• Title/Summary/Keyword: Isolated Children

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Shiga toxin-associated hemolytic uremic syndrome complicated by intestinal perforation in a child with typical hemolytic uremic syndrome

  • Chang, Hye Jin;Kim, Hwa Young;Choi, Jae Hong;Choi, Hyun Jin;Ko, Jae Sung;Ha, Il Soo;Cheong, Hae Il;Choi, Yong;Kang, Hee Gyung
    • Clinical and Experimental Pediatrics
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    • v.57 no.2
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    • pp.96-99
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    • 2014
  • Hemolytic uremic syndrome (HUS) is one of the most common causes of acute renal failure in childhood and is primarily diagnosed in up to 4.5% of children who undergo chronic renal replacement therapy. Escherichia coli serotype O157:H7 is the predominant bacterial strain identified in patients with HUS; more than 100 types of Shiga toxin-producing enterohemorrhagic E. coli (EHEC) subtypes have also been isolated. The typical HUS manifestations are microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency. In typical HUS cases, more serious EHEC manifestations include severe hemorrhagic colitis, bowel necrosis and perforation, rectal prolapse, peritonitis, and intussusceptions. Colonic perforation, which has an incidence of 1%-2%, can be a fatal complication. In this study, we report a typical Shiga toxin-associated HUS case complicated by small intestinal perforation with refractory peritonitis that was possibly because of ischemic enteritis. Although the degree of renal damage is the main concern in HUS, extrarenal complications should also be considered in severe cases, as presented in our case.

Comparative Analysis of the Complete Genome of Lactobacillus plantarum GB-LP2 and Potential Candidate Genes for Host Immune System Enhancement

  • Kwak, Woori;Kim, Kwondo;Lee, Chul;Lee, Chanho;Kang, Jungsun;Cho, Kyungjin;Yoon, Sook Hee;Kang, Dae-Kyung;Kim, Heebal;Heo, Jaeyoung;Cho, Seoae
    • Journal of Microbiology and Biotechnology
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    • v.26 no.4
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    • pp.684-692
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    • 2016
  • Acute respiratory virus infectious diseases are a growing health problem, particularly among children and the elderly. Much effort has been made to develop probiotics that prevent influenza virus infections by enhancing innate immunity in the respiratory tract until vaccines are available. Lactobacillus plantarum GB-LP2, isolated from a traditional Korean fermented vegetable, has exhibited preventive effects on influenza virus infection in mice. To identify the molecular basis of this strain, we conducted a whole-genome assembly study. The single circular DNA chromosome of 3,284,304 bp was completely assembled and 3,250 protein-encoding genes were predicted. Evolutionarily accelerated genes related to the phenotypic trait of anti-infective activities for influenza virus were identified. These genes encode three integral membrane proteins, a teichoic acid export ATP-binding protein and a glucosamine - fructose-6-phosphate aminotransferase involved in host innate immunity, the nonspecific DNA-binding protein Dps, which protects bacteria from oxidative damage, and the response regulator of the three-component quorum-sensing regulatory system, which is related to the capacity of adhesion to the surface of the respiratory tract and competition with pathogens. This is the first study to identify the genetic backgrounds of the antiviral activity in L. plantarum strains. These findings provide insight into the anti-infective activities of L. plantarum and the development of preventive probiotics.

The Low Cost Implementation of Speech Recognition System for the Web (웹에서의 저가 음성인식 시스템의 구현)

  • Park, Yong-Beom;Park, Jong-Il
    • The Transactions of the Korea Information Processing Society
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    • v.6 no.4
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    • pp.1129-1135
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    • 1999
  • isolated word recognition using the Dynamic Time warping algorithm has shown good recognition rate on speaker dependent environment. But, practically, since the searching time of the dynamic Time Warping algorithm is rapidly increased as searching data is increased. it is hard to implement. In the context-dependent-short-query system such as educational children's workbook on the Web, the number of responses to the specific questions is limited. Therefore, the searching space for the answers can be reduced depending on the questions. In this paper, low cost implementation method using DTW for the Web has been proposed. To cover the weakness of DTW, the searching space is reduced by the context. the searching space, depends on the specific questions, is chosen from interest searchable candidates. In the real implementation, the proposed method show better performance of both time and recognition rate.

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Intestinal Neuronal Dysplasia in Twins (쌍생아에서 발생한 Intestinal Neuronal Dysplasia)

  • Lim, In-Suk;Chung, Ju-Young;Choi, Myung-Jai;Kim, Sang-Woo;Kim, Hong-Ju;Kim, Jeong-Yeon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.202-207
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    • 2003
  • Intestinal neuronal dysplasia (IND) is a disorder of abnormal intestinal innervation resulting in dysfunctional colonic motility. IND shares clinical features with Hirschsprung's disease but differentiated by histological findings such as hyperplasia of submucosal and myenteric plexuses, giant ganglia, ectopic ganglion cell and increased acetylcholinesterase activity in lamina propria. Although IND may exist as an isolated condition, more commonly, it occurs in association with Hirschsprung's disease. We report a case of twins affected with IND. Both children manifested with delayed passage of meconium and severe abdominal distention after birth. Barium enema in both patients showed microcolon. They underwent emergency ileostomy under the impression of total aganglionosis. But surgical biopsy specimens showed hyperganglionosis in submucosa with formation of giant ganglia. Both neonates suffers from several episodes of peudo-obstruction after the repair operation of colostomy.

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Biochemical Adaptation to the Freezing Environment - the Biology of Fish Antifreeze Proteins

  • Li, Zhengjun;Li, n Qingsong;Low Woon-Kai;Miao Megan;Hew Choy L.
    • Ocean and Polar Research
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    • v.25 no.4
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    • pp.607-615
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    • 2003
  • Many organisms are known to survive in icy environments. These include both over wintering terrestrial insects and plants as well the marine fish inhabiting high latitudes. The adaptation of these organisms is both a fascinating and important topic in biology. Marine teleosts in particular, can encounter ice-laden seawater that is approximately $1^{\circ}C$ colder than the colligative freezing point of their body fluids. These animals produce a unique group of proteins, the antifreeze proteins (AFPs) or antifreeze glycoproteins (AFGPs) that absorb the ice nuclei and prevent ice crystal growth. Presently, there are at least four different AFP types and one AFGP type that are isolated from a wide variety of fish. Despite their functional similarity, there is no apparent common protein homology or ice-binding motifs among these proteins, except that the surface-surface complementarity between the protein and ice are important for binding. The remarkable diversity of these proteins and their odd phylogenetic distribution would suggest that these proteins might have evolved recently in response to sea level glaciations just 1-2 million years ago in the northern hemisphere and 10-30 million years ago around Antarctica. Winter flounder, Pleuronectes americanus, has been used as a popular model to study the regulation of AFP gene expression. It has a built-in annual cycle of AFP expression controlled negatively by the growth hormone. The signal transduction pathways, transcription factors and promoter elements involved in this process have been studied in our laboratory and these studies will be presented.

Case of seropositive allergic bronchopulmonary aspergillosis in a 10-year-old girl without previously documented asthma

  • Shin, Jeong Eun;Shim, Jae Won;Kim, Deok Soo;Jung, Hae Lim;Park, Moon Soo;Shim, Jung Yeon
    • Clinical and Experimental Pediatrics
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    • v.58 no.5
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    • pp.190-193
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    • 2015
  • Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity lung disease due to bronchial colonization of Aspergillus fumigatus that occurs in susceptible patients with asthma or cystic fibrosis. A 10-year-old girl was referred to the Department of Pediatric Pulmonology for persistent consolidations on chest radiography. Pulmonary consolidations were observed in the right upper and left lower lobes and were not resolved with a 4-week prescription of broad-spectrum antibiotics. The patient had a history of atopic dermatitis and allergic rhinitis but no history of asthma. She had no fever but produced thick and greenish sputum. Her breathing sounds were clear. On laboratory testing, her total blood eosinophil count was $1,412/mm^3$ and total serum IgE level was 2,200 kU/L. Aspergillus was isolated in the sputum culture. The A. fumigatus-specific IgE level was 15.4 kU/L, and the Aspergillus antibody test was also positive. A chest computed tomography scan demonstrated bronchial wall thickening and consolidation without bronchiectasis. An antifungal agent was added but resulted in no improvement of pulmonary consolidations after 3 weeks. Pulmonary function test was normal. Methacholine provocation test was performed, revealing bronchial hyperreactivity ($PC_{20}=5.31mg/mL$). Although the patient had no history of asthma or bronchiectasis, ABPA-seropositivity was suspected. Oral prednisolone (1 mg/kg/day) combined with antifungal therapy was started. Pulmonary consolidations began decreasing after 1 week of treatment and completely resolved after 1 month. This is the first observed and treated case of seropositive ABPA in Korean children without previously documented asthma.

Clinical manifestations of CNS infections caused by enterovirus type 71

  • Choi, Cheol-Soon;Choi, Yun-Jung;Choi, Ui-Yoon;Han, Ji-Whan;Jeong, Dae-Chul;Kim, Hyun-Hee;Kim, Jong-Hyun;Kang, Jin-Han
    • Clinical and Experimental Pediatrics
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    • v.54 no.1
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    • pp.11-16
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    • 2011
  • Purpose: Enterovirus 71, one of the enteroviruses that are responsible for both hand-foot-and-mouth disease and herpangina, can cause neural injury. During periods of endemic spread of hand-foot-andmouth disease caused by enterovirus 71, CNS infections are also frequently diagnosed and may lead to increased complications from neural injury, as well as death. We present the results of our epidemiologic research on the clinical manifestations of children with CNS infections caused by enterovirus 71. Methods: The study group consisted of 42 patients admitted for CNS infection by enterovirus 71 between April 2009 and October 2009 at the Department of Pediatrics of 5 major hospitals affiliated with the Catholic University of Korea. We retrospectively reviewed initial symptoms and laboratory findings on admission, the specimen from which enterovirus 71 was isolated, fever duration, admission period, treatment and progress, and complications. We compared aseptic meningitis patients with encephalitis patients. Results: Of the 42 patients (23 men, 19 women), hand-foot-and-mouth disease was most prevalent (n=39), followed by herpangina (n=3), upon initial clinical diagnosis. Among the 42 patients, 15 (35.7%) were classified as severe, while 27 (64.3%) were classified as mild. Factors such as age, fever duration, presence of seizure, and use of intravenous immunoglobulin (IVIG) were statistically different between the 2 groups. Conclusion: Our results indicate that patients with severe infection caused by enterovirus 71 tended to be less than 3 years old, presented with at least 3 days of fever as well as seizure activity, and received IVIG treatment.

Outcome of ultrasonographic imaging in infants with sacral dimple

  • Choi, Jin Hyuk;Lee, Taekwan;Kwon, Hyeok Hee;You, Sun Kyoung;Kang, Joon Won
    • Clinical and Experimental Pediatrics
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    • v.61 no.6
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    • pp.194-199
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    • 2018
  • Purpose: Sacral dimples are a common cutaneous anomaly in infants. Spine ultrasonography (USG) is an effective and safe screening tool for patients with a sacral dimple. The aim of this study was to determine the clinical manifestations in patients with an isolated sacral dimple and to review the management of spinal cord abnormalities identified with USG. Methods: We reviewed clinical records and collected data on admissions for a sacral dimple from March 2014 through February 2017 that were evaluated with spine USG by a pediatric radiologist. During the same period, patients who were admitted for other complaints, but were found to have a sacral dimple were also included. Results: This study included 230 infants under 6-months-old (130 males and 100 females; mean age $52.8{\pm}42.6days$). Thirty-one infants with a sacral dimple had an echogenic filum terminale, and 57 children had a filar cyst. Twenty-seven patients had a low-lying spinal cord, and only one patient was suspected of having a tethered cord. Follow-up spine USG was performed in 28 patients, which showed normalization or insignificant change. Conclusion: In this study, all but one infant with a sacral dimple had benign imaging findings. USG can be recommended in infants with a sacral dimple for its convenience and safety.

Traumatic Liver Injury in Pediatric Patients (소아 환자에서의 외상성 간 손상)

  • Koo, Byung Han;Park, Joon Beom;Bae, Keum Seok;Kang, Sung Joon
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.242-247
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    • 2009
  • Purpose: Trauma is an important cause of death in children. In particular, the liver is the second most commonly organ injured by blunt abdominal trauma. Treatment of patients with liver injury is has changed, and non-operative treatment is the major treatment method at present. In this study, we reviewed traumatic liver injury in pediatric patients. Methods: Seventy-seven patients younger than 16 years of age with traumatic liver injury were assessed for 10 years from July 1999 to June 2009 at Wonju Christian hospital. Records of the patients were reviewed retrospectively. Demographic and clinical data were analyzed. Results: The median age was 6 years, and the male-to-female ratio was 1.2 : 1. The most common injury grade was grade I. The majority of injuries were caused by was traffic accidents, and the second most common cause of injuries was falls. Twenty-four patients had liver injuries alone, and the most common accopaning injury was a lung injury. The average hospital stay was 20.7 days, and the average ICU stay was 4.8 days. Four patients died (5.2%). There were 6 patients with under 10 points on the Glasgow coma scale (GCS). Among these patients, three died. All mortality cases had over 16 points on the Injury Severity Score (ISS). Two patients were treated surgically, one of whom died. Of the 75 patients with non-operative management, three died due to associated injuries. Conclusion: Most pediatric patients with liver injury have good results with non-operative management. Associated injuries and hemodynamic instability are predictive of patient outcome, and those with isolated liver injuries can be successfully managed non-operatively.

A Case of Pulmonary Inflammatory Myofibroblastic Tumor (폐 염증성 근섬유 아세포종 치험 1예)

  • Na, Kook-Joo;Yu, Ung;Hong, Sung-Bum;Choi, Yong-Sun;Kim, Byong-Pyo;Kim, Sang-Hyung;Ahn, Byong-Hee
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.102-104
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    • 2004
  • Inflammatory myofibroblastoma is a solid tumor, occurring mainly to children and young adults, and occupying 0.7% of total isolated pulmonary nodules. Since 1973, several cases about inflammatory myofibroblastoma have been reported. Firstly, this tumor was found in lungs. Then, tumors have been founded and reported in mesentery or cardioesophageal region. Histologically, this tumor can be classified as a benign tumor. However, since this tumor has two characteristics showing malignancy, that is, local invasion and recurrence, malignancy can not be completely excluded. Recently, a patient with pulmonary inflammatory myofibroblastoma underwent surgical resection without any signs or symptoms of recurrence.