Epidemiology and Clinical Characteristics of Childhood Acute Lymphoblastic Leukemia in Korea / 대한소아혈액종양학회지

PURPOSE: Acute lymphoblastic leukemia (ALL) accounts for approximately 75% of all cases of childhood leukemia. We investigated epidemiology, clinical and laboratory features and treatment outcome of the children with ALL in Korea during recent 5 years. METHODS: One thousand forty nine patients were enrolled between January 1994 and December 1998 from 37 major hospitals in Korea. The data regarding the clinical and laboratory features including age, WBC counts at diagnosis, immunophenotype, morphology, cytogenetics and treatment outcome of patients were analyzed retrospectively by review of patient's medical records. Kaplan-Meier survival curves were constructed. The differences between groups analyzed by log-rank test. RESULTS: There were 597 males and 452 females. The distribution between the age 2 and 5 years is most common in 46.1%. The annual incidence rate per 100,000 population varied from 1.6 to 2.2. The 5 year event free survival (EFS) rates according to good prognostic factors were as follows: 67% bet ween 1-9 year of age at diagnosis, 69% in under 10,000/mm3of initial WBC count, 74% in early pre-B cell CALLA ( ) immunophenotype, 65% in L3 morphology, 68% in no CNS invasion. Most of patients were treated by CCG treatment protocol. The 5 year EFS was 63%. Main complications were sepsis (21.8%) and hemorrhage (12.5%). The relapse rate was 15.6%. The common causes of death were sepsis, DIC, pneumonia, relapse. CONCLUSION: Our results could provide the most recent and important information about acute lymphoblastic leukemia of children in Korea.

Interaction of the mec Regulator Genes in Methicillin Resistant Staphylococcus

PURPOSE: Low-affinity penicillin-binding protein PBP 2a encoded by mecA is closely related to methicillin resistance in staphylococci, and the expression of PBP 2a is controlled by regulator elements encoded by mecR1 and mecI. Deletion or mutation which occurred in mecI is considered to be associated with constitutive production of PBP 2a. We investigated the distribution of mec regulator genes and the presence of the mutations in mecI among mecA gene-positive methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus (MRCNS) strains. METHODS: A total of 28 MRSA and 26 MRCNS clinical strains were isolated at Chung-Ang University Hospital. The distribution of mec regulator genes and the presence of mutations in mecI were analyzed using polymerase chain reaction and direct sequencing. RESULTS: In 28 MRSA and 26 MRCNS, only mecR1A-positive pattern (type lll) was detected in 53.6% of MRSA and 46.4% of MRCNS. The mecR1 (mecR1A and mecR1B) and mecI-positive pattern (type l) were detected in 42.3% of MRSA and 38.5% of MRCNS. In 19.2% of MRCNS was type lV in which no mec regulator genes were detected. Our results showed that a greater genomic variation existed in MRCNS than a MRSA. Results in direct sequencing of mecI revealed that mecI gene tested in our study did not harbour mutations and deletions. There was no correlation between the level of resistance and the presence or absence of mec regulator genes. CONCLUSION: The induction of methicillin resistance and the variability of phenotypic expression of methicillin resistance suggested that additional factors on the chromosome are involved.

Relation between ischemic preconditioning and the duration of sustained ischemia

It has been reported that repetitive brief periods of ischemia and reperfusion (ischemic preconditioning, IP) cause a significant reduction in the extent of myocardial necrosis or in the incidence of reperfusion arrhythmias in rat heart. However, recent reports have stated that IP effect is diminished or lost in the canine or bovine heart if ischemia (mostly regional) is sustained for 40 min or longer. The main objective of this study is to assess whether IP provides myocardial protection in prolonged sustained ischemia under the condition of global ischemia in isolated rabbit heart. The hearts were subjected to 10-60 min sustained ischemia (SI) followed by 60 min reperfusion with (IP heart) or without IP (ISCH heart). IP was induced by 4 cycles of 5 min global ischemia and 5 min reperfusion. Left ventricular function (LVF), extent of infarction (EI) and ultrastructural changes were examined. As a whole, the LVF began to recover on reperfusion but there was no significant difference in the functional parameters. However, extracellular Ca2+ concentration was lower in the ISCH hearts (p <0.05) and the EI was significantly different between the hearts which had received 60 min SI (67% in the ISCH versus 32% in the IP heart, p <0.01). Ultrastructural changes were homogeneous in the ISCH hearts and became irreversible in accordance with increase of the duration of ischemia, while these changes were heterogeneous and restricted in the IP heart. These results suggest that IP does not attenuate the postischemic dysfunction in prolonged ischemia but it can provide an infarct size-limiting effect and delay ultrastructural changes. This cardioprotective effect may be related to calcium homeostasis.

Clinical Analysis of Serum and Urine N-Acetyl-B-D-Glucosaminidase(NAG) in Renal Disease

Recently, NAG activity has gained increasing importance as and aid in the diagnosis of renoparenchymal diseases. Elevation of urine NAG activity has been found to be an indicator of renoparenchymnal diseases. To evaluate the diagnostic value of the NAG activity test in the renal disease, we carried out clinical study on 31 cases of renal disease patients who had been admitted to the Department of Pediatrics, Chung-Ang University Hospital between March 1992 and February 1993. We analyese by two data: (1) Stastical Package for the Social Science. (2) Students'T test. The results were as follows 1) The urine NAG activity significantly increased (p<0.05) to 69.9+/-5165.69U/hr/mg Creatinine (U/hr/mg Cr) in the renal disease group compared to 3.6+/-1.91U/hr/mg Cr in the control group. 2) The serum NAG activity was 11.69+/-5.18U/L in the renal disease group and 10.58+/-4.04U/L in the control group. There was no significant difference in the serum NAG sctivity between two groups. 3) In the renal disease group, the serum NAG activity was 10.78+/-3.32U/L in male 12.53+/-6.47U/L in female. There was no significant difference between both sexes. In the renal disease, the urine NAG activity was 33.62+/-30.67U/hr/mg Cr in male and 114.05+/-241.62U/hr/mg Cr female. There was no significant difference between both sexes (p<0.05). 4) In the renal disease group, the urine NAG activity increased 314.73+/-420.39U/hr/mg Cr in the 2 years old group but there was no significant difference of urine NAG activity compared to above 2 years old group . 5) The urine NAG activities were 93.1+/-0193.04U/hr/mg Cr in the poteinuria subgroup and 13.3+/-47.62U/hr/mg Cr in the nonproteinuria subgroup and 3.66+/-1.91U/hr/mg Cr in the control group. There was no significant difference between the proteinuria subgroup and the nonproteinuria subgroup. but there was significant difference between nonproteinuria subgroup and control grouop(p<0.005).

Effect of Preconditioning on Postischemic Reperfused Rabbit Heart

BACKGROUND: It has been reported that one or more intermittent reperfusion(s) during ischemia may be beneficial to the myocardium by washing out catabolites that have accumlated during ischemia. We evaluated the effect of four cycles of ichemia (2 minutes) and reperfusion (3 miutes), i.e., preconditioning on sustained ischemia (20 minutes) and reperfusion (60 minutes) using isolated Langendorff-perfused rabbit hearts. METHODS: After a fifty-minutes recovery phase, LVP , dLVP/dt and ECG were simultaneously recorded and ultrastructure of the stunned(or risk) area of the left ventricle was examined with conventional methods. RESULTS: In the preconditioned hearts, functional parameters such as LVPP(peak pressure), LVPP recovery rate and LVEDP(end-diastolic pressure) reached to 99.6+/-4.38mmHg, 98.0+/-4.67% and 14.0+/-2.90mmHg (109.3+/-2.91mmHg, 109.4+/-1.29mmHg and 10.7+/-2.67mmHg for the controls), respectively, after 30 minutes from the onset of reperfusion and maintained as in the controls(p>0.01). In contrast, in the ischemia-reperfusion hearts, LVPP and LVPP recovery rate were significantly reduced(81.6+/-6.83mmHg and 85.7+/-5.30%;p<0.05) and LVEDP elevated(21.2+/-3.00mmHg) but dP/dtmax, heart rate and ECG patterns were not significantly different between the preconditioned and the ischemia-refusion hearts during reperfusion. Furthermore, irreversible myocardial injury was homogeneous(both subendo- and subepicardial) in the ischmia-reperfusion hearts but only focal(subendocardial) in preconditioned hearts. CONCLUSION: These results suggest that preconditioning induced by very short periods of ischemia and reperfusion may enhance recovery of the left ventricular function and delay ultrastructhral changes to a certain extent during reperfusion.

Morphometric Study on the Development of the Human Fetal Heart after Mid-term / 체질인류학회지

A total of 23 human fetal hearts from 18 to 40 weeks of gestation were provided for histologic and morphometric studies. The fetuses were the products of spontaneous or artificial abortions and were found to have no congential anomalies or associated lesions at autopsy. Maxima thickness of the left anterior, left lateral, left posterior, right anterior, right lateral, right posterior ventricular wall, and of the interventricular septal wall were measured and the left / right wall thickness ratio was calculated. The cross-sectional area of each ventricle parallel to the base of the heart at about 3-5mm below from the origin of the aorta was measured under drawing attachment-equipped light microscope with the application of point counting or cut-and-weigh method. Data were analyzed by the Anderson-ell ABSTAT dBASE ll statistical package program. The ventricular wall consisted of endocardium, myocardium and epicardium. The myocardium showed epithelial character by stratification of barrel-shaped myocardial cells, but the epithelial character progressively changed to as in adult myocardial tissue from the myocardial area close to the epicardium with increasing fetal age. However, any significant histologic difference between the left and the right ventricular wall at the same fetal age was not found. The growth pattern of both ventricular wall, the interventricular septal wall, and of the cross sectional area were linear (p0.1).

Studies on the Development of Lung and Distribution of Elastic and Reticular Fibers during Fetal Period Proper / 체질인류학회지

To investigate the human lung development and the distribution of elastic and reticular fibers during the fetal period proper, lung tissues taken from the periphery of the right lower lobes of Korean fetuses (n=49) of both sex were studied. The fetuses were the prodocts of spontaneous or therapeutic abortions and were found to have no associated lesions or anomalies at autopsy. The fetal age were estimated from crown-rump length or foot length. Paraffin sections, cut at 5-7 µm, were stained with routine hematoxylin and eosin for general structure, acid orcein and a1dehyde fuchsin for elastic fiber, and with Gomori's silver technique for reticular fiber, respectively. The lung development during fetal period proper, could be subdivided into three continuous periods according to the relation between airspaces, surrounding mesenchymal tissue, their structural changes and distribution, i.e., an early stage of the formation of conductive airways (pseudoglandular period, before 16th week of gestation), a middle stage of the development of lung parenchyma and new blood vessels (canalicular period, between 16th and 28th week of gestation), and a late stage of transition of respiratory portion to vascular organ (terminal sac stage, after 28th week of gestation). In places, secondary septa of sac or saccule formed by capillaries, capillary connective tissue, elastic and reticular fuel could be identified by the 33rd week of gestation. Elastic fibers could be noted in pleura, subepithelial areas of bronchioles and the wall of blood vessels in the late stage of pseudoglandular period. By the 28th week of gestation, elastic fibers were seen in the wall of small blood vessels or capillaries in the septal wall among the airspaces. And these fibers were observed in the tip of the secondary septa by the 33rd week of gestation but were not still completely developed in the walls of primary or secondary septa. Reticular fibers were already developed and widely distributed in fetal lung by the 10th week of gestation. These fibers were concentrated particular around the subepithelial area of bronchicoles, the airspaces and the blood vessel wall in the canalicular period. By the late stage of terminal sac period, reticular fibers formed a network along the small blood vessels in the septum of airspaces. These results indicate that primitive alveoli might be formed by the late stage of fetal period proper. The fibrous framework could partially formed by collagenous and reticular fibers during the pseudoglandular period, by addition of elastic fiber to the preformed network, and incompletely still finally by the three kinds of connective tissue fiber.

Analysis of Asymptomatic Proteinuria in School Children

No abstract available.

Asymptomatic human rotavirus infections during infancy and preschool period

No abstract available.

Physicial Growth of Children in Korean, 1985

No abstract available.

A Case of Thanatophoric Dwarfism

No abstract available.

An Autopsy Case of Agyria

An autopsy case of agyria in a newborn infant was reported. This neonate had her birth weight of 1.62kg after 40 weeks of gestation. The head circumference was 24cm(less than 3 percentile), and was slightly asymmetric. The brain weighed 60 grams. Fronto-occipital diameter was 7cm. And biparietal diameter was 6.5cm. Two small hemispheres were covered with opague congested leptomeninges, and barely no demonstrable gyrial pattern was recongnized. Interhemispheric fissure, Sylvian fissure and Hippocampal fissures was recognized together with poorly developed olfactory fissure. Cerebral mantle consisted of diffusely thick, 4 layered cortex that is hardly distinguishable rom underlying white matter. Multifocal granule cell heterotopias of cerebellum and neruonal heterotopia in interior Olivary nuclei were seen. Besides, dural anomalies and posterior fossa cyst were observed in this case. Extraneural anomalies consisted of ostium secundum atrial septal defet, low-set ears and high-arched palate.

A Pediatric Case of Korean Hemorrhagic Fever Confirmed by Fluorescent Antibody Technique

A case of Korean hemorrhagic fevery confirmed by fluorescent antibody technique in a 8years old boy was reported with a brief review of references.

Studies on pathological changes of the liver in abino rats infected with Clonorchis sinensis

The present study was undertaken to observe the pathologic changes of the liver in albino rats with Clonorchis sinensis. Twenty five rats given 50 metacercariae respectively by mouth were autopsied at 3 days (group 1), one week (group 2), 4 weeks (group 3), 8 weeks (group 4) and 12 weeks (group 5) of infection. The following results were obtained: Parasites were seen in bile ducts of group 2, 3, 4, 5 and increased in number with duration of infection. The pathologic changes in the liver were prominent in intrahepatic bile ducts. Epithelial cells of bile ducts showed definite atypia and proliferation resulting in pseudostratification in group. Stratification of metaplastic squamous cells and glandular proliferation were prominent in group 3. The epithelial cells were keratinized with syncitium and cribriform formation in group 4 and almost suggestive of adenomatous hyperplasia in group 5. Periductal fibrosis seen in group 4 was considerable as well as mature with hyalinized connective tissue in group 5. Heavy inflammatory cell infiltrations around the affected bile ducts in group 1 became smaller in number with duration of infection. The inflammatory cells consisted of the majority of eosinophils in group 1 and chiefly plasma cells, lymphocytes and mononuclear cells in group 5. Veins in portal spaces dilated markedly in group 1 became less prominent with duration of infection. Although portal fibrosis increased definitely in group 3 often extended into the hepatic lobules in group 4, the changes of hepatic cells, sinusoids and central veins were negligible. Above results suggest that clonorchiasis could be a factor in inducing primary carcinoma of liver in albino rats.