• Title/Summary/Keyword: Early onset

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Early Onset Subsequent Vertebral Compression Fracture after Percutaneous Verteroplasty (경피적 척추 성형술 후 조기에 발생한 새로운 척추 압박골절)

  • Kim, Jong-Kil;Choi, Byeong-Yeol;Park, Young-Chul;Kim, Dong-Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.24-29
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    • 2019
  • Purpose: To evaluate the characteristics and the risk factors of early onset subsequent vertebral compression fractures after percutaneous vertebroplasty. Materials and Methods: A total of 44 patients, who had a new subsequent vertebral fracture after percutaneous vertebroplasty for an osteoporotic vertebral compression fracture between January 2013 and December 2015, were recruited. The patients were divided into two groups according to the onset period of subsequent fracture. The number of patients who had a fracture within 3 months following vertebroplasty were 22 cases (Group A); after 3 months were 22 cases (Group B). Variables, including age, sex, bone mineral density (BMD), body mass index (BMI), preexisting vertebral compression fracture, location of the initial fracture, intradiscal cement leakage, injected cement volume, restoration of vertebral body height, and correction of kyphosis, in the two groups were analyzed and compared retrospectively. Results: The age, sex, BMD, BMI, preexisting vertebral compression fracture, location of the initial fracture, intradiscal cement leakage, and correction of kyphosis were similar in the two groups. Both a greater volume of bone cement injected and a greater degree of vertebral height restoration contributed significantly to the risk of fracture within 3 months. Conclusion: The cement volume and degree of height restoration are risk factors for early onset fracture at the adjacent vertebrae after percutaneous vertebroplasty and close attention is needed during the follow-up period.

A case of Becker muscular dystrophy with early manifestation of cardiomyopathy

  • Doo, Ki-Hyun;Ryu, Hye-Won;Kim, Seung-Soo;Lim, Byung-Chan;Hwang, Hui;Kim, Ki-Joong;Hwang, Yong-Seung;Chae, Jong-Hee
    • Clinical and Experimental Pediatrics
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    • v.55 no.9
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    • pp.350-353
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    • 2012
  • An 18-year-old boy was admitted with chest discomfort, nausea, and dyspnea at rest. At the age of 3 years, he underwent muscle biopsy and dystrophin gene analysis owing to an enlarged calf muscle and elevated serum kinase level (6,378 U/L) without overt weakness; based on the results, Becker muscular dystrophy (BMD) was diagnosed. The dystrophin gene showed deletion of exons 45 to 49. He remained ambulant and could step upstairs without significant difficulties. A chest roentgenogram showed cardiomegaly (cardiothoracic ratio, 54%), and his electrocardiogram (ECG) showed abnormal ST-T wave, biatrial enlargement, and left ventricular hypertrophy. The 2-dimensional and M-mode ECGs showed a severely dilated left ventricular cavity with diffuse hypokinesis. The systolic indices were reduced, including fractional shortening (9%) and ejection fraction (19%). Despite receiving intensive medical treatment, he died from congestive heart failure 5 months after the initial cardiac symptoms. We report a case of BMD with early-onset dilated cardiomyopathy associated with deletion of exons 45 to 49. Early cardiomyopathy can occur in BMD patients with certain genotypes; therefore, careful follow-up is required even in patients with mild phenotypes of BMD.

The promotion of mental health and the prevention of mental health problems in child and adolescent

  • Cho, Sun Mi;Shin, Yun Mi
    • Clinical and Experimental Pediatrics
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    • v.56 no.11
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    • pp.459-464
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    • 2013
  • Improving mental health and reducing the burden of mental illness are complementary strategies which, along with the treatment and rehabilitation of people with mental disorders, significantly improve population health and well-being. A Institute of Medicine report describes a range of interventions for mental disorders that included treatment and maintenance, reserving the term "prevention" for efforts that occur before onset of a diagnosable disorder. Mental health problems affect 10-20% of children and adolescents worldwide. Despite their relevance as a leading cause of health-related disability and their long lasting consequences, the mental health needs of children and adolescents are neglected. Early intervention can help reduce the significant impacts that children and adolescents with serious mental health problems may experience. Screening is the first step in early intervention, recognizing emotional and behavioral problems and providing help at an early stage. It is essential to implement early intervention in a sensitive and ethical manner to avoid any of the negative outcomes.

Early Diagnosis of Acute Osteomyelitis by TC-99m Pyrophosphate Bone Imaging (Tc-99m Pyrophosphate-골(骨)스캔에 의한 급성골수염(急性骨髓炎)의 조기진단(早期診斷))

  • Kim, Choon-Yul;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.13 no.1_2
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    • pp.55-60
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    • 1979
  • The radiographic diagnosis of osteomyelitis can be suspected early with deep soft tissue swelling, but the actual bone changes of osteomyelitis may be delayed as long as 10 to 14 days after onset or may be totally aborted by antibiotic therapy. Recognition of osteomyelitis by bone imaging is far more rapid than by conventional radiographic examination and can be used on admission to establish the diagnosis. Ten patients suspected of having early, acute osteomyelitis were studied by TC-99m Pyrophosphate bone imaging. Radiographs taken at the same time were all negative. Of these 9 patients showed positive bone images. The bone imaging provides a safe, accurate, noninvasive technique for the early diagnosis of osteomyelitis.

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Revision of the early-onset periodontitis into the homogeneous phenotypic subsets (조기발병형 치주염의 균질성 표현형 소집단으로의 재분류)

  • Choi, Kwang-Sik;Choi, Jeom-Il;Kim, Sung-Jo
    • Journal of Periodontal and Implant Science
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    • v.26 no.3
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    • pp.725-734
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    • 1996
  • The present study has been performed to revise the forms of early-onset periodontitis(EOP) into the homogeneous phenotypic subsets by cluster analysis using sets of clinical parameters. Retrospective radiographic interproximal alveolar bone levels were measured from cemento-enamel junctions on patients who have previously been diagnosed as having one of EOP during last 5 years. Mean interproximal bone levels(BL) and mesial bone level(Ratio) of 1st molars relative to mean interproximal bone levels of adjacent teeth(lst and 2nd premolars and canines)were calculated on each patient. Using parameters BL and Ratio(BR group) or BL, Ratio and age(BRA group), cluster analysis was performed to revise EOP patients into homogeneous subsets. At least three or four cluster could be homogeneously formed both in BR or BRA groups with statistically significant differences in parameters used among clusters as evidenced by MANOVA test. It was shown that the greater the BL, the smaller the Ratio was. It was also evident that mean interproximal bone levels were lowest aroud 1st molars and/or incisors regardless of cluster types. The results has provided cluster-based studies for identifying laboratory markers responsible for the development of EOP subsets.

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Early-onset sepsis in a neonatal intensive care unit in Beni Suef, Egypt: bacterial isolates and antibiotic resistance pattern

  • Fahmey, Sameh Samir
    • Clinical and Experimental Pediatrics
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    • v.56 no.8
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    • pp.332-337
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    • 2013
  • Purpose: To identify the frequency of bacterial isolates in early-onset neonatal sepsis (EONS) and their antimicrobial resistance pattern. Methods: A retrospective study of EONS was conducted at the Beni Suef University Hospital from September 2008 to September 2012. A case of EONS was defined as an infant who had clinical signs of infection or who was born to a mother with risk factors for infection, and in whom blood culture obtained within 72 hours of life grew a bacterial pathogen. Results: Of 673 neonates screened, there were 138 positive blood cultures (20.5%) (confirmed EONS). Of the recovered isolates, 86.2% were gram-negative pathogens. Klebsiella pneumoniae (42.8%), Enterobacter cloacae (22.5%), and Escherichia coli (13.8%) were the commonest isolated organisms. The most common gram-positive microorganism was Staphylococcus aureus accounting for only 12 isolates (8.7%). All Klebsiella isolates and 93% of Enterobacter isolates were resistant to ampicillin. Gram-negative pathogens had the maximum overall sensitivity to imipenem, cefepime, and ciprofloxacin; whereas, gram-positive isolates were most susceptible to vancomycin, imipenem, and piperacillin. Conclusion: K. pneumoniae was the predominant causative bacteria of EONS followed by E. cloacae and E. coli. There was a high resistance to ampicillin. Imipenem had the maximum overall activity against the causative bacteria. Continuous surveillance is needed to monitor the changing epidemiology of pathogens and antibiotic sensitivity.

Sleepwalking and Sleep Terrors (몽유병과 야경증)

  • Park, Young-Woo
    • Sleep Medicine and Psychophysiology
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    • v.2 no.1
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    • pp.13-22
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    • 1995
  • To provide the physician with adequate information to diagnose and treat sleepwalking and sleep terrors, the author reviewed clinical features, epidemiology, causative and precipitating factors, polysomnography, diagnosis, differential diagnosis, and treatment for these disorders. Sleepwalking and sleep terrors have been defined as disorders of arousal that occur early in the night and have their onset during stage 3 or 4 sleep. In both disorders, patients are difficult to arouse, and complete amnesia or minimal recall of the episode is frequent. Genetic, developmental, and psychological factors have been identified as causes of both sleepwalking and sleep terrors. Sleepwalking and sleep terrors typically begin in childhood or early adolescence and are usually outgrown by the end of adolescence. When sleepwalking or sleep terrors have a post-pubertal onset or continue to adulthood, psychopathology is a more significant causative factors. The behavior that occur from deep slow-wave sleep can be painful or dangerous to the individual and/or disturbing to those close to that individual. The assessment of patients suspected of having these conditions requires a thorough medical and sleep history. The most important consideration in managing patients with sleepwalking or sleep terrors episodes is protection from injury.

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A Pediatric Case of Inflammatory Bowel Disease with Renal Amyloidosis

  • Hyun, Hyesun;Park, Eujin;Kim, Ji Hyun;Cho, Myung Hyun;Kang, Hee Gyung;Moon, Jin Soo;Moon, Kyung Chul;Ha, Il-Soo;Cheong, Hae Il
    • Childhood Kidney Diseases
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    • v.22 no.2
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    • pp.81-85
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    • 2018
  • Amyloidosis is a rare disease that results from the deposition of extracellular protein in various body tissues, causing progressive organ dysfunction. Secondary renal amyloidosis is a rare but serious complication of chronic inflammatory bowel disease, particularly in patients with Crohn's disease or ulcerative colitis. We report a case of secondary renal amyloidosis in a pediatric patient who reported a 16-year history of "very early onset inflammatory bowel disease". Intensive treatment including repeated infliximab infusions improved clinical parameters of inflammatory bowel disease, although renal dysfunction showed progression. Amyloidosis should be considered in patients with IBD, particularly if they suffered disease progression.

Radioisotopic and Radiological Evaluation in Patient with Stress Fracture (피로골절 환자에서 골주사 소견과 방사선 소견의 비교)

  • Ko, Kwang-Seop;Kim, Jai-Young;Kang, Sung-Koo;Kim, So-Yon;Lee, Gwon-Jun
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.1
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    • pp.39-46
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    • 1987
  • The stress fracture is a disease caused by and abnormal stress to the normal bone with constant, repeated pull. Early detection of stress fracture plays an important role in treatment and prevention of its complication. Bone scintigraphy was performed to evaluate 18 patients with stress fracture of the lower extremities from May, 1985 to April, 1987, in the Department of Internal Medicine of National Police Hospital. The results were as follows: 1) Seventeen of the 18 cases showed positive bone scans at the initial study performed from 1 week to S months after the onset of symtom. 2) Ten of the 18 patients had findings of stress fracture at the initial X-ray film. Two out of 8 negative case revealed positive findings in the follow-up studies. 3) The bone scans in the 2 cases taken 5 months after the onset of symton; the one showed only slightly increased radiouptake, the other showed no abnormal findings. In conclusion, bone scanning is a more sensitive indicator of early stress fracture than radiologic study. The healing phase is characterized by a gradual decline in radioactivity at the fracture site in concordance with subsidence of symptom.

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Patterns of Diagnosis and Risk Factors for Type 2 Diabetes in Women with a History of Gestational Diabetes Mellitus (임신성 당뇨 과거력을 가진 여성의 2형 당뇨진단 양상과 관련요인)

  • Choi, Mi Jin;Chung, Chae Weon
    • Perspectives in Nursing Science
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    • v.13 no.1
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    • pp.17-28
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    • 2016
  • Purpose: This study aimed to identify patterns of diagnosis and to explore risk factors for type 2 diabetes beyond the postpartum period in women with a previous history of gestational diabetes, and to identify differences in such risk factors between early and late-onset (aged <45 and ${\geq}45$). Methods: Using epidemiological data from the Korean Genome and Epidemiology Study, a retrospective analysis of 175 women with various timings of type 2 diabetes diagnosis was performed. Results: The average age ($42.6{\pm}10.6$) at type 2 diabetes diagnosis was earlier than the general population, and obesity was prevalent with marked weight gains around 35 years old. Longer duration of breastfeeding was observed in women with late-onset of type 2 diabetes. Conclusion: For prevention of type 2 diabetes, early intervention is required, and modifiable factors such as weight control and breastfeeding should be taken into consideration for intervention strategies.