of thrombasthenia was made with the above history and laboratory results.
Adenosine Diphosphate ; Bleeding Time ; Blood Platelets ; Clot Retraction ; Diagnosis ; Epinephrine ; Epistaxis ; Hemorrhage ; Humans ; Male ; Marriage ; Parents ; Partial Thromboplastin Time ; Platelet Aggregation ; Platelet Count ; Siblings ; Thrombasthenia*

Peptic ulcer disease in children presents an interesting and sometimes difficult problem to the clinicians. Since the incidence is quite small in children, only small collected series have been reported in the literature. With the improvement of diagnostic aids (particularly radiologic equipments and greater attention paid by clinicians, peptic ulcers have been detected with increasing frequency. However, there is a paucity of information available concerning this disease in infancy and childhood in Korea. The symptoms and signs of peptic ulcer disease in childhood are obscure and have many differences from those of tihe adult, which too often go unrecogntzed until complications set in. The authors made on clinical observation on 14 patients with peptic ulcer under the age of 15 years, who had been admitted to the department of pediatrics of National Medical Center from Aug, 1972 to July 1978. The age, sex and seasonal incidences, type and location of ulcer, symptom curation, clinical and laboratory findings, complications and prognosis were analyzed and the data are summerized as follows. 1) The incidence of peptic ulcer in childhood was 0.33% of a total 4221 admissions, and the average number of patients of peptic ulcer per year was 2.3. 2) Among 14 patients, 9 cases (68%) were between 12 and 15 years of age, 4 patients (28%) between 7 and 11, and the majority (93%) were between the ages of 7 and 15. The youngest patients wea 4 year old male. 3) Sex incidence showed that males predominated in a proportion of 13:1. 4) Seasonal incidence was relatively high (inspring) (28.6%) and autumn (42.9%). 5) Three cases (21.5%) had gastric ulcer and 11 cases (78.5%) had duodenal (ulcer, 12 cases were diagnosed as primary type and 2 cases were) thought to be secondary type due to steroid therapy. 6) Duration of symptoms were variable, with the range between 1 week and 3 years. 7) The majority have abdominal pain (100%), vomiting (85.6%) and epigstric tenderness (71.4%), Other symptoms and signs were anemia (42.9%), indigestion (38.5%), melena (38.5%), epigastric pain (28.6%), general weakness (21.5%), weight loss (14.3%) and abdominal rigidity (14.3%). 8) Gastric analysis was performed in 5 patients, 2 of these patients had slight hyperchlorhydria, but 3 cases showed normal results. 9) Complications were found in 4 patients (28.6%). These were perforation (2 cases, 14.3%) and obstruction (2 cases 14.3%). Postoperative condition during hospitalization was excellent. 10) Among the chronic primary ulcer patients (12 cases), ulcer symptoms disappeared in 10 cases with medical treatment such as antacids, tranquilizers and other conservative treatments and within one month after treatments were discharged with improvement.
Abdominal Pain ; Adult ; Anemia ; Antacids ; Child ; Child, Preschool ; Dyspepsia ; Hospitalization ; Humans ; Incidence ; Korea ; Male ; Melena ; Only Child ; Pediatrics ; Peptic Ulcer* ; Prognosis ; Seasons ; Stomach Ulcer ; Ulcer ; Vomiting ; Weight Loss

Eggs of Echinostoma sp. were found from two patients who were hospitalized between Oct. and Dec. 1985. Single dose of 10 mg/kg of praziquantel was prescribed to each patient and after purgation with magnesium salt seven and two adult worms of Echinostoma cinetorchis in respect were recovered from patients. The first case was a 54-year-old male residing at Chungju city in Chungbuk province. He was hospitalized because of severe weight loss and frequent urination. The second case was a 71-year-old male residing at Chungsun-kun in Kangwon province, and hospitalized due to suspected lung cancer. The average size of the eggs found in the stools was 98 x 63 micrometer (the first case) and 100 x 67 micrometer (the second case) respectively, and total nine worms collected were identified as E. cinetorchis.
parasitology-helminth-trematoda ; Echinostoma cinetorchis ; case report ; praziquantel ; intestine

In order to examine the neurotoxic mechanism of oxygen radicals on cultured bovine oligodendrocytes, cytoxic effect of oxygen radicals was examined when cultures were treated with various concentrations of xanthine oxidase (XO) and hypoxanthine (HX) in culture medium. In addition, the neuroprotective effect of iron-chelators against the neurotoxicity induced by oxygen radicals was evaluated by MTT assay. Cell viability was remarkably decreased in a time-dependent manner after exposure of cultured bovine oligodendrocytes to 20mU/ml XO and 0.1mM HX for 4 hours. In the neuroprotective effect of iron-chelators on oxidant-induced neurotoxicity, tetrakis (2-pyridylmethyl)ethylenediamine (TPEN) blocked the neurotoxicity induced by oxygen radicals, while DFX was not effective in blocking oxidant-induced neurotoxicity in these cultures. These results suggest that oxygen radicals are toxic in cultured bovine oligodendrocytes, and also selective iron-chelators such as TPEN are effective in blocking the neurotoxicity induced by oxygen radicals.
Allopurinol* ; Cell Survival ; Hypoxanthine ; Neuroprotective Agents ; Oligodendroglia ; Reactive Oxygen Species ; Xanthine Oxidase

Background: and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes. Methods: We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data. Results: Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4. Conclusion Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.

Background: and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes. Methods: We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data. Results: Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4. Conclusion Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.

Background: and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes. Methods: We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data. Results: Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4. Conclusion Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.