• Title/Summary/Keyword: intrauterine infection

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Evaluation of the role of ischemia modified albumin in neonatal hypoxic-ischemic encephalopathy

  • Talat, Mohamed A.;Saleh, Rabab M.;Shehab, Mohammed M.;Khalifa, Naglaa A.;Sakr, Maha Mahmoud Hamed;Elmesalamy, Walaa M.
    • Clinical and Experimental Pediatrics
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    • v.63 no.8
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    • pp.329-334
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    • 2020
  • Background: Birth asphyxia is a leading cause of neonatal mortality. Ischemia-modified albumin (IMA) levels may have a predictive role in the identification and prevention of hypoxic disorders, as they increase in cases of ischemia of the liver, heart, brain, bowel, and kidney. Purpose: This study aimed to assess the value of IMA levels as a diagnostic marker for neonatal hypoxic-ischemic encephalopathy (HIE). Methods: Sixty newborns who fulfilled 3 or more of the clinical and biochemical criteria and developed HIE as defined by Levene staging were included in our study as the asphyxia group. Neonates with congenital malformation, systemic infection, intrauterine growth retardation, low-birth weight, cardiac or hemolytic disease, family history of neurological diseases, congenital or perinatal infections, preeclampsia, diabetes, and renal diseases were excluded from the study. Sixty healthy neonates matched for gestational age and with no maternal history of illness, established respiration at birth, and an Apgar score ≥7 at 1 and 5 minutes were included as the control group. IMA was determined by double-antibody enzyme-linked immunosorbent assay of a cord blood sample collected within 30 minutes after birth. Results: Cord blood IMA levels were higher in asphyxiated newborns than in controls (250.83±36.07 pmol/mL vs. 120.24±38.9 pmol/mL). Comparison of IMA levels by HIE stage revealed a highly significant difference among them (207.3±26.65, 259.28±11.68, 294.99±4.41 pmol/mL for mild, moderate, and severe, respectively). At a cutoff of 197.6 pmol/mL, the sensitivity was 84.5%, specificity was 86%, positive predictive value was 82.8%, negative predictive value was 88.3%, and area under the curve was 0.963 (P<0.001). Conclusion: IMA levels can be a reliable marker for the early diagnosis of neonatal HIE and can be a predictor of injury severity.

Management of endometriosis-related infertility: Considerations and treatment options

  • Lee, Dayong;Kim, Seul Ki;Lee, Jung Ryeol;Jee, Byung Chul
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.1
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    • pp.1-11
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    • 2020
  • Endometriosis is a common inflammatory disease in women of reproductive age and is one of the major causes of infertility. Endometriosis causes a sustained reduction of ovarian reserve through both physical mechanisms and inflammatory reactions, which result in the production of reactive oxygen species and tissue fibrosis. The severity of endometriosis is related to ovarian reserve. With regard to infertility treatment, medical therapy as a neoadjuvant or adjuvant to surgical therapy has no definite beneficial effect. Surgical treatment of endometriosis can lead to ovarian injury during the resection of endometriotic tissue, which leads to the deterioration of ovarian reserve. To overcome this disadvantage, a multistep technique has been proposed to minimize the reduction of ovarian reserve. When considering surgical treatment of endometriosis in patients experiencing infertility, it should be kept in mind that ovarian reserve can be reduced both due to endometriosis itself and by the process of removing endometriosis. In cases of mild- to moderate-stage endometriosis, intrauterine insemination with ovarian stimulation after surgical treatment may increase the likelihood of pregnancy. In cases of severe endometriosis, the characteristics of the patient should be considered in a multidisciplinary manner to determine the prioritization of treatment modalities, including surgical treatment and assisted reproduction methods such as in vitro fertilization. The risk of cancer, complications after pregnancy, and infection during oocyte retrieval should also be considered when making treatment decisions.

Epidemiological Survey on the Infection of Intestinal Flukes in Residents of Muan-gun, Jeollanam-do, the Republic of Korea

  • Cho, Shin-Hyeong;Cho, Pyo-Yun;Lee, Dong-Min;Kim, Tong-Soo;Kim, In-Sang;Hwang, Eun-Jung;Na, Byoung-Kuk;Sohn, Woon-Mok
    • Parasites, Hosts and Diseases
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    • v.48 no.2
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    • pp.133-138
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    • 2010
  • Infection status of intestinal flukes was investigated in residents of Muan-gun, Jeollanam-do, the Republic of Korea. Total 1,257 fecal samples of residents were examined by formalin-ether sedimentation technique and Kato-Katz thick smear method. Helminth eggs were detected from 95 (7.6%) residents, and eggs of heterophyid flukes and Clonorchis sinensis were found from 62 (4.9%) and 40 (3.2%) cases, respectively. The larger heterophyid eggs, somewhat darkbrown in color and $37.7{\times}21.5{\mu}m$ in average size, and found in 32 (2.6%) out of 62 egg positive cases of heterophyid flukes. To confirm the adult flukes, we performed worm recovery from 12 cases after praziquantel treatment and purgation with $MgSO_4$. A total of 1,281 adult flukes, assigned to 7 species, were recovered from 9 cooperative cases. Heterophyes nocens (total 981 specimens) was collected from 9 cases, Stictodora fuscata (80) from 7, Gymnophalloides seoi (75) from 5, Pygidiopsis summa (140) from 3, Stellantchasmus falcatus (3) from 2, and Stictodora lari and Acanthotrema felis (each 1 worm) from 1 case each. The intrauterine eggs of S. fuscata collected from the recovered worm were identical with the larger heterophyid eggs detected in the stool examination. By the present study, it was confirmed that A. felis is a new intestinal fluke infecting humans, and residents in Muan-gun, Jeollanam-do are infected with variable species of intestinal trematodes.

Effects of gamma-irradiation on the survival and development of Gymnophalloides seoi in C3H mice (방사선 조사가 참굴큰입흡충 피낭유충의 C3H 마우스 내 생존 및 발육에 미치는 영향)

  • CHAI, Jong-Yil;HAN, Moon-Sung;SEO, Min;LEE, Soon-Hyung
    • Parasites, Hosts and Diseases
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    • v.34 no.1
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    • pp.21-26
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    • 1996
  • An experimental study was carried out to observe the effects of radiation on the infectivity of metacercariae of Gymnophalloines seoi to C3H mice. Oysters, the second intermediate host, were collected from an endemic area, and non-irradiated control, metacercaria-irradiation, and oyster-irradiation groups were prepared . One hundred metacercariae were infected orally to each mouse, and worm recovery rate was compared by groups at 7th day post-infection. In the metacercaria-irradiation group, the worm recovery rate was significantly reduced at radiation doses higher than 200 Gy, and the number of intrauterine eggs significantly reduced at doses over 50 Gy. In the oyster- irradiation group, 50 Gy significantly reduced both the worm recovery rate and number of uterine eggs. In the two groups, no worm was recovered at 1,000 Gy irradiation. Conclusively, irradiation of oysters with 200-1,000 Gy was effective to control infectivity of metacercariae to C3H mice, and could be adopted as a control measure for gymno-phalloidiasis.

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Treatment of Aplasia Cutis Congenita on Scalp using Hyalomatix$^{(R)}$: A Case Report (하이알로매트릭스를 이용한, 두개골결손을 동반한 선천성피부무형성증의 치료: 1례 보고)

  • Rhee, Suk-Hyun;Hong, Jong-Won;Roh, Tai-Suk;Kim, Young-Seok;Rah, Dong-Kyun
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.469-472
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    • 2010
  • Purpose: Aplasia Cutis Congenita (ACC) is a rare disease characterized by the focal defect of the skin at birth, frequently involving scalp, but it may affect any region of the body. There are no etiology known but some conditions such as intrauterine vascular ischemia, amniotic adherences and viral infections are associated. The ideal treatment for the ACC is not known. Superficial and relatively small sized defects (< $3{\times}5\;cm$) may heal spontaneously and large defects related with risks of infection and bleeding may require aggressive surgical treatment. Hyalomatrix$^{(R)}$ is a bilayer of an esterified hyaluronan scaffold beneath a silicone membrane. It has been used as a temporary dermal substitute to cover deep thickness skin defect and has physiological functions derive from the structural role in extracellular matrix and interaction with cell surface receptor. This material has been used for the wound bed pre-treatment for skin graft to follow and especially in uncooperative patient, like a newborn, this could be a efficient and aseptic way of promoting granulation without daily irritative wound care. For this reason, using Hyalomatrix$^{(R)}$ for the treatment of ACC was preferred in this paper. Methods: We report a case of a newborn with ACC of the vertex scalp and non-ossified partial skull defect. The large sized skin and skull defect ($6{\times}6\;cm$) was found with intact dura mater. No other complications such as bleeding or abnormal neurologic sign were accompanied. Escharectomy was performed and Hyalomatrix$^{(R)}$ was applied for the protection and the induction of acute wound healing for 3 months before the split-thickness skin graft. During the 3 months period, the dressing was renewed in aseptic technique for every 3 weeks. The skin graft was achieved on the healthy granulation bed. Results: The operative procedure was uneventful without necessity of blood transfusion. Postoperative physical examination revealed no additional abnormalities. Regular wound management was performed in out-patient clinic and the grafted skin was taken completely. No other problems developed during follow-up. Conclusion: Hyalomatrix$^{(R)}$ provides protective and favorable environment for wound healing. The combination of the use of Hyalomatrix$^{(R)}$ and the skin graft will be a good alternative for the ACC patients with relatively large defect on vertex.

Number of intrauterine eggs in female Enterobius Mermicularis by body length (요충 자충의 길이별 보유 충란수)

  • Jo, Seung-Yeol;Jang, Im-Won;Jang, Hyeon-Jeong
    • Parasites, Hosts and Diseases
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    • v.23 no.2
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    • pp.253-259
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    • 1985
  • In order to correlate the number of eggs In female Enterobius vermicularis with their body length and to re-evaluate the number of eggs liberated by gravid females, a total of 203 worms were examined. Those females were removed from naturally infected orphans with mebendazole (100mg) and had been fixed in 10% formalin(Cho et al., 1981). The decent ones which were selected under dissecting microscope were unbroken, neatly fixed females without contaminated eggs on their surface. The worms were measured by their body length, softened in 0.1N NaOH solution overnight, and teased by dissecting needles. And their number of shelled eggs was measured in a counting chamber made as described by Denham et at. (1971). The results were summarized as follows: 1. The observed females, 4.10~9.90mm long, began to have shelled eggs in uterus when body length was 5.50mm or longer. 2. The percentage of females with eggs in uterus was as follows by range of body length: 25% in 5.50~5.99mm long, 53.3% in 6.00~6.49mm long, 86.7% in 6.50~6.99mm long, 95.2% in 7.00~7.49mm long and 100% in 7.50mm or longer. 3. The mean and standard deviation of egg number were as follows by the length of females: $19{\pm}50$ in 5.50~5.99mm long, $734{\pm}1,597$ in 6.00~6.49mm long, $1,473{pm}1,606$ in 6.50~6.99mm long, $1,530{\pm}2,055$ in 7.00~7.49mm long, $2,567{\pm}2,046$ in 7.50~7.99mm long, $5,598{\pm}2,470$ in 8.00~8.49mm long, $9,318{\pm}2,651$ in 8.50~8.99mm long, $10,678{\pm}2,892$ in 9.00~9.49mm long and $13,323{\pm}1,778$ in 9.50~9.90mm long. 4. The numbers of uterine eggs showed greater individual variation when the female lengths were in range of 5.5~8.0mm. When the female length was longer than 9.0mm, the egg numbers were over 10,000 in majority, and showed lesser individual variations. Above results su99ested that the e99 Production in female 5. vermicularis began in 28~32 days after infection and that in early stapes, the egg Production varied by individual worms, but in gravid females longer than 9. Qmm at last deposited 10,000 to 16,000 eggs in their uterus with the least individual variations.

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Current Status of Children Born from Renal Transplanted Mother (신이식을 받은 산모로부터 출생한 소아의 성장상태)

  • Ki Mina;Yook Jinwon;Kim Ji Hong;Kim Pyung-Kil;Moon Jang Il;Kim Soon Il;Kim Yu Seun;Park Kiil;Park Young Won
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.77-83
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    • 2000
  • Purpose: Pregnancy in transplanted mother is considered as a high-risk pregnancy, and significant incidences of prematurity and low-birthweight(LBW) infants have been reported. The objective of this study is to examine the outcome of pregnancy in transplanted mothers and to evaluate the current growth status in their children. Patients and Methods: We retrospectively reviewed 54 pregnancies in 40 kidney recipients until June 1999. Outcomes of pregnancy were reviewed and assessment of the current growth status in children was performed. Results: 54 pregnancies in 40 recipients were identified; 22 ended in termination of pregnancy because of unwanted pregnancy or therapeutic purposes. And of the other 32, 29 livebirths resulted in 28 recipients. The mean age of conception was $30.3{\pm}3.8$ years, with a mean interval from transplantation to conception of $35.9{\pm}23.2$ months. All patients were maintained on immunosuppressive regimens. Incidence of drug-treated hypertension(HTN) prior to pregancy was $52\%$, HTN during pregnancy, $48\%$; preeclampsia, $41\%$; urinary tract infection, $48\%$; oligohydramnios $4\%$; and no rejection during pregnancy and up to 3month post delivery. Of the 29 liveborn infants, prematurity(<37wk) occurred in $52\%$, LBW(<2500g) in $62\%$, VLBW(<1500g) in $7\%$ and $48\%$ born intrauterine growth retardation(IUGR). Mean gestational age was $36.3{\pm}3.0\;wk$; a mean birthweight, $2.23{\pm}0.6\;kg$; a mean birth-height, $45.1{\pm}3.6cm$. Current mean height standard deviation score (height SDS) was $0.29{\pm}0.91$ and mean weight SDS was $0.62{\pm}1.34$. Only one child($4\%$) under 1 year of age was below 10 percentile in height. Most of children had no medical problems except for 4 children; cleft palate(1), tuberous sclerosis(1), essential hematuria(1), and one child expired due to sepsis. Conclusion: This study showed similar incidence of premaure birth($57\%$) and low birth weight infants($62\%$), but lower incidence of spontaneous abortion($5.6\%$) was observed and compared to other studies. Postnatal growth in majority of children($96\%$) achieved catch-up growth before 1 year. Present study supports a more optimistic view of pregnancy in renal transplant mother and normal growth in their children.

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