Purpose : As the prevalence of childhood obesity is increasing, hypertension, hyperlipidemia, insulin resistance and diabetes mellitus have become problems. High homocysteine levels and low vitamin $B_{12}$ supplementation are acknowledged to have a role in coronary artery disease, but there are few studies on homocysteine, insulin and vitamin $B_{12}$ levels in obese children. We aimed to study whether homocysteine, insulin, vitamin $B_{12}$, folic acid levels could have any difference and relation in obese children. Methods : The disease group consisted of 27 children from 8 to 11 years old, whose obesity index was over 130. The control group consisted of 30 healthy children of the same age group. Obesity index and body mass index were calculated by height and body weight of the children, and their systolic and diastolic blood pressures at resting state were checked. Total cholesterol, triglyceride, homocysteine, insulin, vitamin $B_{12}$, folic acid levels were studied after 10 hours of fasting. Intracellular fluid, extracellular fluid, protein, mineral, muscle mass, lean body fat, fat mass and fat percentages were checked by bioelectrical impedance. Results : Homocysteine levels were higher in obese children($8.1{\pm}2.1{\mu}mol/mL$ vs. $4.9{\pm}1.0{\mu}mol/mL$). Insulin levels were also higher in obese children($26.8{\pm}11.2{\mu}IU/mL$ vs. $12.5{\pm}5.24{\mu}IUl/mL$). Vitamin $B_{12}$ was lower in obese children($798.6{\pm}174.3pg/mL$ vs. $967.8{\pm}405.0pg/mL$). But there was not a difference in the folic acid levels between the two groups. In obese children, systolic blood pressure (r=0.535), triglyceride(r=0.517), total cholesterol(r=0.408), folic acid(r=0.408), vitamin $B_{12}$(r=0.338) and abdomoanl fat %(r=0.306) had a positive correlation. Conclusion : We found definite differences of insulin, homocysteine, and vitamin $B_{12}$ plasma levels in obese children, but we need more study to use those parameters as risk factors of metabolic syndrome in pediatric obese patients.
Purpose : The differential diagnosis for a pulmonary nodule is intriguing in cancer patients. Metastasis might be a preferential diagnosis, and yet possibilities of other medical conditions still exist. Pulmonary tuberculosis should be enlisted in the differential diagnosis for a pulmonary nodule in cancer patients in Korea. This study was aimed at analyzing the incidence and clinical features of pulmonary tuberculosis that were misdiagnosed as pulmonary metastasis during radiologic follow-up in pediatric cancer patients. Methods : We retrospectively studied 422 cancer patients less than 18 years old in the Korea Cancer Center Hospital from January 2001 to June 2007. We collected episodes of lung metastasis of primary tumor and tuberculosis during treatment or follow-up, and analyzed medical records. Results : There were 5 cases of tuberculosis confirmed after surgery which were initially regarded as cancer. Two patients had respiratory symptoms such as cough and sputum but the other 3 patients did not. One patient had a family history of tuberculosis. Acid-fast M. tuberculosis was found in one case upon tissue specimen analysis. Two cases were Mantoux positive and the sputum examination was negative in all cases. The polymerase chain reaction for tuberculosis on a pathologic specimen was used to differentiate M. tuberculosis from non-tuberculosis mycobacterium (NTM). It was positive in one case. Lung lesions in one case showed a concurrence of tuberculosis along with lung metastasis. One of these patients died after cancer recurrence. Conclusion : It is necessary to consider the possibility of tuberculosis when a lung mass is newly detected during treatment or follow-up in patients with childhood cancer.
In adaptive radiotherapy(ART), generated composite dose of surrounding normal tissue on overall treatment course which is using deformable image registration from multistage images. Also, compared with doses summed by each treatment plan and clinical significance is considered. From the first of May, 2011 to the last of July, 2012. Patients who were given treatment and had the head and neck cancer with 3-dimension conformal radiotherapy or intensity modulated radiotherapy, those who were carried out adaptive radiotherapy cause of tumor shrinkage and weight loss. Generated composite dose of surrounding normal tissue using deformable image registration was been possible, statistically significant difference was showed to mandible($48.95{\pm}3.89$ vs $49.10{\pm}3.55$ Gy), oral cavity($36.93{\pm}4.03$ vs $38.97{\pm}5.08$ Gy), parotid gland($35.71{\pm}6.22$ vs $36.12{\pm}6.70$ Gy) and temporomandibular joint($18.41{\pm}9.60$ vs $20.13{\pm}10.42$ Gy) compared with doses summed by each treatment plan. The results of this study show significant difference between composite dose by deformable image registration and doses summed by each treatment plan, composite dose by deformable image registration may generate more exact evaluation to surrounding normal tissue in adaptive radiotherapy.
Background: Despite recent advances in surgical technique and perioperative care of total anomalous pulmonary venous return (TAPVR), post-repair pulmonary vein stenosis (PVS) remains as a serious complication. We thought that the most important factors of TAPVR repair to prevent PVS were good exposure, proper alignment, and sufficient stoma size. We analyzed our experience retrospectively. Material and Method: Between Jan. 1995 and Feb. 2005, we studied 74 patients diagnosed with TAPVR suitable for biventricular repair. Supra-cardiac type (n=41, 55.4%) was the most common. Mean CPB time, ACC time, and TCA (40.5%, 30/74) time were $92.1{\pm}25.9\;min,\;39.1{\pm}10.6\;min$, and $30.2{\pm}10.7\;min$, respectively. Mean follow-up duration was $41.4{\pm}29.1$ months and follow-up was possible in all patients. Result: The median age and body weight at operation were 28.5 days ($0{\sim}478$ days) and 3.4 kg $(1.4{\sim}9\;kg)$. Early mortality was 4.1% (3/74). Causes of death were pulmonary hypertensive crisis, sepsis, and sudden death. There was PR-PVS in 2 patients (early: 1, late: 1). Both patients were cardiac type TAPVR drained to coronary sinus. Re-operations were done but only one patient survived. Cumulative survival rate in 5 year and percent freedom from PVS were $94.5{\pm}2.7%\;and\;97.2{\pm}2.0%$, respectively. Conclusion: There was no PVS in patients who underwent extra-cardiac anatomosis between LA and CPVC. Therefore it could be said that our principle might be effective in preventing PR-PVS in patients suitable two-ventricle.
A total of 72 finishing pigs(L${\times}$Y${\times}$D; 80kg of initial body weight) were employed for 5 weeks to investigate the effects of feeding mushroom substrate waste(MSW) treated with pleurotus ostreatus and probiotics on productivity, carcass traits, nutrient digestibility and emissions of harmful gases and malodor in manure. Treatments were Control(C: basal diet), T1(3% MSW) and T2(3% MSW+ 0.1% probiotics). Average daily gain(ADG) was lower(p<0.05) in pigs fed a T1 diet than those fed a C diet, however, there was no difference in ADG of pigs fed diets between C and T2. Similar trends were found in feed/gain(F/G) among treatments, though feed intake was not different. No differences were found in back fat thickness among treatments, but carcass dressing percentage was significantly(p<0.05) improved in pigs fed a T2 diet compared to C or T1 diets. Nutrient digestibilities including dry matter, crude protein, energy and crude fiber were lower(p<0.05) in T1 than C or T2. $NH_3$ and $H_2S$ gas emissions were reduced(p<0.05) or not produced in pig manure from T2 as compared to C or T1. In conclusion, the present result shows that feeding MSW with probiotics is desirable for finishing pigs in terms of productivity, carcass traits and nutrient digestibility. It also appears that the emission of harmful gases and malodor in manure can be reduced by the inclusion of probiotics in the diet.
Jeong, Myung Sook;Chun, Jung Mi;Kim, Kyung Ah;Ko, Sun Young;Lee, Yeon Kyung;Shin, Son Moon;Lee, Eu-Ree
Clinical and Experimental Pediatrics
/
v.48
no.8
/
pp.826-831
/
2005
Purpose : This study is directed to evaluate standardized developmental test performances of infants and children who, as fetuses, had mild isolated cerebral ventriculomegaly diagnosed by ultrasound. Methods : All prenatal sonographic findings from 2001 to 2002 were evaluated. Live isolated mild ventriculomegaly(IMVM) of 10-15 mm were observed in 95 cases(1.1 percent). Standardized developmental testing of 40 cases of IMVM and 36 cases in a comparison group were offered to parents Both groups of children were adjusted to normal antepatum subjects with respect to sex, race, indication for ultrasound and gestational age at the time of ultrasound. Test of cognitive and motor development(Bayley Scales of Infant Development, Second Edition; BSID-II) were administered by developmental examiners. Results : Forty cases and 34 comparison sujects completed the testing. The IMVM and comparison groups were similar with respect to parental age, gestational age, birth weight, familial socioeconomic status. The IMVM subjects scored lower than the comparison group on both the BSID-II, but there was not statistically significant. differences; metal development index(MDI)($92.7{\pm}12.9$ vs $94.7{\pm}14.1$, P=0.47) and psychomotor development index(PDI)($100.3{\pm}14.1$ vs $101.3{\pm}10.7$, P=0.75). Eleven cases(27.5 percent) of IMVM group and five cases(14.7 percent) of the comparison group were developmentally delayed, but most cases in both groups showed mild delays. Resolution or lack of progression, lateral ventricle diameter ${\leq}12mm$ and females were associated with better scores, but there were not statistically significant. Polarity, and head circumference were not related to later development. Conclusion : This study show children with MIVM did not delay performance in the developmental test, but we might suggest a tendency to increase the risk of mild developmental delay.
Purpose : Obesity is closely related to insulin resistance, compensatory hyperinsulinemia and dyslipidemia in adults. We identified the effect of obesity measured by BMI and insulin resistance on dyslipidemia in children and adolescents. Methods : The fasting serum insulin, glucose, total cholesterol, triglyceride, HDL- and LDL-cholesterol were measured and insulin resistance(HOMA-IR) was calculated in 35 children with simple obesity(age :$10.6{\pm}2.8$ years; male 20, female 15; BMI : $27.1{\pm}5.4kg/m^2$). Results : The hypertriglyceridemia(37%), hyperinsulinemia(54%) and HDL-hypocholesterolemia(5.7%) were observed. HOMA-IR was well expressed by fasting insulin. As BMI increased, there was a statistically significant increase in insulin resistance and insulin level in both sexes. BMI was not related with lipid profile in both sexes. Triglyceride was correlated with only insulin level and insulin resistance index in boys. In girls, there was no correlation between triglyceride, HDL-cholesterol and insulin(insulin resistance). Conclusion : These results suggest that hypertriglyceridemia was dependent on insulin resistance in pre-adult males. Monitoring of insulin resistance and those risk factors known to become a part of insulin resistance syndrome should become part of routine medical care for obese children.
Moon, Soo Kyoung;Lee, Jae In;Yoon, Hye Sun;Ahn, Young Min
Clinical and Experimental Pediatrics
/
v.50
no.9
/
pp.855-861
/
2007
Purpose : The most common causes of acute viral gastroenteritis in newborn period are rotavirus, astrovirus, norovirus and enteric adenovirus. This study was designed to investigate the clinical characteristics, clinical symptoms, isolation rate and distribution of these viruses in full-term neonates during neonatal period. We also studied the influence on the viral isolation rate by postnatal care place and feeding type. Methods : We evaluated 112 healthy full-term neonates who were admitted to Eulji hospital, presenting with symptoms of acute viral gastroenteritis from September 2004 to August 2005. Epidemiologic, clinical and laboratory data were reviewed. Enzyme-linked immunosorbent assay (ELISA) for rotavirus, astrovirus and norovirus and RT-PCR for enteric adenovirus were performed in study subjects.Results : The mean age at the admission was $11.4{\pm}5.4days$, mean weight loss was $5.9{\pm}5.1%$, mean hospitalization duration was $6.3{\pm}3.4days$. Moderate and severe weight loss were expressed in 51.7% and metabolic acidosis was in 13.4%. The percent of living in postnatal care facility (PCF) was 74.1 % and the percent of mixed feeding was 64.3%. Isolation rate of virus was 33%. The most prevalent virus was rotavirus (59.5%), followed by astrovirus (29.7%) and norovirus (10.8%). There was no differences in virus isolation rate by postnatal care place and by feeding type. The rotavirus was main virus in both home group and PCF group. But astrovirus was more detected in PCF and norovirus was more detected in home (P<0.05). According to monthly distribution of virus, acute viral gastroenteritis in newborn period was concentrated in September to December. Conclusion : The isolation rate of 4 type viruses was 33% and rotavirus was the leading cause of acute gastroenteritis during neonatal period. There was no differences in clinical characteristics on each viral groups.
In order to investigate the osmoregulation capability of grey mullet, Mugil cephalus with the different salinities, juvenile fish $(13.6{\pm}0.2\;TL)$ stocked in seawater (SW) were abruptly transferred to each experimental group $0\%SW(0\%_{\circ}),\;25\%SW(7.7\%_{\circ}),\;50\%SW(16.1\%_{\circ})\;and \;100\%SW(32.8\%_{\circ})$ and reared for 60 days. Blood samples were taken by the time schedule after the transfer. Plasma $Na^{+},\;K^{+},\;Cl^{-}$ and osmolality, muscle water content, and the electron microscopical observations of chloride cells were analyzed and made by the time schedule. In $100\%SW$, the maintainable levels of plasma $Na^{+},\;K^{+},\;Cl^{-}$ and osmolality were $167.1{\pm}7.7mM/l,\;9.1{\pm}2.1mM/l,\;137.8{\pm}5.6mM/l\;and\;351{\pm}18\;mOsm/kg$, respectively. These values were significantly changed at $6h\~1\;day$ after the beginning of the experiment with four different salinities. Fish from $0\%\;and\;25\%SW$ had lower osmolalities than those of fish from $50\%\;and\;100\%SW$, and showed the hyposmotic regulation pattern. At the end of the experiment (60 days after transfer), however, no significant difference was found in the concentrations of plasma $Na^{+},\;K^{+}\;and\;Cl^{-}$ among four experimental groups. Hematocrit was increased with salinity (P<0.01). After 10 days, fish from $0\%\;and\;25\%SW$ showed the hypertrophy, fusion and edema of epithelial layer in gill lamella. However, at the 15th day, epithelial layer in gill lamella was back to the normal status. On gill of fish from $0\%SW$, one apical pit held two or three chloride cells in common. Muscle water content was subsequently regulated to near the normal levels within 4 days, and there was no significant difference among four different salinities at the end of the experiment.
The purpose of this study was to provide a reference range for plasma homocysteine and to explore the relation between plasma homocysteine and nutritional indexes in a Korean college women. Thirty women were selected from college students in Seoul area With mean age of 22.4y. Dietary intakes of Vitamins B$_{6}$, B$_{12}$, folate were estimated from a 3 day food diary method and plasma homocysteine concentration was mearsured as well as the levels of blood vitamins. The results obtained are as follows. Mean daily intake of energy, vitamin B$_{6}$, B$_{12}$, and folate were 1731.9kcal, 0.9mg, 2.2mg and 139.8$\mu\textrm{g}$ respectively. Mean plasma homocysteine concentration was 12.4$\mu$mol/l with a range between 6.7 and 17.8$\mu$mol/l and the mean concentrations of plasma vitamin B$_{6}$(PLP), serum vitamin $_{12}$, Serum folate and RBC folate were 77.5nmol/l, 267.4pmol/l, 17.1 nmol/l and 736.5nmol/l arid 736.5nmol/l respectively. we found a negative correlation between plasma homocysteine concentration and dietary vitamins, and blood levels of vitamin although it was not significant.
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