Drug rash with eosinophilia and systemic symptoms syndrome induced by chloral hydrate in early childhood.

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, also known as drug-induced hypersensitivity syndrome (DIHS), is a rare, acute and severe life-threatening systemic disease. DRESS syndrome is characterized by fever, lymphadenopathy, rash, hypereosinophilia and involvement of systemic organs. The most commonly implicated drugs are anticonvulsants, sulfonamides and allopurinol. Chloral hydrate is a sedative and hypnotic drug frequently used in pediatric patients. We first report a case of DRESS syndrome induced by chloral hydrate in a 14-month-old female.

Congenital internal hernia presented with life threatening extensive small bowel strangulation.

Internal hernia (IH) is a rare cause of small bowel obstruction occurs when there is protrusion of an internal organ into a retroperitoneal fossa or a foramen in the abdominal cavity. IH can be presented with acute or chronic abdominal symptom and discovered by accident in operation field. However, various kinds of imaging modalities often do not provide the assistance to diagnose IH preoperatively, but computed tomography (CT) scan has a high diagnostic accuracy. We report a case of congenital IH in a 6-year-old boy who experienced life threatening shock. CT scan showed large amount of ascites, bowel wall thickening with poor or absent enhancement of the strangulated bowel segment. Surgical exploration was performed immediately and had to undergo over two meters excision of strangulated small bowel. To prevent the delay in the diagnosis of IH, we should early use of the CT scan and take urgent operation.

Expression, purification, and biochemical properties of arginase from Bacillus subtilis 168.

The arginine-degrading and ornithine-producing enzymes arginase has been used to treat arginine-dependent cancers. This study was carried out to obtain the microbial arginase from Bacillus subtilis, one of major microorganisms found in fermented foods such as Cheonggukjang. The gene encoding arginase was isolated from B. subtilis 168 and cloned into E. coli expression plasmid pET32a. The enzyme activity was detected in the supernatant of the transformed and IPTG induced cell-extract. Arginase was purified for homogeneity from the supernatant by affinity chromatography. The specific activity of the purified arginase was 150 U/mg protein. SDS-PAGE analysis revealed the molecular size to be 49 kDa (Trix·Tag, 6×His·Tag added size). The optimum pH and temperature of the purified enzyme with arginine as the substrate were pH 8.4 and 45°C, respectively. The Km and Vmax values of arginine for the enzyme were 4.6 mM and 133.0 mM/min/mg protein respectively. These findings can contribute in the development of functional fermented foods such as Cheonggukjang with an enhanced level of ornithine and pharmaceutical products by providing the key enzyme in arginine-degradation and ornithine-production.

Functional and esthetic assessment of radial forearm flap donor site repaired with split thickness skin graft.

The purpose of this study was to evaluate the long-term functional and esthetic outcomes of radial forearm flap (RFF) donor site repaired with split thickness skin graft (STSG). Nineteen patients underwent surgical reconstruction of oro-facial defects by the use of RFF and their donor sites were reconstructed with STSG. The patients were followed up at least for 12 months postoperatively and the left hand was the non-dominant hand in all of them. Objective methods including pinch strength, grip strength, range of motion, current perception threshold (CPT) and two-point discrimination, and subjective methods including patients interview, visual analogue score (VAS) about function, sensitivity, pain and color match, were collectively employed for donor site assessment. Our data revealed some degree of reduction in motor function and sensation compared to the non-donor hand. The difference of pinch strength means was 9.81% and of the grip strength was 12.6%. The difference of wrist flexion means was 17.6% and of wrist extension was 13.4%. However, none of the patients had functional defects of forearm supination and pronation, wrist ulnar deviation or wrist radial deviation. Subjective evaluation showed that the donor site repaired with STSG was well accepted by the patients particularly from a functional point of view. These results demonstrate that STSG represents a favorable choice for RFF donor site repair.