RESUMEN
A 47-day-old male infant presented with fever, poor oral intake, irritability, and right-sided bluish buccal swelling. Contrast-enhanced computed tomography of the neck showed a round mass lesion of about 2.0x1.5 cm that suggested abscess formation in the right masticator space. Ultrasound-guided extraoral aspiration of the abscess at the right masseter muscle was successful. Staphylococcus aureus was identified in the culture from the aspirated pus and blood. Appropriate antibiotics were given and the patient recovered. The patient underwent follow-up ultrasonography that showed an improved state of the previously observed right masseter muscle swelling at about 1 month after hospital discharge. A masticator space abscess usually originates from an odontogenic infection in adults. We report a case of masticator space abscess in a 47-day-old infant in whom septicemia without odontogenic infection was suspected.
Asunto(s)
Adulto , Humanos , Lactante , Masculino , Absceso , Antibacterianos , Bacteriemia , Fiebre , Estudios de Seguimiento , Músculo Masetero , Cuello , Sepsis , Staphylococcus aureus , SupuraciónRESUMEN
PURPOSE: The normal flora, which was suggested to prevent infection, is acquired first from the birth canal and develops by dietary factors. Here presents a case-control study, aimed to evaluate the postnatal acquisition factors relating to the achievement of the normal flora in infants with urinary tract infection (UTI). METHODS: 115 UTI infants, admitted at Ewha Womans University Mokdong Hospital from 2004 to 2005 and 116 age-matched control infants, who had visited well baby clinic, were evaluated. The suggested postnatal acquisition factors of the normal flora such as vaginal delivery, breast feeding, probiotics and yogurt intake and their relationship with UTI were evaluated. RESULTS: The rate of vaginal delivery was 50%(58/115) in UTI infants, which was not significantly different from 60%(69/116) in control infants(P>0.05). In the infants with UTI, the feeding pattern(breast milk 19%, mixed 26%, formula 55%) was significantly different from that(44%, 19%, 37%) in control infants(P0.05). The odds ratios of breast feeding and probiotics intake against UTI were significantly low as 0.30 (95% CI 0.17-0.55)(P<0.01) and 0.03 (95% CI 0.01-0.07)(P<0.01). CONCLUSION: The significantly lower rates of breast feeding and probiotics intake in UTI infants suggest that these dietary factors might have preventive effects in infants with UTI.
Asunto(s)
Femenino , Humanos , Lactante , Lactancia Materna , Estudios de Casos y Controles , Leche , Oportunidad Relativa , Parto , Probióticos , Infecciones Urinarias , Sistema Urinario , YogurRESUMEN
PURPOSE: Childhood primary VUR is generally diagnosed after urinary tract infection, is more prevalent among girls and has a low spontaneous resolution rate in cases of severe VUR. The aim of the present study is to examine the age and gender-related characteristics and the spontaneous resolution rate of infantile primary VUR. METHODS: The medical records of 96 infants with primary VUR, diagnosed after their first UTI, were retrospectively reviewed(1995-2004). The clinical characteristics including gender, the degree of VUR and presence of renal scars were evaluated. The spontaneous resolution rate and contributing factors were also analyzed. RESULTS: Infantile primary VUR was more prevalent in males than females. The percentage of atrophic scarred kidney was significantly higher in males than females(17.2% vs 3.4%)(P<0.05). The cumulative spontaneous resolution rate in 3 years was very high(89.1%), and was not significantly different between gender and among VUR grades. But in the first year, the spontaneous resolution rate of severe refluxing ureters was significantly higher in males than in females(46.2% vs 7.1%)(P<0.05) and the spontaneous resolution rate of refluxing ureters with no scarred kidneys was significantly higher than those associated with atrophic scarred kidneys(76.6% vs 20%)(P<0.05). CONCLUSION: Infantile primary VUR was more prevalent among males and tends to be associated with atrophic scarred kidneys in male infants. The cumulative spontaneous resolution rate in 3 years was very high, even in high-grade VUR and associated atrophic scarred kidneys. In infantile primary VUR, surgery should be withheld even in infants with high-grade VUR with atrophic scarred kidneys.
Asunto(s)
Femenino , Humanos , Lactante , Masculino , Cicatriz , Riñón , Registros Médicos , Estudios Retrospectivos , Uréter , Infecciones Urinarias , Reflujo VesicoureteralRESUMEN
Polymorphism of angiotensin converting enzyme (ACE) gene is reported to be associated with ischemic heart disease, hypertrophic cardiomyopathy, and idiopathic dilated cardiomyopathy. In this study, we investigated the relationship between Kawasaki disease and insertion/deletion polymorphism of ACE gene. Fifty five Kawasaki disease patients and 43 healthy children were enrolled. ACE genotype was evaluated from each of the subjects' DNA fragments through polymerase chain reaction (PCR). Frequencies of ACE genotypes (DD, ID, II) were 12.7%, 60.0%, 27.3% in Kawasaki group, and 41.9%, 30.2%, 27.9% in control group respectively, indicating low rate of DD and high rate of ID genotype among Kawasaki patients (p<0.01). Comparing allelic (I, D) frequencies, I allele was more prevalent in Kawasaki group than in control group (57.3% vs. 43.0%, p<0.05). In Kawasaki group, both genotype and allelic frequencies were not statistically different between those with coronary dilatations and those without. ACE gene I/D polymorphism is thought to be associated with Kawasaki disease but not with the development of coronary dilatations.
Asunto(s)
Masculino , Lactante , Humanos , Femenino , Preescolar , Polimorfismo Genético , Peptidil-Dipeptidasa A/genética , Síndrome Mucocutáneo Linfonodular/enzimología , Genotipo , Frecuencia de los Genes , Dilatación Patológica , Vasos Coronarios/patología , Estudios de Casos y Controles , AlelosRESUMEN
PURPOSE: Abdominal obesity is encountered as a risk factor for cardiovascular diseases. However, the anthropometric cut-off value to estimate the cardiovascular risk, has not been suggested. This study was designed to find the relationship between the abdominal fat and various parameters of obesity to find the cardiovascular risk factors related to abdominal obesity and to establish practical methods to measure them. METHODS: Twenty seven obese Korean adolescents of moderate to severe degree and 22 healthy adolescents were enrolled. The body mass index (BMI), arm circumference and skinfold thickness were measured. Furthermore, blood lipid, sugar, insulin and four different cytokines' levels were checked and the distribution of body composition was measured by bioelectrical impedance analysis. The subcutaneous and intra-abdominal fat thickness by abdominal ultrasonography (US) and the total and intra-abdominal fat area by abdominal computerized tomography (CT) were measured in the obese group. RESULTS: The most accurate method to measure abdominal fat in children is abdominal CT and the fat mass measured by bioelectrical impedance was strongly correlated with it (r=0.954). It was also correlated with arm circumference, fat thickness measured by abdominal US, BMI, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and triglyceride level. CONCLUSION: Abdominal CT is the most accurate method to measure intra-abdominal fat, and it can be replaced by abdominal US for cost effectiveness. The screening methods that can be used at school or in outpatient basis include bioelectrical impedance, waist/hip ratio, and arm circumference. The cardiovascular risk factors include leptin, triglyceride and insulin level.
Asunto(s)
Adolescente , Niño , Humanos , Grasa Abdominal , Alanina Transaminasa , Brazo , Aspartato Aminotransferasas , Composición Corporal , Índice de Masa Corporal , Enfermedades Cardiovasculares , Análisis Costo-Beneficio , Diagnóstico , Impedancia Eléctrica , Insulina , Grasa Intraabdominal , Leptina , Tamizaje Masivo , Obesidad , Obesidad Abdominal , Pacientes Ambulatorios , Obesidad Infantil , Factores de Riesgo , Grosor de los Pliegues Cutáneos , Tomografía Computarizada por Rayos X , Triglicéridos , UltrasonografíaRESUMEN
PURPOSE: Adolescent obesity is known to be associated with complications such as hypertension, coronary artery disease and insulin resistance. We measured the common carotid artery by ultrasound as a predictor of atherosclerosis, and investigated the relationship between carotid artery parameters and serum cytokines in obese adolescents. METHODS: Twenty-nine obese adolescents (16-17 years old, obesity index> 130 percent) and twenty- seven normal controls were included. Obesity index and body mass index were calculated from their height and weight. Skin fold thickness was measured at the triceps, and fat mass and fat distribution by bioelectrical impedence analysis. Blood pressure was measured at resting state and serum lipid, insulin, and homocysteine levels after a 12-hour fasting period. Intimal wall thickness, systolic and diastolic diameters of the common carotid artery were measured by ultrasound, and compliance and distensibility calculated by equation. RESULTS: Systolic and diastolic diameters of the carotid artery significantly correlated with arm circumference, body mass index, fat distribution and fat mass. The higher systolic blood pressure was, the larger systolic and diastolic diameter. The higher diastolic blood pressure was, the larger carotid intimal thickness. Insulin levels had positive correlations with systolic, diastolic diameters and serum homocysteine level with intimal thickness. CONCLUSION: The carotid artery diameter significantly increased with the degree of obesity and blood pressure. The carotid intimal wall thickness significantly correlated with diastolic blood pressure. Measurement of carotid artery thickness, insulin and homocysteine levels might be useful to predict the development of coronary artery disease.
Asunto(s)
Adolescente , Humanos , Brazo , Aterosclerosis , Presión Sanguínea , Índice de Masa Corporal , Arterias Carótidas , Arteria Carótida Común , Adaptabilidad , Enfermedad de la Arteria Coronaria , Citocinas , Ayuno , Homocisteína , Hipertensión , Insulina , Resistencia a la Insulina , Obesidad , Obesidad Infantil , Piel , UltrasonografíaRESUMEN
PURPOSE: The prevalence of obesity and complications related to obesity among Korean adolescents were reviewed. To prevent obesity related complications in adolescents, the applicability of the "Questionnaire on risk factors associated with obesity in adolescents" as an assessment and management guideline was evaluated. METHODS: Weight, height, blood pressure and serum lipid and glucose level of 7,265 high school students in Seoul were investigated. Two-hundred ninety nine obese students submitted a self-reporting questionnaire, and the risk of developing obesity related complications was scored for each student according to the "Questionnaire on risk factors associated with obesity in adolescents". RESULTS: Among the obese, those of moderate to severe degree were 83.6%. The average score on the questionaire was 4.0+/-1.6, which might require any form of intervention. Of the 403 obese students of moderate to severe degree, those complicated with hypertension were 19.1%, with hyperlipidemia 46.6%, with liver dysfunction 97.5%, and those with family history of hypertension were 19.1 %. The recorded scores were significantly related with cardiovascular family history, serum lipid lev el, etc. Furthermore, as the body mass index(BMI) of the mother increased, the BMI of their child increased. CONCLUSION: By recording this score on follow-up visits, it would be easy to intervene to prevent progression to the adulthood morbidity, and those with high scores can be referred to a specialist. Therefore, this "Questionnaire on risk factors associated with obesity in adolescents" is valuable to screen and prevent obesity related complications in dolescents.