• Title/Summary/Keyword: Early-onset

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Infantile Hypertrophic Pyloric Stenosis -Clinical Differences between Premature and Full-term Infants (미숙아와 만삭아에서의 비후성 유문 협착증의 임상적 차이)

  • Lee, Suk-Koo;Kim, Seong-Hwan;Lee, Woo-Yong;Kim, Hyun-Hahk
    • Advances in pediatric surgery
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    • v.4 no.1
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    • pp.34-38
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    • 1998
  • Infantile hypertrophic pyloric stenosis(IHPS) is common in full-term babies, and relatively rare in prematures. The diagnosis of IHPS in premature infants may be obscured because of the lack of classic symptoms and signs and the absence of the standard criteria for ultrasonic diagnosis. The purpose of this study is to discover the clinical differences between premature and full-term infants with pyloric stenosis, and determine the appropriate diagnostic methods for early diagnosis in premature infants. The clinical records of 52 IHPS patients who had been operated upon from October, 1994 to April, 1997 were reviewed. The incidence of IHPS in premature infants was 25 %. The onset of symptom was 4.7 weeks of age in premature, and 2.9 weeks in full-term babies. Diagnosis was established by typical symptoms. signs. and diagnostic imaging studies. In two premature infants, diagnosis was confirmed by upper gastrointestinal(GI) series, because ultrasonography did not meet the diagnostic criteria. Two premature infants initially diagnosed as gastroesophageal reflux by esophagography. were found to have IHPS by upper GI series. For the diagnosis of IHPS, a new set of criteria for premature babies has to be developed.

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Clinical outcome of acute necrotizing encephalopathy in related to involving the brain stem of single institution in Korea

  • Lee, Cha Gon;Kim, Ji Hye;Lee, Munhyang;Lee, Jeehun
    • Clinical and Experimental Pediatrics
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    • v.57 no.6
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    • pp.264-270
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    • 2014
  • Purpose: Acute necrotizing encephalopathy (ANE) is a fulminant disease of the brain characterized by bilateral thalamic lesions, and is prevalent among children in East Asia. The prognosis of ANE is usually poor with a high mortality rate and neurological sequelae. This study aimed to delineate the clinical characteristics and prognostic factors of ANE. Methods: We retrospectively analyzed clinical data of 399 pediatric patients with encephalitis who were admitted to Samsung Medical Center from December 1998 to March 2011. We enrolled ten patients (11 cases) with ANE and analyzed their demographic, clinical, and neuroimaging data. The location and extent of the brain regions were checked based on fluid-attenuated inversion recovery, T1-, and T2-weighted imaging findings; the presence of contrast enhancement, restricted diffusion, and hemorrhage. Results: Ten patients were identified, including one patient with two episodes. The median age of onset was 1.5 years (0.4-8.4 years). The mortality rate was 40%, and only 30% of patients survived without neurological sequelae. The definite involvement of the brainstem on brain magnetic resonance imaging was significantly correlated with mortality (P =0.04). Conclusion: Broad and extensive brainstem involvement suggested the fulminant course of ANE. Early diagnosis of ANE before brainstem involvement, through careful identification of symptoms of brain dysfunction, may be the best way to achieve better neurological outcomes.

Food Protein-induced Enterocolitis Syndrome: an Update on Clinical Approaches and Its Pathophysiology (식품 단백질 유발성 장염 증후군: 임상적 접근과 병태생리의 최신 지견)

  • Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.117-128
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    • 2007
  • Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated hypersensitivity disorder, which is associated with mainly gastrointestinal symptoms and has a delayed onset. The vomiting and/or diarrheal symptoms of FPIES typically begin in the first month of life in association with a failure to thrive, metabolic acidosis, and shock. Therefore, the differential diagnosis of FPIES and neonatal or infantile sepsis-like illnesses or gastroenteritis is difficult. The early recognition of indexes of suspicion for FPIES may help in the diagnosis and treatment of this disorder. The diagnosis of FPIES is generally made through clinical practice and food-specific IgE test findings are typically negative in this condition. Therefore, oral cow's milk challenge (OCC) remains the valid diagnostic standard for FPIES. An investigation of positive OCC outcomes helps to find out a diagnostic algorithm of criteria of a positive challenge in FPIES. Moreover, it has not been clearly determined in infantile FPIES when $1^{st}$ follow up-oral food challenge (FU-OFC) should be performed, with what kind of food protein (e.g., cow's milk, soy), and how much protein should be administered. Hence, to prevent the risk of inappropriate FU-OFC or accidental exposure and achieve appropriate dietary management, it is necessary to identify tolerance rates to major foods under the careful follow up of infantile FPIES patients. On the other hand, small intestinal enteropathy with villous atrophy is observed in FPIES and this enteropathy seems to be in part induced by both of epithelial apoptosis and intercellular junctional complex breakdown. The purpose of this report is to introduce an update on diagnostic and therapeutic approaches in FPIES and suggest the possible histopathological evidences in this disorder.

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Osteogenic Potency of Nacre on Human Mesenchymal Stem Cells

  • Green, David W.;Kwon, Hyuk-Jae;Jung, Han-Sung
    • Molecules and Cells
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    • v.38 no.3
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    • pp.267-272
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    • 2015
  • Nacre seashell is a natural osteoinductive biomaterial with strong effects on osteoprogenitors, osteoblasts, and osteoclasts during bone tissue formation and morphogenesis. Although nacre has shown, in one study, to induce bridging of new bone across large non-union bone defects in 8 individual human patients, there have been no succeeding human surgical studies to confirm this outstanding potency. But the molecular mechanisms associated with nacre osteoinduction and the influence on bone marrow-derived mesenchymal stem cells (BMSC's), skeletal stem cells or bone marrow stromal cells remain elusive. In this study we highlight the phenotypic and biochemical effects of Pinctada maxima nacre chips and the global nacre soluble protein matrix (SPM) on primary human bone marrow-derived stromal cells (hBMSCs) in vitro. In static co-culture with nacre chips, the hBMSCs secreted Alkaline phosphatase (ALP) at levels that exceeded bone morphogenetic protein (rhBMP-2) treatment. Concentrated preparation of SPM applied to Stro-1 selected hBMSC's led to rapid ALP secretions, at concentrations exceeding the untreated controls even in osteogenic conditions. Within 21 days the same population of Stro-1 selected hBMSCs proliferated and secreted collagens I-IV, indicating the premature onset of an osteoblast phenotype. The same SPM was found to promote unselected hBMSC differentiation with osteocalcin detected at 7 days, and proliferation increased at 7 days in a dose-dependent manner. In conclusion, nacre particles and nacre SPM induced the early stages of human bone cell differentiation, indicating that they may be promising soluble factors with osteoinductive capacity in primary human bone cell progenitors such as, hBMSC's.

Transitional Flow study on non-newtonian fluid in a Concentric Annulus with Rotating Inner Cylinder (안쪽축이 회전하는 환형관내 비뉴튼 유체의 천이 유동 연구)

  • Kim, Young-Ju;Hwang, Young-Kyu;Kwon, Hyuk-Jung;Suh, Byung-Taek;Hwang, In-Ju
    • Proceedings of the KSME Conference
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    • 2001.11b
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    • pp.324-329
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    • 2001
  • This experimental study concerns the characteristics of a transitional flow in a concentric annulus with a diameter ratio of 0.52, whose outer cylinder is stationary and inner one rotating. The pressure losses and skin-friction coefficients have been measured for the fully developed flow of $0.1\sim0.4%$ aqueous solution of sodium carbomethyl cellulose (CMC), respectively at inner cylinder rotational speed of $0\sim600rpm$. The transitional flow has been examined by the measurement of pressure losses to reveal the relation of the Reynolds and Rossby numbers with the skin-friction coefficients. The present results show that the skin-friction coefficients have the significant relation with the Rossby numbers, only for laminar regime. The occurrence of transition has been checked by the gradient changes of pressure losses and skin-friction coefficients with respect to the Reynolds numbers. The increasing rate of skin-friction coefficients due to the rotation in uniform for laminar flow regime, whereas it is suddenly reduced for transitional flow regime and, then, is gradually declined for turbulent flow regime. Consequently, the critical(axial-flow) Reynolds number decrease as the rotational speed increases. Thus, the rotation of inner cylinder promotes the early occurrence of transition due to the onset of taylor vortices.

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Intracellular Mechanisms of Growth Hormone Action on Apoptosis in Cultured Porcine Ovarian Granulosa Cells

  • Sirotkin, A.V.;Makarevich, A.V.;Pivko, J.;Genieser, H.G.
    • Asian-Australasian Journal of Animal Sciences
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    • v.15 no.7
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    • pp.1045-1050
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    • 2002
  • The aims of this study were to detect spontaneously occurring apoptosis in cultured porcine ovarian cells, to examine the role of growth hormone (GH), tyrosine kinase (TK), protein kinase G (PKG) and cyclin-dependent kinase (CDK) in the control of this process, and to determine whether the effect of GH on apoptosis is mediated by TK-, PKG- and cdc2-dependent intracellular mechanisms. We studied the action of pGH (10 ng/ml), blockers of TK (genistein, lavendustin, both 100 ng/ml), PKG (Rp-Br-PET-cGMPS, 50 nM; KT5823, 100 ng/ml) and CDK (olomoucine, $1{\mu}g/ml$), as well as combinations of GH with these blockers, on the onset of apoptosis in cultured granulosa cells isolated from antral (3-6 mm) porcine follicles. The functional characteristics of an early apoptotic event, DNA fragmentation, were determined using terminal deoxynucleotidyltransferase (TdT)-mediated dUTP nick end labelling (TUNEL), whilst morphological signs of advanced apoptosis such as pyknosis, chromatin marginalization, shrinkage and fragmentation of nucleus, were detected using routine light microscopy. After culture, some ovarian granulosa cells exhibited DNA fragmentation, which in some cases was associated with morphological apoptosis-related changes (pyknosis, shrinkage and fragmentation of the nucleus). GH significantly reduced the proportion of TUNEL-positive cells. Neither TK nor CDK blockers when given alone, significantly affected the percentage of TUNEL-positive cells although both PKG blockers significantly increased this index. Furthermore, TK and PKG blockers given together with GH, prevented or reversed the inhibitory effect of GH on apoptosis, whilst the CDK blocker olomoucine promoted it. These observations demonstrate apoptosis in porcine ovaries and suggest the involvement of GH, TK, PKG and CDK in the control of this process. They also suggest that the effect of GH on ovarian apoptosis is mediated or regulated by multiple signalling pathways including TK-, PKG- and CDK-dependent intracellular mechanisms.

The CHEK2 I157T Variant and Breast Cancer Susceptibility: A Systematic Review and Meta-analysis

  • Liu, Chuan;Wang, Ying;Wang, Qing-Shui;Wang, Ya-Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1355-1360
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    • 2012
  • Background: The cell cycle checkpoint kinase 2 (CHEK2) gene I157T variant may be associated with an increased risk of breast cancer, but it is unclear whether the evidence is sufficient to recommend testing for the mutation in clinical practice. Materials and Methods: We systematically searched PubMed, Embase, Elsevier and Springer for relevant articles published before Nov 2011. Summary odds ratio (OR) and 95% confidence interval (95% CI) incidence rates were calculated using a random-effects model with STATA (version 10.0) software. Results: A total of fifteen case-control studies, including 19,621 cases and 27,001 controls based on the search criteria, were included for analysis. A significant association was found between carrying the CHEK2 I157T variant and increased risk of unselected breast cancer (OR = 1.48, 95% CI = 1.31-1.66, P < 0.0001), familial breast cancer (OR = 1.48, 95% CI = 1.16-1.89, P < 0.0001), and early-onset breast cancer (OR = 1.47, 95% CI = 1.29-1.66, P < 0.0001). We found an even stronger significant association between the CHEK2 I157T C variant and increased risk of lobular type breast tumors (OR = 4.17, 95% CI = 2.89-6.03, P < 0.0001). Conclusion: Our research indicates that the CHEK2 I157T variant may be another important genetic mutation which increases risk of breast cancer, especially the lobular type.

Repercussions of Breastfeeding by Diabetic Women for Breast Cancer

  • Franca, Eduardo Luzia;Franca-Botelho, Aline Do Carmo;Franca, Juliana Luzia;Ferrari, Carlos Kusano Bucalen;Honorio-Franca, Adenilda Cristina
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6233-6239
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    • 2013
  • Diabetes represents a serious health problem. In the diabetic state, alterations in metabolism, increased susceptibility to infections and immunological changes occur. The suppression of the immune response has been identified as a relevant factor that contributes to the increase in the rate of infections in these patients. At the same time, breast cancer is the most frequent malignant tumor in women. The molecular and cellular mechanisms underlying cancer development have revealed that immune cells functionally regulate epithelial cancer development and progression. Breastfeeding has been hypothesized to reduce the risk of breast cancer. However, early systematic reviews have not yielded consistent findings for this association. The demand for human milk is increasing due to the promotion and consumer acceptance of the health benefits of consuming a natural product rich in bioactive components. However, due to changes in glucose metabolism, the components of the milk from diabetic women are modified depending on the time of evaluation. In this literature review, we summarize important new findings revealing the paradoxical role of breastfeeding in preventing the onset of breast cancer in diabetic mothers. We hypothesized that the milk component production in diabetic mothers is affected by changes in glucose metabolism. Therefore, adequate maternal glycemic control and an adequate duration of breastfeeding for diabetic mothers are crucial to ensure that the immunity components are able to confer protection against breast cancer.

The Changes in the Clinical Aspects of Peritonsillar Abscess during the Past 14 Years (14년 동안의 편도주위농양의 임상적 양상의 변화)

  • Park, Beom-Seok;Myung, Nam-Sook;Lee, Hyoung-Ju;Park, Hong-Seok;Han, Cheol-Woo;Koo, Soo-Kweon
    • Korean Journal of Bronchoesophagology
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    • v.15 no.2
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    • pp.57-63
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    • 2009
  • Background and Objectives : Peritonsillar abscess is one of the most common illnesses m the ENT field, though its prevalence has been drastically reduced with the development of antibiotics and appropriate early treatment. We analyzed recent clinical characteristics of peritonsillar abscess and compared them with ones of 7 and 14 years ago respectively. Materials and Methods : Sixty-six cases of peritonsillar abscess from 2006 through 2008 were investigated retrospectively and compared with results of 7 and 14 years ago on various clinical factors. Results : Peritonsillar abscess was prevalent in men in their 20s and 30s. Mean period from symptom onset to visit to hospital tended to decrease(5.2 days) but admission days has increased(7.4 days). Body temperature on admission was lower than that of previous studies($36.4^{\circ}C$). Bacteria were isolated in 26 cases(74.2%) out of 35 cases in which culture had been performed. The most common cultured organism was a-hemolytic streptococcus and $\beta$-hemolytic streptococcus that had been most frequently cultured 14 years ago wasn't detected in this study. Conclusion : We found some changes of clinical features in peritonsillar abscess when compared with previous researches. Although there were some differences in cultured organism, antibiotics used commonly-cephalosporin, aminoglycoside, quinolone - were still effective for their eradication.

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The Optimal Length of Time to Observe Patients with Contrast Media Anaphylaxis in the Emergency Department (조영제 부작용환자의 적절한 병원내 관찰시간에 대한 고찰)

  • Hwang, Sun-Min;Lee, Sung-Hwa;Yeom, Seok-Ran;Ryu, Ji-Ho;Jeong, Jin-Woo;Kim, Yong-In;Han, Sang-Kyoon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.8 no.1
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    • pp.37-42
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    • 2010
  • Purpose: The purpose of this study was to determine the optimal length of time to observe patients with contrast media anaphylaxis in the Emergency Department. Methods: This study included the patients of all age groups who presented with anaphylaxis due to contrast media to the ED of Pusan National University Hospital from January 2006 to August 2009. The medical records were retrospectively reviewed. We analyzed the 100 patients who met the inclusion criteria. Their median age was 55 (46-62), and 38 out of the 100 patients (38%) were male. Results: The most common symptom of patients was urticaria. Corticosteroid and H1 antihistamine were given to most of the patients in the ED. All were discharged after observation in the ED and none were admitted to the ward. The average time from injection of the contrast media to the onset of symptom was 31 minutes (24-39) and the average time to symptom recovery was 127 minutes (89-188). The mean observation time in the ED was 93 minutes (59-153). Biphasic reactions were reported in only one case (1/100, 1%). Conclusion: These results suggest that patients who present with an anaphylactic reaction after radiologic studies that use intravenous contrast media can be safely discharged early from the ED because the symptom recovery time is not long and a biphasic reaction is rare.

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