Kaatano, Godfrey M.;Min, Duk-Young;Siza, Julius E.;Yong, Tai-Soon;Chai, Jong-Yil;Ko, Yunsuk;Chang, Su-Young;Changalucha, John M.;Eom, Keeseon S.;Rim, Han-Jong
Parasites, Hosts and Diseases
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v.53
no.5
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pp.545-551
/
2015
Schistosomiasis is one of the important neglected tropical diseases (NTDs) in Tanzania, particularly in Lake Victoria zone. This baseline survey was a part of the main study of integrated control of schistosomiasis and soil-transmitted helminths (STHs) aimed at describing morbidity patterns due to intestinal schistosomiasis among adults living on Kome Island, Sengerema District, Tanzania. Total 388 adults from Kome Islands (about 50 people from each village) aged between 12 and 85 years, were examined by abdominal ultrasound according to the Niamey protocol. Liver image patterns (LIPs) A and B were considered normal, and C-F as distinct periportal fibrosis (PPF). The overall prevalence of PPF was 42.2%; much higher in males than in females (47.0% in male vs 34.4% in females, P=0.007). Abnormal increase of segmental branch wall thickness (SBWT) and dilated portal vein diameter (PVD) were also more common in males than in females. Hepatosplenomegaly was frequently encountered; 68.1% had left liver lobe hepatomegaly and 55.2% had splenomegaly. Schistosoma mansoni-related morbidity is quite high among adults in this community justifying the implementation of integrated control strategies through mass drug administration, improved water supply (pumped wells), and health education that had already started in the study area.
The purpose of this study was to determine the effects of taurine supplementation and taurine depletion on blood glucose and blood lipid concentrations in insulin-treated diabetic rats. Four groups of Sprague-Dawley male rats were fed the purified diet for 3 weeks ; nontaurine-supplemented diabetic rats(E0), nontaurine-supplemented diabetic rats with insulin treatment(E0+I), 1% taurine-supplemented diabetic rats with insulin treatment(E1+I) and taurine-depleted diabetic rats with insulin treatment(EA+I). Diabetes was induced by streptozotocin injection(50mg/kg B.W.). Isophane insulin was given subcutaneously into the abdominal wall of the diabetic rats(4 unit/rat/day). E1+I were supplemented with 1% taurine in drinking water. To induce taurine depletion, EA+I were treated with 5% $\beta$-alanine in drinking water. E1+I had significantly higher body weight compared to that of E0. The food intakes of E1+I and E0+I were significantly decreased compared to that of E0. There was no sigfniciant difference in food intake between E1+I and E0+I. The water intake of rats was significantly different among the groups ; E0>E0+I>E1+I>EA+I. The urine volume of E0 was significantly increased compared to those of insulin-treated goups. The blood glucose concentration of E0 was significantly increased compared to those of insulin-treated groups. In the oral glucose tolerance test(OGTT), E0+I and E1+I had significantly lower blood blucose concentrations compared to E0 after 30 min. Also EA+I had significantly lower bloodglucose concentrtion compared to E0 and E0+I. The plasma total cholesterol and LDL-cholesterol concentratons of EA+I were significantly incrased compared to those of other groups. Therefore, it may be suggested that tuarine supplementation is useful for insulin-dependent diabetes in order to prevent diabetic complications suchas cardiac vascular diseases.
Purpose: Limited means exist to assess gastrointestinal activity in pediatric patients postoperatively. Recently, myoelectric gastrointestinal activity recorded by cutaneous patches has been shown in adult patients to be predictive of clinical return of gastrointestinal function postoperatively. The aim of this case series is to demonstrate the feasibility of this system in pediatric patients and to correlate myoelectric signals with return of bowel function clinically. Methods: Pediatric patients undergoing abdominal surgery were recruited to have wireless patches placed on the abdomen within two hours postoperatively. Myoelectric data were transmitted wirelessly to a mobile device with a user-interface and forwarded to a cloud server where processing algorithms identified episodes of motor activity, quantified their parameters and nominally assigned them to specific gastrointestinal organs based on their frequencies. Results: Three patients (ages 5 months, 4 year, 16 year) were recruited for this study. Multiple patches were placed on the older subjects, while the youngest had a single patch due to space limitations. Rhythmic signals of the stomach, small intestine, and colon could be identified in all three subjects. Patients showed gradual increase in myoelectric intestinal and colonic activity leading up to the first recorded bowel movement. Conclusion: Measuring myoelectric intestinal activity continuously using a wireless patch system is feasible in a wide age range of pediatric patients. The increase in activity over time correlated well with the patients' return of bowel function. More studies are planned to determine if this technology can predict return of bowel function or differentiate between physiologic ileus and pathologic conditions.
The diagnosis of the main complications resulting from lipoabdominoplasty has not yet been standardized. Infrared thermal imaging has been used to assess possible complications, such as necrosis and changes in micro- and macro-circulation, based on perforator mapping techniques, among others. The objective of this study was to present two clinical cases involving thermal imaging monitoring of the healing process of lipoabdominoplasty in the immediate postoperative evaluation and its preliminary results. Infrared thermography was performed 24 hours after the operation and on postoperative days 5, 25, and 27. In clinical case 1, it was found that the delta-R (∆TR)-defined as the difference in minimum temperature between the highest and lowest points in the SA3 region (caution suction area) following the classification established by Matarasso-was 0.4℃ at 24 hours after surgery and decreased to 0.1℃ on a postoperative day 5. There were no complications in this case. In contrast, in clinical case 2, the ∆TR was 1.7℃ at 24 hours after surgery (upon hospital discharge) and remained high, at 2.2℃, on postoperative day 5. A higher ∆TR was found in the second patient, who developed necrosis of the surgical wound. The ∆TR thermal index may be a new tool for predicting possible complications, complementing the clinical evaluation and therapeutic decision-making.
Purpose: We investigated the relationship between sonographic measurements of fatty liver and body mass index standard deviation score (BMI-Z score), abdominal wall fat thickness (AWFT), and serum biochemical parameters in childhood obesity. Methods: Anthropometric, laboratory, and ultrasonography data were obtained from 174 children with BMI-Z score >1. After the qualitative grading of hepatosteatosis (grades 0-3), the quantitative liver-kidney echogenicity ratio (LKER) was calculated using a software tool. Groups according to sex, age (AG-I to AG-III), BMI-Z score (BMG-I to BMG-III), and hepatosteatosis degree (HS-I and HS-II) were formed. The differences and distributions of the variables were statistically analyzed and compared among the groups. Results: Serum transaminase and glucose levels showed a positive correlation with LKER, whereas the HDL level showed a negative correlation. BMI-Z score and AWFT showed a positive correlation with fasting insulin level and HOMA-IR value. LKER was significantly higher in girls than in boys (p=0.008). In the AG-I group (age 3-8.9 years), the BMI-Z score was significantly higher, whereas AWFT was significantly lower than in the other age groups (p<0.001). The cutoff point of LKER for predicting grade 2 or higher steatosis (HS-II group) was determined to be 1.83. Cardiovascular disease risk was significantly higher in the HS-II group (p=0.035). Conclusion: As a valuable quantitative measurement tool, LKER can be used for the sonographic screening of fatty liver. AWFT, on the basis of its correlation with fasting insulin level and HOMA-IR value, may be a useful sonographic parameter in the management of childhood obesity.
Kim, Hyung Nam;Han, Sun Ae;Park, Ha Yeol;Kim, Hyun Woo;Hong, Ran;Choi, Nam Gyu;Shin, Min Ho;Yoon, Na Ra;Kim, Hyun Lee;Chung, Jong Hoon;Shin, Byung Chul
Korean Journal of Transplantation
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v.32
no.4
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pp.104-107
/
2018
Mucormycosis is an extremely rare but potentially life-threatening fungal infection. Gastrointestinal (GI) mucormycosis is very rare and occurs primarily in highly malnourished patients, especially in infants and children. A 55-year-old man with end-stage renal disease due to diabetic nephropathy, who had undergone deceased donor kidney transplantation 2 years prior, complained of abdominal pain and distension with a 3-day duration. Computed tomography revealed diffuse gastric wall thickening, and a huge amount of grey colored necrotic debris surrounded by erythematous erosive mucosa was observed at the antrum to upper body by GI endoscopy. The microscopic examination obtained from a GI endoscopic specimen demonstrated peptic detritus with numerous non-septate mucor hyphae in the mucosa and submucosa. Mucormycosis was diagnosed based on the clinical findings and morphological features. A total gastrectomy was performed and an antifungal agent was administered. A microscopic examination of the surgical specimen demonstrated invasive mucormycosis with numerous fungal hyphae with invasion into the mucosa to subserosa. The patient and graft were treated successfully by total gastrectomy and antifungal therapy.
Celiac artery compression is a rare condition in which the celiac artery is compressed by the median arcuate ligament. Case reports of compression after trauma are hard to find. Blunt traumatic pericardium rupture is also a rare condition. We report a single patient who experienced both rare conditions from a single blunt injury. An 18-year-old woman was brought to the trauma center after a fatal motorcycle accident, in which she was a passenger. The driver was found dead. Her vital signs were stable, but she complained of mild abdominal pain, chest wall pain, and severe back pain. There were no definite neurologic deficits. Her initial computed tomography (CT) scan revealed multiple rib fractures, moderate lung contusions with hemothorax, moderate liver injury, and severe lumbar spine fracture and dislocation. She was brought to the angiography room to check for active bleeding in the liver, which was not apparent. However, the guide wire was not able to pass through the celiac trunk. A review of the initial CT revealed kinking of the celiac trunk, which was assumed to be due to altered anatomy of the median arcuate ligament caused by spine fractures. Immediate fixation of the vertebrae was performed. During recovery, her hemothorax remained loculated. Suspecting empyema, thoracotomy was performed at 3 weeks after admission, revealing organized hematoma without pus formation, as well as rupture of the pericardium, which was immediately sutured, and decortication was carried out. Five weeks after admission, she had recovered without complications and was discharged home.
Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.
Son, Il Wan;Kim, Suk;Hong, Seung Baek;Lee, Nam Kyung;Jeong, Mi Ri;Han, Sung Yong;Woo, Hyun Young
Journal of Yeungnam Medical Science
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v.39
no.1
/
pp.18-23
/
2022
Background: This study was performed to evaluate periprocedural factors, complications, and repuncture rate of the newly developed puncture needle and compare it with the routinely used puncture needle for ultrasound (US)-guided paracentesis. Methods: We retrospectively identified 137 patients who underwent US-guided paracentesis between July 2018 and March 2019. Among them, 82 patients underwent US-guided paracentesis with a newly developed puncture needle. The other 55 patients underwent US-guided paracentesis with a routinely used puncture needle. The periprocedural factors, complications, and repuncture rate were compared between the two groups using the Mann-Whitney U test and Fisher exact test. The repuncture-associated factors were assessed using logistic regression analysis. Results: There were no major or minor complications in either group. The rate of repuncture was significantly lower in the group using the newly developed puncture needle compared with the group using the routinely used puncture needle (p=0.01). The duration of the procedure was significantly shorter with the newly developed puncture needle compared with the routinely used puncture needle (p=0.01). In univariate analysis, the thickness of the abdominal wall (p=0.04) and the use of the newly developed puncture needle (p=0.01) were significantly associated with the rate of repuncture. In multivariate analysis, only the use of the newly developed puncture needle was significantly associated with the rate of repuncture. Conclusion: Using this novel puncture needle with a hard plastic sheath and plastic wings, the rate of repuncture and the duration of the procedure were decreased without complications of US-guided paracentesis.
Background: This study aimed to examine the effect of Scutellaria baicalensis extract (SBE) on ameliorating pain response and inflammation in an animal model. Methods: The effects of SBE on joint inflammation-induced rats and pain writhing response were measured. In rats with monosodium iodoacetate (MIA)-induced knee osteoarthritis (OA), the weight-bearing distribution of the hind legs was measured, the actual joint condition was visually confirmed, and serum cytokines were extracted from whole blood and measured. In addition, the acetic acid-induced pain was measured by the number of abdominal wall contractions and writhing responses. Results: 1. The weight-bearing distribution of the hind limbs of the SBE group was remarkably improved compared with that of the control group 7 days after MIA treatment, and the SBE 300 group was improved similarly to that of the indomethacin group. 2. Cartilage erosion was significantly recovered in the SBE and indomethacin groups, and the degree of healing of cartilage erosion by SBE was similar to that by indomethacin. 3. The serum levels of cytokines interleukin-1β, tumor necrosis factor-α, and interleukin-6 were significantly decreased in the SBE group compared with that in the control group, and the SBE 300 group had reduced levels of cytokines similar to the indomethacin group. 4. As regards acetic acid-induced writhing response, the number of writhes was significantly reduced in the SBE and ibuprofen groups, and the SBE 600 group had fewer writhes than the ibuprofen group. Conclusion: SBE significantly improves knee OA and pain and is expected to show similar therapeutic effects to indomethacin and ibuprofen.
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