• Title/Summary/Keyword: age at onset

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A study on the clinical courses, sigmoidoscopic and histologic findings of allergic proctocolitis (알레르기성 직결장염의 임상상과 내시경 및 조직소견)

  • Lee, Joo Hee;Kim, Sung Shin;Park, Jae Ock
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.276-285
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    • 2008
  • Purpose : Allergic proctocolitis is a major cause of bloody stool in early infancy. This study was aimed at ascertaining the clinical courses, sigmoidoscopic and histologic findings of allergic proctocolitis. We also analyzed the relationship between peripheral eosinophilia, the age at symptom onset, and sigmoidoscopic and histologic findings. Methods : We reviewed 25 infants retrospectively who had sigmoidoscopy and biopsy performed with a clinical diagnosis of allergic proctocolitis from April 2003 to April 2007. Results : The mean age at symptom onset was $15.2{\pm}13.2$ weeks. Fourteen infants (56.0%) were breast fed, one (4.0%) was formula fed, six (24.0%) were on combined formula, and four (16.0%) were on a weaning diet. Peripheral eosinophilia (${\geq}250/mm^3$) was seen in eighteen infants (75.0%), but total serum IgE was increased only in six (24.0%). Sigmoidoscopic findings were variable from normal (8.0%), erythema or edema (20.0%), lymphoid hyperplasia (8.0%), erosion (12.0%), hemorrhage and ulcer (4.0%) to lymphoid hyperplasia with erosion, hemorrhage, or ulcer (48.0%). Histologic findings showed focal infiltration of eosinophils in lamina propria (96.0%) and crypt epithelium (96.0%). In twenty four infants (96.0%), the number of eosinophils in mucosa was increased by a more than 60/10 high power field. There was a negative correlation between peripheral eosinophilia and the age at symptom onset. Among the twelve breast fed infants, bloody stool disappeared in ten (83.0%) with a maternal elimination diet of major food groups, but two improved spontaneously. Conclusion : Allergic proctocolitis should be considered as one of the major causes of bloody stool in healthy appearing infants. To confirm the diagnosis it is necessary to perform sigmoidoscopy and biopsy but histologic findings are more informative than sigmoidoscopic findings. Peripheral eosinophilia was prominent in the infants with an early onset of symptoms. Most infants experienced benign courses and recovered with the elimination of causative foods but did not need exclusive food restrictions.

A study and the growth and the development of microvascular complications in patients with type 1 diabetes mellitus (1형 당뇨병 환자의 성장과 미세혈관 합병증 발생에 대한 연구)

  • Lee, Young Ah;Yun, Kyong-Ah;Shin, Choong Ho;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • v.50 no.2
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    • pp.190-197
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    • 2007
  • Purpose : Reduced growth and microvascular complications have been recognized as consequences of type 1 diabetes mellitus (T1DM). We assessed the effect of T1DM on growth and factors associated with the development of microvascular complications. Methods : We conducted a retrospective longitudinal evaluation of 154 patients above 16 years of age. We analyzed factors which affect final height standard deviation scores (SDS) and development of microvascular complications. Results : Final height SDS was $-0.11{\pm}1.15$ ($-0.26{\pm}1.33$ in females, $0.04{\pm}0.91$ in males). Final height SDS was significantly lower than midparental height SDS and height SDS at diagnosis. There was no difference in final height SDS according to age at onset, existence or nonexistence of complications, or average $HbA_{1C}$. Height SDS at onset of puberty, midparental height SDS and pubertal growth gain affected final height SDS. The number of patients with complications was 37 (24 percent). Microvascular complications developed at a younger age and after longer duration of diabetes in patients with a prepubertal onset of T1DM compared to patients with pubertal onset. Patients with complications had a higher level of average $HbA_{1C}$ than patients without complications. Patients whose microalbuminuria regressed had lower levels of average $HbA_{1C}$, systolic BP, second 24h urine microalbumin than patients with persistant or progressed microalbuminuria. Conclusion : The results suggest that degrees of glycemic control don't affect final height, but various factors associated with T1DM can impair growth potential. Additionally, the degrees of glycemic control and puberty affect the development of microvascular complications.

Which Emphasizing Factors Are Most Predictive of Hematoma Expansion in Spot Sign Positive Intracerebral Hemorrhage?

  • Kim, So Hyun;Jung, Hyun Ho;Whang, Kum;Kim, Jong Yun;Pyen, Jin Su;Oh, Ji Woong
    • Journal of Korean Neurosurgical Society
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    • v.56 no.2
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    • pp.86-90
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    • 2014
  • Objective : The spot sign is related with the risk of hematoma expansion in spontaneous intracerebral hemorrhage (ICH). However, not all spot sign positive patients undergo hematoma expansion. Thus, the present study investigates the specific factors enhancing the spot sign positivity in predicting hematoma expansion. Methods : We retrospectively studied 316 consecutive patients who presented between March 2009 to March 2011 with primary ICH and whose initial computed tomography brain angiography (CTA) was performed at our Emergency Department. Of these patients, 47 primary ICH patients presented spot signs in their CTA. We classified these 47 patients into two groups based on the presence of hematoma expansion then analyzed them with the following factors : gender, age, initial systolic blood pressure, history of anti-platelet therapy, volume and location of hematoma, time interval from symptom onset to initial CTA, spot sign number, axial dimension, and Hounsfield Unit (HU) of spot signs. Results : Of the 47 spot sign positive patients, hematoma expansion occurred in 26 patients (55.3%) while the remaining 21 (44.7%) showed no expansion. The time intervals from symptom onset to initial CTA were $2.42{\pm}1.24$ hours and $3.69{\pm}2.57$ hours for expansion and no expansion, respectively (p=0.031). The HU of spot signs were $192.12{\pm}45.97$ and $151.10{\pm}25.14$ for expansion and no expansion, respectively (p=0.001). Conclusions : The conditions of shorter time from symptom onset to initial CTA and higher HU of spot signs are the emphasizing factors for predicting hematoma expansion in spot sign positive patients.

Seizures and Epilepsy following Aneurysmal Subarachnoid Hemorrhage: Incidence and Risk Factors

  • Choi, Kyu-Sun;Chun, Hyoung-Joon;Yi, Hyeong-Joong;Ko, Yong;Kim, Young-Soo;Kim, Jae-Min
    • Journal of Korean Neurosurgical Society
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    • v.46 no.2
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    • pp.93-98
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    • 2009
  • Objective: Although prophylactic antiepileptic drug (AED) use in patients with aneurysmal subarachnoid hemorrhage (SAH) is a common practice, lack of uniform definitions and guidelines for seizures and AEDs rendered this prescription more habitual instead of evidence-based manner. We herein evaluated the incidence and predictive factors of seizure and complications about AED use. Methods: From July 1999 to June 2007, data of a total of 547 patients with aneurysmal SAH who underwent operative treatments were reviewed. For these, the incidence and risk factors of seizures and epilepsy were assessed, in addition to complications of AEDs. Results: Eighty-three patients (15.2%) had at least one seizure following SAH. Forty-three patients (79%) had onset seizures, 34 (6.2%) had perioperative seizures, and 17 (3.1%) had late epilepsy. Younger age (< 40 years), poor clinical grade, thick hemorrhage, acute hydrocephalus, and rebleeding were related to the occurrence of onset seizures. Cortical infarction and thick hemorrhage were independent risk factors for the occurrence of late epilepsy. Onset seizures were not predictive of late epilepsy. Moreover, adverse drug effects were identified in 128 patients (23.4%) with AEDs. Conclusion: Perioperative seizures are not significant predictors for late epilepsy. Instead, initial amount of SAH and surgery-induced cortical damage should be seriously considered as risk factors for late epilepsy. Because AEDs can not prevent early postoperative seizures (< 1 week) and potentially cause unexpected side effects, long-term use should be readjusted in high-risk patients.

Heat stress effects on the genetics of growth traits in Thai native chickens (Pradu Hang dum)

  • Wuttigrai Boonkum;Vibuntita Chankitisakul;Srinuan Kananit;Wootichai Kenchaiwong
    • Animal Bioscience
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    • v.37 no.1
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    • pp.16-27
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    • 2024
  • Objective: The objective of this study was to investigate the effect of heat stress on the growth traits and genetic parameters of Thai native chickens. Methods: A total of 16,487 records for growth traits of Thai native chickens between 2017 and 2022 were used in this study. Data included the body weight at birth, body weight at 4, 8, and 12 weeks of age (BW0, BW4, BW8, BW12), average daily gain during 0 to 4, 4 to 8, and 8 to 12 weeks of age (ADG0-4, ADG4-8, ADG8-12), absolute growth rate at birth, at 4, 8, and 12 weeks of age (AGR0, AGR4, AGR8, AGR12). The repeatability test day model used the reaction-norm procedure to analyze the threshold point of heat stress, rate of decline of growth traits, and genetic parameters. Results: At temperature and humidity index (THI) of 76, Thai native chickens began to lose their growth traits, which was the onset of heat stress in this study. The estimated heritability, genetic correlation between animal and heat stress effect, and correlations between the intercept and slope of the permanent environmental effects were 0.27, -0.85, and -0.83 for BW, 0.17, -0.81, and -0.95 for ADG, 0.25, -0.61, and -0.83 for AGR, respectively. Male chickens are more affected by heat stress than female chickens with a greater reduction of BW, ADG, and AGR, values equal to -9.30, -0.23, -15.21 (in males) and -6.04, -0.21, -10.10 (in females) gram per 1 level increase of THI from the THI of 76. Conclusion: The influence of thermal stress had a strong effect on the decline in growth traits and genetic parameters in Thai native chickens. This study indicated that genetic models used in conjunction with THI data are an effective method for the analysis and assessment of the effects of heat stress on the growth traits and genetics of native chickens.

Analysis of Atopic Dermatitis Patients according to the Sasang Constitution (아토피 피부염 환자의 체질분석)

  • Kim Hae-jeong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.16 no.3
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    • pp.200-209
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    • 2003
  • Objectives : The aim of this study was to investigate the relationship between atopic dermatitis and the Sasang constitution. Methods : I examined 64 patients with moderate to severe atopic dermatitis for a long time who visited Department of Dermatology in Kangnam Korean Hospital, Kyunghee University and classified them into 4 types according to Sasang constitution under consulting a Sasang specialist. 1. The Sasang specialist classified the patients using the Questionnaire for the Sasang Constitution Classification Ⅱ(QSCCⅡ), body components examination, facial morphology measurement and Meridian function examination. 2. I analyzed the distribution of sex and age, first onset age, history period, digestion condition, existences of past history and family history, basal material volume, immunoglobulin E and eosinophil. Results and Conclusions : 1. As the distribution of sex and age, 28 patients(pts) were male and 36 pts were female. 20's female group was the most common. 2. As the distribution of Sasang constitution types, Soeumin were 28(43.7$\%$) pts, Taeumin were 24(37.5$\%$) pts, Soyangin were 11(17.2$\%$) pts, and Taeyangin was 1(1.6$\%$) pI. 3. As the mean age at first visit, Soeumin's was 20yrs, Taeumin's and Soyangin's were 27yrs, and Taeyangin's was 15yrs. 4. As the mean onset age, Soeumin's was 7yrs the lowest, Taeumin's was 15.7yrs, Soyangin's was 10.54yrs and Taeyangin's was 15yrs. 5. As the history period. Soeumin's was 13.8yrs. Taeumin's was 11.8yrs. Soyangin's was 16.5yrs. Tae yangin's was 13yrs. 6. As the existence of past history of atopic diseases, Soeumin were 12(43$\%$) pts, Taeumin were 7(29$\%$) pts and Soyangin were 5(45$\%$) pts. 7. As immunoglobulin E, 21(75$\%$) pts of Soeumin were normal, 7(25$\%$) pts were abnormal.. 22(92$\%$) pts of Taeumin were normal, 2(8$\%$) pts were abnormal. 8(73$\%$) pts of Soyangin were normal, 3(27$\%$) pts were abnormal. As the defecation condition, 19(68$\%$) pts of Soeumin were normal, 9(32$\%$) pts were abnormal. 14(58$\%$) pts of Taeumin were normal, 10(42$\%$) pts were abnormal, 8(73$\%$) pts of Soyangin were normal, 3(27$\%$) pts were abnormal. 8. The mean value of immunoglobulin E of Soeumin was 1236, Taeeumin was 442, Soyangin was 2010, the mean value of eosinophil of Soeumin was 3.5, Taeeumin was 2.47, Soyangin was 4.28.

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Four years Incidence Rate of Colorectal Cancer in Iran: A Survey of National Cancer Registry Data - Implications for Screening

  • Azadeh, Safaee;Reza, Fatemi Seyed;Sara, Ashtari;Mohsen, Vahedi;Bijan, Moghimi-Dehkordi;Zali, Zali Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2695-2698
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    • 2012
  • Introduction: Design and implementation of screening programs in each country must be based on epidemiological data. Despite the relatively high incidence of CRC, there is no nationwide comprehensive program for screening in Iran. This study was designed to investigate national CRC data and help to determine guidelines for screening. Methods: Incidence data used in this study were obtained from Iranian annual of National Cancer Registration report. Age standardized rates (ASR)were calculated using world standard population and were categorized by age, sex, anatomic subsite and morphology of tumor. Data were analyzed using SPSS.V.13 and Open Source Epidemiologic Statistics for Public Health software (OpenEpi v.2.3.1). Results: A quarter of cases were less than 50 years of age. The majority of tumors were detected in the colon. The overall ASR in the four years period was 38.0 per 100000 and was higher for men compared women (P<0.05). Incidence rate of colorectal cancer increased with age. Conclusion: Results of present study indicated that incidence of colorectal cancer is relatively high in Iran. Incidence of CRC in people under 50 years and in rectum were reported higher than other countries that related etiologic factors should be investigate in further studies. According to the increasing of ASR after age 50 years, it seems that onset of screening at age 50 would be appropriate.

Factors associated with seizure and cognitive outcomes after epilepsy surgery for low-grade epilepsy-associated neuroepithelial tumors in children

  • Ko, Ara;Lee, Joon Soo
    • Clinical and Experimental Pediatrics
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    • v.63 no.5
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    • pp.171-177
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    • 2020
  • Low-grade epilepsy-associated neuroepithelial tumors (LEATs) are responsible for drug-resistant chronic focal epilepsy, and are the second-most common reason for epilepsy surgery in children. LEATs are extremely responsive to surgical treatment, and therefore epilepsy surgery should be considered as a treatment option for LEATs. However, the optimal time for surgery remains controversial, and surgeries are often delayed. In this review, we reviewed published article on the factors associated with seizure and cognitive outcomes after epilepsy surgery for LEATs in children to help clinicians in their decision whether to pursue epilepsy surgery for LEATs. The achievement of gross total resection may be the most important prognostic factor for seizure freedom. A shorter duration of epilepsy, a younger age at surgery, and extended resection of temporal lobe tumors have also been suggested as favorable prognostic factors in terms of seizure control. Poor cognitive function in children with LEATs is associated with a longer duration of epilepsy and a younger age at seizure onset.

Cyclic Vomiting Syndrome: A Functional Disorder

  • Kaul, Ajay;Kaul, Kanwar K.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.4
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    • pp.224-229
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    • 2015
  • Cyclic vomiting syndrome (CVS) is a functional disorder characterized by stereotypical episodes of intense vomiting separated by weeks to months. Although it can occur at any age, the most common age at presentation is 3-7 years. There is no gender predominance. The precise pathophysiology of CVS is not known but a strong association with migraine headaches, in the patient as well as the mother indicates that it may represent a mitochondriopathy. Studies have also suggested the role of an underlying autonomic neuropathy involving the sympathetic nervous system in its pathogenesis. CVS has known triggers in many individuals and avoiding these triggers can help prevent the onset of the episodes. It typically presents in four phases: a prodrome, vomiting phase, recovery phase and an asymptomatic phase until the next episode. Complications such as dehydration and hematemesis from Mallory Wise tear of the esophageal mucosa may occur in more severe cases. Blood and urine tests and abdominal imaging may be indicated depending upon the severity of symptoms. Brain magnetic resonance imaging and upper gastrointestinal endoscopy may also be indicated in certain circumstances. Management of an episode after it has started ('abortive treatment') includes keeping the patient in a dark and quiet room, intravenous hydration, ondansetron, sumatriptan, clonidine, and benzodiazepines. Prophylactic treatment includes cyproheptadine, propranolol and amitriptyline. No mortality has been reported as a direct result of CVS and many children outgrow it over time. A subset may develop other functional disorders like irritable bowel syndrome and migraine headaches.

Cerebrovascular Events in Pediatric Inflammatory Bowel Disease: A Review of Published Cases

  • Rohani, Pejman;Taraghikhah, Nazanin;Nasehi, Mohammad Mehdi;Alimadadi, Hosein;Aghdaei, Hamid Assadzadeh
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.3
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    • pp.180-193
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    • 2022
  • Pediatric inflammatory bowel disease (PIBD) is a multisystem disorder characterized by intestinal and extraintestinal manifestations and complications. Cerebrovascular events (CVE) are rare extraintestinal complications in patients with PIBD. Statistics show that 3.3% patients with PIBD and 1.3-6.4% adult patients with inflammatory bowel disease (IBD) experience CVE during the course of the disease. Therefore, this study aimed to review the records of children with IBD who developed CVE during the course of the disease. We retrospectively reviewed 62 cases of PIBD complicated by CVE. The mean patient age at the time of thrombotic events was 12.48±4.13 years. The incidence of ulcerative colitis was significantly higher than that of Crohn's disease (43 [70.5%] vs. 13 [21.3%] patients). Most patients (87.93%) were in the active phase of IBD at the time of CVE. The mean time interval between the onset of IBD and CVE was 20.84 weeks. Overall, 11 (26.83%) patients showed neurological symptoms of CVE at disease onset. The most frequent symptom on admission was persistent and severe headaches (67.85%). The most common site of cerebral venous thrombosis was the transverse sinuses (n=23, 53.48%). The right middle cerebral artery (n=3, 33.34%) was the predominant site of cerebral arterial infarction. Overall, 41 (69.49%) patients who were mostly administered unfractionated heparin or low-molecular-weight heparin (56.09%) recovered completely. Patients with IBD are at a risk of thromboembolism. CVE may be the most common type of thromboembolism. Based on these findings, the most common risk factor for CVE is IBD flares. In patients with CVE, anticoagulant therapy with heparin, followed by warfarin, is necessary.