• Title/Summary/Keyword: Very early onset

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Oral Symptoms of Intractable Ulcerating Enterocolitis of Infancy and Differential Diagnosis: A Case Report (난치성 궤양성 소장결장염 영아의 구강 내 증상과 감별진단: 증례보고)

  • Min, Hyoseon;Choi, Hyungjun;Lee, Jaeho;Choi, Byungjai;Lee, Hyoseol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.1
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    • pp.80-84
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    • 2014
  • Intractable ulcerating enterocolitis is an uncommon inflammatory bowel disease syndrome of neonatal onset first described in 1991. Intractable ulcerating enterocolitis usually presents in the neonate with a mouth ulceration and the subsequent development of perianal disease and colitis. In this case report, an infant, 18 days from birth, with ulcerative lesion on hard palate for systemic differential diagnosis about oral lesion is referred from the department depiatrics. At that time, there is no abnormality, except oral lesion-like Aphthous ulcer. The patient was discharged from pediatrics, but returned to the hospital 3weeks later with blood diarrhea. As a result of endoscopy, there were large ulcerating lesions and the patient was diagnosed intractable ulcerating enterocolitis. Early recognition of Intractable ulcerating enterocolitis appears to be beneficial because colectomy, as opposed to immunosuppression, appears to be effective in controlling disease symptoms and progression. Most of the infants who were affected intractable ulcerating enterocolitis were normal at birth and oral manifestation appeared earlier than others. So, it is very meaningful for dentists to know about Intractable ulcerating enterocolitis.

A Case of Miliary Tuberculosis Mimicking ARDS due to Bilateral Severe Pneumonia (양측성 중증 폐렴으로 인한 ARDS로 오진된 속립성 결핵)

  • Han, Koon Hee;Jung, Bock Hyun;Kim, Young Don;Hwang, Jung Won;Hong, Hyun Il;Yoon, Sung Kyu;Kim, Mi Hye;Ryu, Dae Sik;Kang, Gil Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.1
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    • pp.109-113
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    • 2005
  • Miliary tuberculosis is the most serious form of tuberculous disease, but is rarely complicated with acute respiratory distress syndrome (ARDS). When a patient with miliary tuberculosis initially presents with ARDS, the mortality is much higher. Therefore, the early detection of miliary tuberculosis as the underlying cause of ARDS is very important for the prognosis and survival of the patient. The diagnosis of miliary tuberculosis may be easy if the patient presents typical clinical manifestations associated with the characteristic pattern of miliary nodules on chest radiology. However, the diagnosis of miliary tuberculosis when complicated with ARDS can be difficult due to the nonspecific radiologic patterns, such as diffuse bilateral consolidation and ground glass opacity, without miliary nodular infiltration. However, these nonspecific patterns are known as less likely findings of miliary tuberculosis. We experienced a pregnant woman with miliary tuberculosis, mimicking ARDS due to bilateral severe pneumonia. She was admitted, via the emergency room, with sudden onset of fever, chill, cough and dyspnea. The initial chest PA and HRCT showed diffuse bilateral consolidation and ground glass opacity, without miliary nodular infiltration. All bacteriological studies, including blood and sputum cultures, tuberculosis-PCR and serologic study for infectious disease were negative. However, the definite diagnosis of unusual miliary tuberculosis as the underlying cause of ARDS was confirmed from the radiological finding and transbronchial fiberoptic lung biopsy. We report this case, with a review of the literature.

Long-Term Durability of Infliximab for Pediatric Ulcerative Colitis: A Retrospective Data Review in a Tertiary Children's Hospital in Japan

  • Shimizu, Hirotaka;Arai, Katsuhiro;Takeuchi, Ichiro;Minowa, Kei;Hosoi, Kenji;Sato, Masamichi;Oka, Itsuhiro;Kaburaki, Yoichiro;Shimizu, Toshiaki
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.1
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    • pp.7-18
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    • 2021
  • Purpose: The long-term efficacy and safety of infliximab (IFX) in children with ulcerative colitis (UC) have not been well-evaluated. Here, we reviewed the long-term durability and safety of IFX in our single center pediatric cohort with UC. Methods: This retrospective study included 20 children with UC who were administered IFX. Results: For induction, 5 mg/kg IFX was administered at weeks 0, 2, and 6, followed by every 8 weeks for maintenance. The dose and interval of IFX were adjusted depending on clinical decisions. Corticosteroid (CS)-free remission without dose escalation (DE) occurred in 30% and 25% of patients at weeks 30 and 54, respectively. Patients who achieved CS-free remission without DE at week 30 sustained long-term IFX treatment without colectomy. However, one-third of the patients discontinued IFX treatment because of a primary nonresponse, and one-third experienced secondary loss of response (sLOR). IFX durability was higher in patients administered IFX plus azathioprine for >6 months. Four of five patients with very early onset UC had a primary nonresponse. Infusion reactions (IRs) occurred in 10 patients, resulting in discontinuation of IFX in four of these patients. No severe opportunistic infections occurred, except in one patient who developed acute focal bacterial nephritis. Three patients developed psoriasis-like lesions. Conclusion: IFX is relatively safe and effective for children with UC. Clinical remission at week 30 was associated with long-term durability of colectomy-free IFX treatment. However, approximately two-thirds of the patients were unable to continue IFX therapy because of primary nonresponse, sLOR, IRs, and other side effects.

Hypernatremia and Intraventricular Hemorrhage in Very Low Birth Weight Infants(<1,250 g) (극소 저체중 출생아(<1,250 g)에서 고나트륨혈증 발생 및 뇌출혈과의 관계)

  • Lee, Soo-Ho;So, Cheol-Hwan;Keum, Seung-Hoon;Yoo, Seung-Taek;Choi, Doo-Young;Oh, Yeon-Kyun
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.89-95
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    • 2011
  • Purpose: Hypernatremia most frequently occurs in the immature newborn and be severe in association with intraventricular hemorrhage (IVH). This study examined the frequency, onset and risk factors of hypernatremia, and the relationship between hypernatremia and IVH in very low birth weight (VLBW; <1,250 g) infants. Methods: We retrospectively reviewed the medical records of 55 VLBW infants admitted between January 2006 and December 2009 to the neonatal intensive care unit of Wonkwang University Hospital and who survived over 7 days. Serum sodium concentration, sodium intake, fluid and weight loss, as suggested risk factors of hypernatremia, and the incidence of IVH were evaluated. The infants were divided into a hypernatremia group (${\geq}$150 mEq/L) and nonhypernatremia group, and were compared. Results: Incidence of hypernatremia in the VLBW infants was 52.7%, and mean starting time of hypernatremia was 2.8${\pm}$1.3 days. There were no differences in the sodium and fluid intake between the two groups. Weight loss at day 3 after birth was significantly higher in the hypernatremia compared to the nonhypernatremia group (P<0.05); thereafter weight loss was non-significantly higher. The incidence of IVH in VLBW infants was 38.2%, and the difference between the two groups was not significant. Conclusion: Hypernatremia occurs commonly in VLBW infants and is most commonly caused by weight loss in the early days after birth. Incidence of IVH is not likely influenced by hypernatremia with marginally elevated sodium concentration.

Effect of Suckling on Progesterone Secretion during Lactation in the Rat (포유중인 Rat 의 Progesterone 분비에 대한 포유 효과)

  • 오석두;성환후;민관식;윤창현
    • Korean Journal of Animal Reproduction
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    • v.23 no.2
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    • pp.95-103
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    • 1999
  • This experiment was conducted to investigate how the lactation regulation such as restricted-lactation and early weaning during the suckling period influences on ovarian functions and change in serum levels of progesterone in primiparous rats. All the rats were raised in the individual cage from a few days before parturition through the suckling period. The normal lactation(NL) groups were controled 8 pups. The restricted-lactation(RL) and weaned(W) groups were subdivided into 5 subgroups as RL0, RL5, RL10, RL15 and RL20 as well as W0, W5, W10, W15, and W20 according to the day of onset of suckling. The number of pups were regulated from 8 to 4 on experimental strating day in RL gropus, and also perfectly weaned on the each on-set day in W groups. The results obtained were summarized as follows: 1. During the whole suckling period of 25 days the pups in RL group grew significantly(P<005) faster than those in normal-lactation(NL) group. The pups in earlier RL group grew significantly(P<0.05) faster than those in later RL rats, and there was no found any significant difference in body weight of pups between RL20 and NL group. The gestation period and litter size were found to be 21.53$\pm$0.04 days and 13.75$\pm$0.07, respectively. 2. The estrous cycle was not expressed in the NL group through the whole suckling period. An irregular estrous cycle was found around day 20 in RL0 group, and the regular estrous cycles were exhibited continuously from day 10 in the day 0 weaned rats. 3. In the rats of NL group the serum progesterone concentration increased from 33.16$\pm$2.64ng/$m\ell$ on day 0 to 122.5$\pm$53.68 ng/$m\ell$ on day 10, and then decreased slightly to 97.30$\pm$3.21 ng/$m\ell$ on day 20, but then decreased abruptly. However, the serum level of progesterone decreased greatly(P<0.05) in 5 to 10 days following suckling restriction in the rats from which suckling began to be under restriction on day 0 or day 15. In the early weaning group the significant ( (P<0.05) decrease in progesterone concentration was found similarly in 48 hours following weaning in all the rats weaned on day 0 through day 20. It was suggested that lactation stimulation is a very pivotal on the function of ovary.

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PERIODONTOPATHIC BACTERIA IN DOWN'S SYNDROME (다운증후군 환자의 치주질환 원인균의 출현율)

  • Kim, Seon-Mi;Yang, Kyu-Ho;Choi, Nam-Ki;Oh, Jong-Suk;Kang, Mi-Sun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.717-725
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    • 2005
  • It is widely known that individuals with Down's syndrome(DS) often develop early onset severe periodontal diseases. In this study, We examined the prevalence of periodontopathic bacteria in DS patients to compare controls with mental disabilities(MD) The subjects were 27 DS patients (7 to 19 years old) and 27 age-matched controls with MD. Plaque index and gingival index were measured. And 5 pathogens, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, were surveyed in subgingival plaque samples using a polymerase chain reaction. No significant difference in plaque index and gingival index were observed between the DS and control group. The prevalence in DS was 96.3% for F. nucleatum, 74.1% for T. forsythia, 63.0% for P. gingivalis, 55.6% for A. actinomycetemcomitans. 40.7% for T. denticola. No significant differences were observed in the prevalence of periodontopathic bacterias between the DS and control. Prevalence of P.g(16.7%) at age $7{\sim}10$ is lower than other age group in DS, but its prevalence increased with age. Prevalence of A.a(83.3%) is peak at age $7{\sim}10$ in DS. These results suggest that various periodontopathic pathogens can colo nize in the very early childhood of DS and MD patients. But no significant difference was observed in the prevalence of periodontopathic bacterias between the DS and control.

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Assessment of Renal Function in Silicobis with Urinary N-acetyl-$\beta$-D-glucosaminidase Activity (규폐증환자의 신기능 평가를 위한 요중 N-acetyl-$\beta$-D-glucosaminidase활성치 측정의 의의)

  • Lee, Hoo-Rak;Kim, Don-Kyoun;Lee, Su-Il;Cho, Byung-Mann;Kim, Wha-Jo
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.1 s.41
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    • pp.49-64
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    • 1993
  • To provide the basic data for assessment of renal dysfunction related to silicosis, urinary N-acetyl-$\beta$-D-giucobarninidase(NAG) activity known as a sensitive markers for early renal damage were measured in 58 silicosis patients, and control subjects of 40 pulmonary tuberculosis Patients and 51 official workers. The results were summarized as fellows. 1. The values of blood urea nitrogen and serum creatinine in all subjects were within reference limits. But the mean value of urinary NAG activity($7.25{\pm}7.31U/g\;creatinine$) was beyond reference value and more sensitive test than others. 2. The mean value of urinary NAG activity in silicosis group was $11.98{\pm}9.05U/g\;creatinine$ and significantly higher than in tuberculosis and healthy group(p<0.01), but the mean values of NAG activity in tuberculosis and healthy group were not different(p>0.05). 3. The value of NAG activity in tuberculosis had a tendency to be increased according to severity of disease, but that was not significant(p>0.05). The value of NAG activity was increased significantly by use of nephrotoxic antituberculosis drugs(p<0.05). 4. The value of NAG activity in silicosis had a tendecy to be increased according to the size of nodule, use of nephrotoxic antituberculosis drugs and shortness of onset duration, but the increase was not significant(p>0.05). 5. After excluding the users of nephrotoxic antituberculosis drugs, the mean values of NAG activity in healthy control and in tuberculosis control were same as 3.63 U/g creatinine and 3.60 U/g creatinine, respectively. But the mean value of NAG activity in silicosis group was remarkably increased as 10.90 U/g creatinine(p<0.01). As above results, even though there are no abnormal finding in screening renal function test, silicosis can be related with renal dysfunction. And it will be very useful to apply urinary NAG activity in health management of workers exposed to dust.

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The strengthening of North Atlantic Deep Water during the late Oligocene based on the benthic foraminiferal species Oridorsalis umbonatus (저서성 유공충 Oridorsalis umbonatus의 산출 상태에 기록된 후기 올리고세 북대서양 심층수의 강화)

  • Lee, Hojun;Jo, Kyoung-nam;Lim, Jaesoo
    • Journal of the Geological Society of Korea
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    • v.54 no.5
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    • pp.489-499
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    • 2018
  • A series of geological events such as the formation of the Antarctic continental ice sheets, the changes in ocean circulation and a mass extinction after the onset of Oligocene has been studied as major concerns by various researches. However, paleoclimatic and paleoceanographic changes during the most period of Oligocene since the Eocene-Oligocene transition (EOT) still remains unclear. Especially, although the late Oligocene warming (LOW) has been assessed as the largest period in the paleoceanographic changes, the detailed understanding on the changed components is very low. The purpose of this study is the reconstruction of the paleoceanographic history during the late Oligocene using core sediments from IODP Expedition 342 Site U1406 performed in J-Anomaly Ridge in North Atlantic. Because North Atlantic deep water (NADW) has flowed southward through the study area since the early Oligocene, this area has been considered to an important location for studies on the changes of NADW. The core sediment analyzed in this study were deposited from about 26.0 to 26.5 Ma as evidenced by both of onboard and shore-based paleomagnetic data, and this is corresponded to the earliest period of LOW. The sediment profile can be divided into three Units (Unit 1, 2 & 3) based on the changes in both of total number and test size of Oridorsalis umbonatus as well as grain size data of clastic sediments. Unit 2 represents largest values in these three data. Because the total number, test size of O. umbonatus and grain size can be proxy records on the oxygen concentration and circulation intensity of deep water, we interpreted that Unit 2 had been deposited during the period of relatively strengthened NADW. Previous Cibicidoides spp. stable isotope results from the low latitude region of the North Atlantic also support our interpretation that is the intensified formation of NADW during the identical period. In conclusion, our results present a new evidence for the previous ideas that the causes on LOW are directly related to the changes in NADW.