• Title/Summary/Keyword: Delayed-Retardation

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Hepatic glycogenosis in type 1 diabetes mellitus mimicking Mauriac syndrome

  • Jung, In Ah;Cho, Won Kyoung;Jeon, Yeon Jin;Kim, Shin Hee;Cho, Kyoung Soon;Park, So Hyun;Jung, Min Ho;Suh, Byung-Kyu
    • Clinical and Experimental Pediatrics
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    • v.58 no.6
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    • pp.234-237
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    • 2015
  • Hepatic glycogenosis in type 1 diabetes mellitus (DM) can be caused by poor glycemic control due to insulin deficiency, excessive insulin treatment for diabetic ketoacidosis, or excessive glucose administration to control hypoglycemia. Mauriac syndrome, which is characterized by hepatomegaly due to hepatic glycogenosis, growth retardation, delayed puberty, and Cushingoid features, is a rare diabetic complication. We report a case of hepatic glycogenosis mimicking Mauriac syndrome. A 14-year-old girl with poorly controlled type 1 DM was admitted to The Catholic University of Korea, Seoul St. Mary's Hospital for abdominal pain and distension. Physical examination revealed hepatomegaly and a Cushingoid face. The growth rate of the patient had decreased, and she had not yet experienced menarche. Laboratory findings revealed elevated liver enzyme levels. A liver biopsy confirmed hepatic glycogenosis. Continuous glucose monitoring showed hyperglycemia after meals and frequent hypoglycemia before meals. To control hyperglycemia, we increased insulin dosage by using an insulin pump. In addition, we prescribed uncooked cornstarch to prevent hypoglycemia. After strict blood glucose control, the patient's liver functions and size normalized. The patient subsequently underwent menarche. Hepatic glycogenosis is a complication of type 1 DM that is reversible with appropriate glycemic control.

Neuropathological Mechanisms of Perinatal Brain Injury (주산기 뇌손상의 신경병리적 기전)

  • Song Ju-Young;Kim Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.15 no.4
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    • pp.199-207
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    • 2003
  • This review describes the neurophathological mechanisms that are implicated in perinatal brain injury. Perinatal brain injury is the most important cause of morbidity and mortality to infants, often leading to spastic motor deficits, mental retardation, seizures, and learning impairments. The immature brain injury is usually caused by cerebral hypoxia-ischemia, hemorrhage, or infection. The important form of perinatal brain injury is the hypoxic-ischemic injury and the cerebral hemorrhage. The pathology of hypoxic-ischemic injury include delayed energy failure by mitochondrial dysfunction, neuronal excitotoxicity and vulnerability of white matter in developing brain. The immature brain has the fragile vascular bed of germinal matrix and can not effectively centralize their circulation. Therefore, the cerebral hemorrhage process is considered to be involved in the periventricular leukomalacia.

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TREATMENT OF THE CHILD WITH ROBINOW SYNDROME UNDER GENERAL ANESTHESIA : A CASE REPORT (Robinow 증후군 환아의 전신마취를 이용한 치료증례보고)

  • Park, Jae-Hong;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.3
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    • pp.601-608
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    • 1996
  • Robinow syndrome or fetal face syndrome is a rare inherited disorder characterized by short stature, mesomelic brachymelia, hypoplastic genitalia, and a typical facial appearence ("fetal face") with frontal bossing, hypertelorism, ear abnormalities, a short upturned nose, long philtrum, micrognathia, and macrocephaly. Intraoral features have included quite a few dental cavities, crowding, hypoplastic uvula, cleft lip or/and cleft palate, gingival hyperplasia, alveolar hyperplasia, enamel hypoplasia, delayed eruption, and congenital missing of the permanent teeth. We report on a 10 years old girl with Robinow syndrome. The patient had most of the typical anomalies of the syndrome and negative family history but, in addition, had mental retardation, hearing loss, and serous otitis media. Intraoral findings included dental cavities, crowding, hypoplastic uvula, repaired cleft palate, and mouth breathing. Dental treatment and V-tube insertion(by dept. of ENT) were performed under general anesthesia. In all cases of Robinow syndrome, thorough evaluation and united treatments with medical specialists should be performed.

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1p36 deletion syndrome confirmed by fluorescence in situ hybridization and array-comparative genomic hybridization analysis

  • Kang, Dong Soo;Shin, Eunsim;Yu, Jeesuk
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.14-18
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    • 2016
  • Pediatric epilepsy can be caused by various conditions, including specific syndromes. 1p36 deletion syndrome is reported in 1 in 5,000-10,000 newborns, and its characteristic clinical features include developmental delay, mental retardation, hypotonia, congenital heart defects, seizure, and facial dysmorphism. However, detection of the terminal deletion in chromosome 1p by conventional G-banded karyotyping is difficult. Here we present a case of epilepsy with profound developmental delay and characteristic phenotypes. A 7-year-and 6-month-old boy experienced afebrile generalized seizure at the age of 5 years and 3 months. He had recurrent febrile seizures since 12 months of age and showed severe global developmental delay, remarkable hypotonia, short stature, and dysmorphic features such as microcephaly; small, low-set ears; dark, straight eyebrows; deep-set eyes; flat nasal bridge; midface hypoplasia; and a small, pointed chin. Previous diagnostic work-up, including conventional chromosomal analysis, revealed no definite causes. However, array-comparative genomic hybridization analysis revealed 1p36 deletion syndrome with a 9.15-Mb copy loss of the 1p36.33-1p36.22 region, and fluorescence in situ hybridization analysis (FISH) confirmed this diagnosis. This case highlights the need to consider detailed chromosomal study for patients with delayed development and epilepsy. Furthermore, 1p36 deletion syndrome should be considered for patients presenting seizure and moderate-to-severe developmental delay, particularly if the patient exhibits dysmorphic features, short stature, and hypotonia.

The Long-term Outcome of Esophageal Atresia (선천성 식도 폐쇄의 수술 후 경과 및 장기 예후)

  • Jeong, Jae-Hong;Kim, Hye-Eun;Lee, Suk-Koo;Seo, Jeong-Meen
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.117-124
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    • 2008
  • Children who underwent reparative operations for esophageal atresia (EA) with or without tracheoesophageal fistula (TEF), are confronted with many gastrointestinal or respiratory problems, especially during the early years of life. We reviewed the medical records of 50 patients who underwent repairs of EA with or without TEF at the Division of Pediatric Surgery, Samsung Medical Center, from December 1994 to December 2005. Current status of children was accessed by telephone-interview, but only 27 of them were accessible. Of 50 patients, 3 patients (6 %) were type A, 45 patients (90 %) were type C, and 2 patients (4 %) were type E. The mean interval between primary operation and interview was 5.5 years. The incidences of growth retardation (<10 percentile of height/weight) were 39 % and 21 % during the first 5 years after repairs, respectively. The incidences of dysphagia or gastroesophageal reflux and recurrent respiratory infections were 33 % and 39 %, respectively. However, these problems were likely to improve as the children grew. The incidences of growth retardations (<10 percentile of height/weight) were 11 % and 11 % for the children more than five years postoperative. The incidences of dysphagia or gastroesophageal reflux and recurrent respiratory infections were 22 % and 22 %, respectively. Children with EA with or without TEF are faced with many obstacles. Close observation and adequate treatment for delayed postoperative complications are necessary to improve the quality of life for these children.

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Regulation of retinal angiogenesis by endothelial nitric oxide synthase signaling pathway

  • Ha, Jung Min;Jin, Seo Yeon;Lee, Hye Sun;Shin, Hwa Kyoung;Lee, Dong Hyung;Song, Sang Heon;Kim, Chi Dae;Bae, Sun Sik
    • The Korean Journal of Physiology and Pharmacology
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    • v.20 no.5
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    • pp.533-538
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    • 2016
  • Angiogenesis plays an essential role in embryo development, tissue repair, inflammatory diseases, and tumor growth. In the present study, we showed that endothelial nitric oxide synthase (eNOS) regulates retinal angiogenesis. Mice that lack eNOS showed growth retardation, and retinal vessel development was significantly delayed. In addition, the number of tip cells and filopodia length were significantly reduced in mice lacking eNOS. Retinal endothelial cell proliferation was significantly blocked in mice lacking eNOS, and EMG-2-induced endothelial cell sprouting was significantly reduced in aortic vessels isolated from eNOS-deficient mice. Finally, pericyte recruitment to endothelial cells and vascular smooth muscle cell coverage to blood vessels were attenuated in mice lacking eNOS. Taken together, we suggest that the endothelial cell function and blood vessel maturation are regulated by eNOS during retinal angiogenesis.

A Case of Nephrogenic Diabetes Insipidus with a Rare X-linked Recessive Mutation in an Infant with Developmental and Growth Retardation Tracked by the Korean National Health Screening Program

  • Kim, Min-Ji;Cho, Jae Young;Park, Ji Sook;Park, Eun Sil;Seo, Ji-Hyun;Lim, Jae-Young;Woo, Hyang-Ok;Youn, Hee-Shang
    • Childhood Kidney Diseases
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    • v.24 no.2
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    • pp.131-137
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    • 2020
  • Nephrogenic diabetes insipidus (DI) is a rare disease in which the patient cannot concentrate urine despite appropriate or high secretion of antidiuretic hormone. Congenital nephrogenic DI is caused by the arginine vasopressin receptor 2 (AVPR2) or aquaporin 2 (AQP2) gene mutation; the AVPR2 genetic mutation accounts for 90% of the cases. National health screening for infants and children was launched in 2007 in order to prevent accidents and promote public health in infants and children in Korea. The program has been widely used as a primary clinical service in Korea. We treated an infant with faltering growth and delayed development detected by the National health screening program, and diagnosed the problem as nephrogenic DI caused by a rare missense mutation of c.490T>C on the AVPR2 gene. This case can be a good educational nephrogenic DI with a rare AVPR2 mutation, which was well screened and traced by the national health screening program for infants and children in Korea.

ER71/ETV2 Promotes Hair Regeneration from Chemotherapeutic Drug-Induced Hair Loss by Enhancing Angiogenesis

  • Lee, Tae-Jin;Kang, Hee-Kyoung;Berry, Jeffrey C.;Joo, Hong-Gu;Park, Changwon;Miller, Mark J.;Choi, Kyunghee
    • Biomolecules & Therapeutics
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    • v.29 no.5
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    • pp.545-550
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    • 2021
  • Chemotherapy-induced alopecia and hair loss can be stressful in patients with cancer. The hair grows back, but sometimes the hair tends to stay thin. Therefore, understanding mechanisms regulating hair regeneration may improve the management of chemotherapy-induced alopecia. Previous studies have revealed that chemotherapeutic agents induce a hair follicle vascular injury. As hair growth is associated with micro-vessel regeneration, we postulated that the stimulation of angiogenesis might enhance hair regeneration. In particular, mice treated with 5-fluorouracil (5-FU) showed delayed anagen initiation and reduced capillary density when compared with untreated controls, suggesting that the retardation of anagen initiation by 5-FU treatment may be attributed to the loss of perifollicular micro-vessels. We investigated whether the ETS transcription factor ETV2 (aka ER71), critical for vascular development and regeneration, can promote angiogenesis and hair regrowth in a 5-FU-induced alopecia mouse model. Tie2-Cre; Etv2 conditional knockout (CKO) mice, which lack Etv2 in endothelial cells, presented similar hair regrowth rates as the control mice after depilation. Following 5-FU treatment, Tie2-Cre; Etv2 CKO mice revealed a significant reduction in capillary density, anagen induction, and hair restoration when compared with controls. Mice receiving lentiviral Etv2 injection after 5-FU treatment showed significantly improved anagen induction and hair regrowth. Two-photon laser scanning microscopy revealed that enforced Etv2 expression restored normal vessel morphology after 5-FU mediated vessel injury. Our data suggest that vessel regeneration strategies may improve hair regrowth after chemotherapeutic treatment.

The Efficacy of Speech and Language Therapy for Children with Speech and Language Delays according to the Eiologies (말 언어 지연을 보인 소아에서 원인에 따른 말 언어 치료의 효과)

  • Kim, June Bum;Suh, Jin-Soon;Kim, Young-Hoon;Chung, Seung-Yun;Lee, In-Goo;Whang, Kyung-Tai;Lee, Byung-Churl
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.924-928
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    • 2005
  • Purpose : Treatment efficacy for children with speech and language delay has been the subject of considerable debate in recent years. We evaluated the clinical features of children with delayed speech and language and their prognoses according to their etiologies after 6 months of speech and language therapy. Methods : From January, 2000 to March, 2004, we retrospectively reviewed 56 children with speech and language delay who were administered speech and language therapy for 6 months in Uijongbu St. Mary's Hospital. Results : Of 56 cases, the proportion of developmental language disorder was 66.1 percent, structural malformation 19.6 percent, mental retardation 12.5 percent, hearing defect 1.8 percent. The ratio of male to female was 4.6 : 1 and the most frequent age group was over 47 months. The mean age of first spontaneous words with useful meaning was 15.9 months. The mean gestational age of the subjects was 39.8 weeks. The proportion of full-term infants was 96.4 percent and of premature infants was 3.6 percent. As for the birth order, the proportion of the first baby was 51.8 percent, the one of second babies it was 42.9 percent, and percent of third babies it was 7.1 percent. After 6 months of language intervention, 32.4 percent of patients with developmental language disorder showed normal linguistic development. All the patients with mental retardation showed sustained language and speech delay. As for the patients with structural malformations, five out of 11 patients showed normal linguistic development. Conclusion : The relatively advanced old age of majority of participants in this study suggests the necessity of screening test for language delay in this local community.

Preparation of EVA/Intumescent/Nano-Clay Composite with Flame Retardant Properties and Cross Laminated Timber (CLT) Application Technology (난연특성을 가지는 EVA/Intumescent/나노클레이 복합재료 제조 및 교호집성재(Cross Laminated Timber) 적용 기술)

  • Choi, Yo-Seok;Park, Ji-Won;Lee, Jung-Hun;Shin, Jae-Ho;Jang, Seong-Wook;Kim, Hyun-Joong
    • Journal of the Korean Wood Science and Technology
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    • v.46 no.1
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    • pp.73-84
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    • 2018
  • Recently, the importance of flame retardation treatment technology has been emphasized due to the increase in urban fire accidents and fire damage incidents caused by building exterior materials. Particularly, in the utilization of wood-based building materials, the flame retarding treatment technology is more importantly evaluated. An Intumescent system is one of the non-halogen flame retardant treatment technologies and is a system that realizes flame retardancy through foaming and carbonization layer formation. To apply the Intumescent system, composite material was prepared by using Ethylene vinyl acetate (EVA) as a matrix. To enhance the flame retardant properties of the Intumescent system, a nano-clay was applied together. Composite materials with Intumescent system and nano - clay technology were processed into sheet - like test specimens, and then a new structure of cross laminated timber with improved flame retardant properties was fabricated. In the evaluation of combustion characteristics of composite materials using Intumescent system, it was confirmed that the maximum heat emission was reduced efficiently. Depending on the structure attached to the surface, the CLT had two stages of combustion. Also, it was confirmed that the maximum calorific value decreased significantly during the deep burning process. These characteristics are expected to have a delayed combustion diffusion effect in the combustion process of CLT. In order to improve the performance, the flame retardation treatment technique for the surface veneer and the optimization technique of the application of the composite material are required. It is expected that it will be possible to develop a CLT structure with improved fire characteristics.