• Title/Summary/Keyword: Perinatal

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A case of delayed hemorrhage of a subcapsular liver hematoma in a neonate (신생아에서 발생한 대량 피막하 간 혈종의 지연성 파열 1례)

  • Moon, Soo Kyoung;Lee, Tae Suk;Yoon, Hye Sun
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.89-92
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    • 2008
  • A subcapsular liver hematoma (SLH) is a relatively common lesion in fetuses and neonates. Although an SLH ruptures rarely, it may be life threatening. We report on a term neonate with a delayed rupture of an SLH that occurred on day 7 of life. The infant had been resuscitated with intubation, positive pressure ventilation, and chest compression at birth because of meconium-associated perinatal depression. The SLH was diagnosed by abdominal ultrasonography and paracentesis, and the ruptured SLH was treated operatively. After intensive medical and surgical management, the infant was discharged healthy on day 27 of life. A newborn infant presenting with the sudden onset of extreme shock and pallor associated with abdominal distension should undergo differential diagnosis for SLH and a clinical evaluation concurrent with fluid resuscitation and timely surgery.

Efficacy of Oral Administration of Lentinula eododes Mycelia Extract for Breast Cancer Patients Undergoing Postoperative Hormone Therapy

  • Suzuki, Nobutaka;Takimoto, Yuko;Suzuki, Riho;Arai, Takanari;Uebaba, Kazuo;Nakai, Masuo;Strong, Jeffry Michael;Tokuda, Harukuni
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3469-3472
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    • 2013
  • Extract of Lentinula edodes mycelia (LEM) is currently utilized as an oral biological response modifier (BRM) medicine for cancer patients. However, its effectiveness for breast cancer patients with postoperative adjuvant hormone therapy has not yet been scientifically verified. In this study, we investigated the influence of LEM on the quality of life (QOL) and immune response in breast cancer patients undergoing postoperative adjuvant hormone therapy. Twenty patients were studied in total. They received only hormone therapy in the first 4 weeks followed by hormone therapy and LEM during the next 8 weeks. Laboratory tests, QOL score and peripheral blood cytokine production levels were evaluated during the study period. No changes in QOL or cytokines were noted after the first 4 weeks. In contrast, during the following combined therapy period, improvements were noted in QOL and cytokine levels. Although a future large-scale investigation is necessary to confirm these results, these data suggest that the concomitant use of LEM with postoperative adjuvant hormone therapy improves the QOL and immune function of patients.

The effect of low-dose intravenous bisphosphonate treatment on osteoporosis in children with quadriplegic cerebral palsy

  • Moon, Soon Jeong;An, Young Min;Kim, Soon Ki;Kwon, Young Se;Lee, Ji Eun
    • Clinical and Experimental Pediatrics
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    • v.60 no.12
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    • pp.403-407
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    • 2017
  • Purpose: Quadriplegic children with cerebral palsy are more susceptible to osteoporosis because of various risk factors that interfere with bone metabolism. Pamidronate is effective for pediatric osteoporosis, but there are no guidelines for optimal dosage or duration of treatment in quadriplegic children with osteoporosis. We aimed to evaluate the efficacy of low-dose pamidronate treatment in these patients. Methods: Ten quadriplegic patients on antiepileptic drugs (6 male, 4 female patients; mean age, $10.9{\pm}5.76years$), with osteoporosis and gross motor function classification system level V, were treated with pamidronate (0.5-1.0 mg/kg/day, 2 consecutive days) every 3-4 months in a single institution. The patients received oral supplements of calcium and vitamin D before and during treatment. The lumbar spine bone mineral density (BMD) z score and biochemical markers of bone metabolism were measured regularly during treatment. Results: The main underlying disorder was perinatal hypoxic brain damage (40%, 4 of 10). The mean cumulative dose of pamidronate was $4.49{\pm}2.22mg/kg/yr$, and the mean treatment period was $10.8{\pm}3.32months$. The BMD z score of the lumbar spine showed a significant increase from $-4.22{\pm}1.24$ before treatment to $-2.61{\pm}1.69$ during treatment (P=0.008). Alkaline phosphatase decreased during treatment (P=0.037). Significant adverse drug reactions and new fractures were not reported. Conclusion: Low-dose pamidronate treatment for quadriplegic children with cerebral palsy increased lumbar BMD and reduced the incidence of fracture.

The Fast Skeletal Muscle Myosin Light Chain Is Differentially Expressed in Smooth Muscle Cells of OVA-challenged Mouse Trachea

  • Kim, Ho-Young;Rhim, TaiYoun;Ahn, Mi-Hyun;Yoon, Pyoung-Oh;Kim, Soo-Ho;Lee, Sang-Han;Park, Choon-Sik
    • Molecules and Cells
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    • v.25 no.1
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    • pp.78-85
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    • 2008
  • In a search for new molecular pathways associated with asthma, we performed an mRNA differential display analysis using total RNA extracted from the tracheal tissues of ovalbumin (OVA)-challenged mice and sham controls. cDNAs corresponding to mRNAs for which expression levels were altered by OVA-challenge were isolate and sequenced. Twenty-eight genes differentially expressed in sham and OVA challenged mice were identified. A GenBank BLAST homology search revealed that they were related to cytoskeleton remodeling, transcription, protein synthesis and modification, energy production, and cell growth and differentiation. Two were selected for further characterization. Up-regulation of both the perinatal skeletal myosin heavy chain (skMHC) and fast skeletal muscle myosin light chain (skMLC) genes was confirmed by RT-PCR of trachea tissue from OVA challenged mice. Overexpression of skMLC protein was observed in the smooth muscle layers of OVA-challenged mice by immunohistochemistry, and the surface areas stained with skMLC antibody increased in the OVA-challenged mice. The overexpression of skMLC in murine asthma may be associated with the changes of bronchial smooth muscle.

Month and Season of Birth as a Risk Factor for Alzheimer's Disease: A Nationwide Nested Case-control Study

  • Tolppanen, Anna-Maija;Ahonen, Riitta;Koponen, Marjaana;Lavikainen, Piia;Purhonen, Maija;Taipale, Heidi;Tanskanen, Antti;Tiihonen, Jari;Tiihonen, Miia;Hartikainen, Sirpa
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.2
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    • pp.134-138
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    • 2016
  • Objectives: Season of birth, an exogenous indicator of early life environment, has been related to higher risk of adverse psychiatric outcomes but the findings for Alzheimer's disease (AD) have been inconsistent. We investigated whether the month or season of birth are associated with AD. Methods: A nationwide nested case-control study including all community-dwellers with clinically verified AD diagnosed in 2005 to 2012 (n=70 719) and up to four age- sex- and region of residence-matched controls (n=282 862) residing in Finland. Associations between month and season of birth and AD were studied with conditional logistic regression. Results: Month of birth was not associated with AD (p=0.09). No strong associations were observed with season (p=0.13), although in comparison to winter births (December-February) summer births (June-August) were associated with higher odds of AD (odds ratio, 1.03; 95% confidence interval, 1.00 to 1.05). However, the absolute difference in prevalence in winter births was only 0.5% (prevalence of those born in winter were 31.7% and 32.2% for cases and controls, respectively). Conclusions: Although our findings do not support the hypothesis that season of birth is related to AD/dementia risk, they do not invalidate the developmental origins of health and disease hypothesis in late-life cognition. It is possible that season does not adequately capture the early life circumstances, or that other (postnatal) risk factors such as lifestyle or socioeconomic factors overrule the impact of prenatal and perinatal factors.

Cognitive Dysfunction and Hippocampal Damage Induced by Hypoxic-Ischemic Brain Injury and Prolonged Febrile Convulsions in Immature Rats

  • Byeon, Jung Hye;Kim, Gun-Ha;Kim, Joo Yeon;Sun, Woong;Kim, Hyun;Eun, Baik-Lin
    • Journal of Korean Neurosurgical Society
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    • v.58 no.1
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    • pp.22-29
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    • 2015
  • Objective : Perinatal hypoxic-ischemic encephalopathy (HIE) and prolonged febrile seizures (pFS) are common neurologic problems that occur during childhood. However, there is insufficient evidence from experimental studies to conclude that pFS directly induces hippocampal injury. We studied cognitive function and histological changes in a rat model and investigated which among pFS, HIE, or a dual pathologic effect is most detrimental to the health of children. Methods : A rat model of HIE at postnatal day (PD) 7 and a pFS model at PD10 were used. Behavioral and cognitive functions were investigated by means of weekly open field tests from postnatal week (PW) 3 to PW7, and by daily testing with the Morris water maze test at PW8. Pathological changes in the hippocampus were observed in the control, pFS, HIE, and HIE+pFS groups at PW9. Results : The HIE priming group showed a seizure-prone state. The Morris water maze test revealed a decline in cognitive function in the HIE and HIE+pFS groups compared with the pFS and control groups. Additionally, the HIE and HIE+pFS groups showed significant hippocampal neuronal damage, astrogliosis, and volume loss, after maturation. The pFS alone induced minimal hippocampal neuronal damage without astrogliosis or volume loss. Conclusion : Our findings suggest that pFS alone causes no considerable memory or behavioral impairment, or cellular change. In contrast, HIE results in lasting memory impairment and neuronal damage, gliosis, and tissue loss. These findings may contribute to the understanding of the developing brain concerning conditions caused by HIE or pFS.

Transient intubation for surfactant administration in the treatment of respiratory distress syndrome in extremely premature infants

  • Koh, Ji Won;Kim, Jong-Wan;Chang, Young Pyo
    • Clinical and Experimental Pediatrics
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    • v.61 no.10
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    • pp.315-321
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    • 2018
  • Purpose: To investigate the effectiveness of transient intubation for surfactant administration and extubated to nasal continuous positive pressure (INSURE) for treatment of respiratory distress syndrome (RDS) and to identify the factors associated with INSURE failure in extremely premature infants. Methods: Eighty-four infants with gestational age less than 28 weeks treated with surfactant administration for RDS for 8 years were included. Perinatal and neonatal characteristics were retrospectively reviewed, and major pulmonary outcomes such as duration of mechanical ventilation (MV) and bronchopulmonary dysplasia (BPD) plus death at 36-week postmenstrual age (PMA) were compared between INSURE (n=48) and prolonged MV groups (n=36). The factors associated with INSURE failure were determined. Results: Duration of MV and the occurrence of BPD at 36-week PMA were significantly lower in INSURE group than in prolonged MV group (P<0.05), but BPD plus death at 36-week PMA was not significantly different between the 2 groups. In a multivariate analysis, a reduced duration of MV was only significantly associated with INSURE (P=0.001). During the study period, duration of MV significantly decreased over time with an increasing rate of INSURE application (P<0.05), and BPD plus death at 36-week PMA also tended to decrease over time. A low arterial-alveolar oxygen tension ratio (a/APO2 ratio) was a significant predictor for INSURE failure (P=0.001). Conclusion: INSURE was the noninvasive ventilation strategy in the treatment of RDS to reduce MV duration in extremely premature infants with gestational age less than 28 weeks.

Radiation Protective Effect of Selenium and Folic Acid Mixtures in the Development of Congenital Anomalies Following Radiation Exposure to the Fetus of Perinatal Female White Rats (주산기 암컷 백서의 태아에 방사선피폭에 따른 선천성기형 발생 시 셀레늄과 엽산 혼합물의 방사선 방호효과)

  • Jung, Do-Young;Choi, Hyung-Seok;Kim, Jang-Oh;Shin, Ji-Hye;Kim, Joo-Hee;Park, Gyeong-Jin;Min, Byung-In
    • Journal of radiological science and technology
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    • v.41 no.2
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    • pp.157-162
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    • 2018
  • This study is a search for radiation protection effects of radiation exposure on the organogenic period during the prenatal period, which is known to be the most likely to have congenital malformations by radiation exposure. To study the radiation protection for the mixture of selenium that is strong antioxidant and folic acid that is essential vitamin for DNA synthesis, 2 Gy of radiation was irradiated to pregnant female rats. then, after 14 days of fetal birth, observing blood components, SOD(Superoxide Dismutase), histological changes and external malformations. There was a significant protective effect to reduce blood cell damage(p<0.05) in the irradiation group after selenium and folic acid mixture were administered than irradiation group, and the activation of SOD which is antioxidant enzymes was increased. In addition, confirmed the effect of suppressing the expression of apoptosis of small intestinal cells and the reduction of cerebral cortex layer reduction by radiation. thus, it was confirmed that the congenital malformations were reduced as a result of these protective effects. Based on these results, selenium and folic acid mixture may reduce the incidence of congenital malformations, and it will reduce the damage of the fetus caused by the exposure of the organogenic period due to accidents.

Blood Lead Level and Intelligence among Children (정상 소아들의 혈중 연 농도와 지능지수와의 관련성)

  • Lee, Duk-Hee;Lee, Yong-Hwan;Kim, Jin-Ha;Park, In-Geun;Han, Tae-Young;Jang, She-Han
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.2 s.50
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    • pp.373-385
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    • 1995
  • The association between blood lead of children and Intelligent Quotient(I.Q) was investigated in a sample of 100 boys and girls aged $6\sim8$ years from one primary school within an industrial area of Pusan. The trained undergraduates in school of public health administered an 1.0. test one by one. Parents answered a questionnaire on demographic, perinatal and socioeconomic variables. Atomic Absorbtion Spectrophotometer was used to determine blood lead levels. The geometric mean of blood lead value was $7.99{\mu}g/dl$. In total children, there was no significant relationship between blood lead level and I.Q. But in the children who were born of gestational age of less than 38 weeks, children with higher levels of blood lead performed more poorly on I.Q test with correlation coefficient from -0.68 to -0.71. But, the children who were born of gestational age of 38 weeks and more were same as total children. These results suggest that exposure to low levels of lead in the children who were born premature probably may result in impaired intelligent development. But, We think that more profound study should be performed with sufficient numbers of subjects.

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The Importance of Multidisciplinary Management during Prenatal Care for Cleft Lip and Palate

  • Han, Hyun Ho;Choi, Eun Jeong;Kim, Ji Min;Shin, Jong Chul;Rhie, Jong Won
    • Archives of Plastic Surgery
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    • v.43 no.2
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    • pp.153-159
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    • 2016
  • Background The prenatal ultrasound detection of cleft lip with or without cleft palate (CL/P) and its continuous management in the prenatal, perinatal, and postnatal periods using a multidisciplinary team approach can be beneficial for parents and their infants. In this report, we share our experiences with the prenatal detection of CL/P and the multidisciplinary management of this malformation in our institution's Congenital Disease Center. Methods The multidisciplinary team of the Congenital Disease Center for mothers of children with CL/P is composed of obstetricians, plastic and reconstructive surgeons, pediatricians, and psychiatrists. A total of 11 fetuses were diagnosed with CL/P from March 2009 to December 2013, and their mothers were referred to the Congenital Disease Center of our hospital. When CL/P is suspected in the prenatal ultrasound screening examination, the pregnant woman is referred to our center for further evaluation. Results The abortion rate was 28% (3/11). The concordance rate of the sonographic and final diagnoses was 100%. Ten women (91%) reported that they were satisfied with the multidisciplinary management in our center. Conclusions Although a child with a birth defect is unlikely to be received well, the women whose fetuses were diagnosed with CL/P on prenatal ultrasound screening and who underwent multidisciplinary team management were more likely to decide to continue their pregnancy.