• Clinical and Experimental Pediatrics
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• v.46 no.8
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• pp.758-762
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• 2003

Purpose : Our examination was designed to determine the diagnostic properties of the cutoff point for the prediction of bacteremia in febrile children less than 3 years of age. Cutoff point is the value that simultaneously maximizes both sensitivity and specificity. Methods : We conducted a retrospective study of febrile children, less than 3 years of age, who clinically have no identifiable source of fever. Peripheral blood leukocyte count(WBC), absolute neutrophil count(ANC), erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) were measured at the same time. All patients received blood culture, urine culture and/or CSF culture. Bacterial infection was defined as single pathogen isolated from the CSF or blood or a urinary tract infection (UTI). Patients were dichotomized into two groups : those with bacterial infection and no bacterial infection. We analyzed the characteristics of the children in the two groups. Results : Seventy-one patients(44 males; 27 females) were enrolled in the study. Twenty patients (28%) had a serious bacterial infection(twelve urinary tract infection, five bacteremia, three meningitis) and fifty-one(72%) had no serious bacterial infection. WBC, ESR and CRP were significantly different between the two groups(P<0.05). The cutoff point of WBC, ESR and CRP were $20,000/mm^3$, 30 mm/hr and 3.0 mg/dL, respectively. The sensitivity and specificity of each cutoff point were WBC(75%, 75%), ESR(79%, 68%) and CRP(83%, 77%), respectively. Conclusion : These data show the ability of predictors to identify febrile children less than 3 years of age with bacterial infection. Febrile children who reach the cutoff point must be treated intensively and those who do not reach the cutoff point can be carefully managed without administering antimicrobial agents.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1153-1160
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• 2009

Purpose:To evaluate the risk factors for mortality and prognostic factors in pediatric hemato-oncology patients admitted to the pediatric intensive care unit (PICU). Methods:We retrospectively reviewed the medical records of pediatric hemato-oncology patients admitted at the PICU of the Asan Medical Center between September 2005 and July 2008. Patients admitted at the PICU for perioperative or terminal care were excluded. Results:Total 88 patients were analyzed. Overall ICU mortality rate was 34.1%. Mean age at PICU admission was $7.0{\pm}5.7$ years and mean duration of PICU stay was $18.1{\pm}22.2$ days. Hematologic diseases contributed to 77.3% of all the primary diagnoses, and the primary cause of admission was respiratory failure (39.8%). The factors related to increased mortality were C-reactive protein level (P<0.01), ventilation or dialysis requirement (P<0.01), and hematopoietic stem cell transplantation (P<0.05). In all, 3 scoring systems were investigated [Number of Organ System Failures (OSF number), the Pediatric Risk of Mortality III (PRISM III) score, and the Sequential Organ Failure Assessment (SOFA) score]; higher score correlated with worse outcome (P<0.01). The Oncological Pediatric Risk of Mortality (O-PRISM) scores of the 21 patients who had received hematopoietic stem cell transplantation were higher among the non-survivors, but not statistically significant (P=0.203). Conclusion:The PRISM III and SOFA scores obtained within 24 hours of PICU admission were found to be useful as early mortality predictors. The highest OSF number during the PICU stay was closely related to poor outcome.

• Development and Reproduction
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• v.2 no.1
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• pp.9-20
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• 1998

It has been wel known that phospholipase C(PLC) plays an important role in the intracellular signaling in a variety of cell types. However, involvement of PLC in mouse oocyte maturation and preimplantation embryo development remains unknown. The present study examined the expression patterns of the mouse PLC \beta 1 and \gamma 1 during oocyte maturatio and preimplantation embryo development study examined the expression patterns of the mouse PLC \beta 1 and \gamma 1 during oocyte maturation and preimplantation embryo development by the competitive reverse transcription-polymerase chain reaction (RT-PCR method). PLC \gamma 1 mRNA (0.1 fg) was readily detected in germinal vesicle (GV)-stage oocyte and its level was reduced as meiotic resumption proceeded. PLC-\beta 1 mRNA (<0.1 fg) as detected at low level at GV-stage oocytes and scarcely detected at germinal vescle breakdown (GVBD)-stage oocytes. After fertilization, both PLC \beta 1 and \gamma 1 mRNA levels began to increase at morula-stage embryos (0.2 fg) and were more prominent in blastocyst-stage embryos(1 fg). to elucidate the possible involvement of PLC via protein kinase C(PKC) pathway during oocyte maturation and preimplantation embryo development , the effects of sphingosine (PKC inhibitor), sn-$diC_{8}$(PKC activator) anc U73122 (PLC ingibitor) were examined. Treatment of GV-stage oocytes with sphingosine (20 \mu M) facilitated the meiotic resuption by 10-20 over the control within 1 h as judged by GVBD, whereas U73122 failed to show any significant effect. U73122 (10 \mu M) effectively blocked the compaction of morula, while sn-$diC_{8}$(50 \mu M). In summary, the present study shows that the mouse PLC \beta 1 and \gamma 1 are expressed in a developmental stage-specific manner and PLC-PKC pathway may be involved in early preimplantation embryo development.