Clinical importance of F-waves as a prognostic factor in Guillain-Barré syndrome in children / 소아과

PURPOSE: A limited number of studies have examined the link between F-wave abnormalities and clinical presentation in pediatric Guillain-Barré syndrome (GBS). Therefore, this study examined the importance of F-wave abnormalities as a prognostic factor in pediatric GBS patients. METHODS: The records and electrodiagnostic studies (EDS) of 70 GBS patients were retrospectively evaluated, and divided into 2 groups according to the results of EDS. Group A (n=33) presented with F-wave abnormalities, and group B (n=26) exhibited normal findings. We compared laboratory reports, clinical features, response to treatment, and prognosis between the 2 groups. RESULTS: Motor weakness was the most frequently observed symptom for either group. Clinically, the incidence of fever and upper respiratory symptoms differed between the 2 groups, while the prevalence of abnormal deep tendon reflex (DTR) was significantly higher in group A than B (P<0.05). Patients diagnosed with GBS had received intravenous immunoglobulin treatment: 94% in group A and 58% in group B. Furthermore, significantly greater numbers of patients in group A showed H-reflex abnormalities and poor prognosis compared with group B (P<0.05). CONCLUSION: This study demonstrated that F-waves are a clinically important prognostic factor in GBS. F-wave abnormalities were associated with abnormal DTR and poor prognosis in patients. Limited studies have examined the link between F-wave abnormalities and clinical results; therefore, further randomized controlled studies are needed to confirm the clinical characteristics and efficacy of treatments.

Difference in the distribution of onset age of intussusception after rotavirus vaccination and according to the type of rotavirus vaccine: single medical center study / 영남의대학술지

BACKGROUND: Rotavirus is the most common cause of severe gastroenteritis in children <5 years of age. The first vaccine, RotaShield was developed, but withdrawn because of its association with increased risk of intussusception. Then, RotaTeq and Rotarix were developed. Although in pre-licensure studies, they were not associated with an increased risk of intussusceptions, in recent studies, it has been controversial. Regarding increased risk of intussusception, we studied the difference in the age of intussusception after rotavirus vaccination. METHODS: A retrospective analysis was conducted on 136 patients diagnosed with intussusception at Yeungnam University Medical Center for 4 years in the pre-vaccination period (group A) and in the post vaccination period (group B). Sex, mean age and age distribution of intussusceptions were compared according to the type of rotavirus vaccine (group B-1, RotaTeq; group B-2, Rotarix). RESULTS: The median ages of group A and group B were 18.8+/-19.6 months and 15.5+/-10.2 months, with no significant differences (p=0.23). The median ages of group B-1 and group B-2 were 15.3+/-9.3 months and 15.6+/-10.8 months, with no significant differences (p=0.91). And No significant difference in the distribution of onset age was observed between groups, and only 6 patients were diagnosed with intussusceptions within 1 month after vaccination. CONCLUSION: No difference was observed in the distribution of onset age of intussusception after rotavirus vaccination and according to the type of rotavirus vaccine. Our study has a limitation in that it was conducted in part of the Daegu area. Additional study is needed.

Effects of Human Adipose-Derived Stem Cells in Regenerating the Damaged Renal Tubular Epithelial Cells in an Animal Model of Cisplatin-Induced Acute Kidney Injury

BACKGROUND: We conducted this experimental study to examine whether human adipose-derived stem cells (ADSCs) are effective in achieving a recovery of damaged renal tubular epithelial cells in an animal model of cisplatin-induced acute kidney injury using rats. METHODS: To examine the in vitro effects of ADSCs in improving nephrotoxicity, we treated mouse renal tubular epithelial cells with both ADSCs and cisplatin mouse renal tubular epithelial cells. And we equally divided 30 male white Sprague-Dawley (SD) rats into the three groups: the control group (intraperitoneal injection of a sterile saline), the cisplatin group (intraperitoneal injection of cisplatin) and the ADSC group (intraperitoneal injection of cisplatin and the hADSC via the caudal vein). At five days after the treatment with cisplatin, serum levels of blood urine nitrogen (BUN) and creatinine were measured from each SD rat. We performed histopathologic examinations of tissue samples obtained from the kidney. RESULTS: The degree of the expression of TNF-alpha and that of Bcl-2 were significantly higher and lower respectively, in cisplatin group (P<0.05). Serum levels of BUN (P=0.027) and creatinine (P=0.02) were significantly higher in cisplatin group. On histopathologic examinations, there was a significant difference in the ratio of the renal injury between cisplatin group and ADSC group (P=0.002). CONCLUSION: The ADSCs might have a beneficial effect in regenerating the damaged renal tubular epithelial cells.

Pediatric Bacterial and Aseptic Meningitis in Daegu

PURPOSE: The aim of this study was to investigate the clinical characteristics and causative organisms of meningitis in the Daegu region and seek a useful tool for the early prediction of bacterial meningitis in children. METHODS: We retrospectively reviewed the medical records of 115 pediatric patients diagnosed with bacterial or aseptic meningitis at Yeungnam university hospital in Daegu from March 2012 to July 2013. We evaluated their clinical symptoms, laboratory findings, clinical courses, bacterial meningitis scores and complications. RESULTS: The subjects included 106 with aseptic meningitis and 9 with bacterial meningitis. At the time of visit, fever was the most frequent symptom, followed by headache, vomiting and neck stiffness. In cerebrospinal fluid (CSF) analysis, white blood cell (WBC) count were higher in the bacterial meningitis group (1423.8+/-1980.4 vs. 120.0+/-161.6 mg/dL). Mean CSF protein was 219.4+/-183.6 mg/dL in bacterial meningitis and 42.4+/-27.0 mg/dL in aseptic meningitis (P <0.001). Bacterial meningitis score (BMS) were higher in the group with bacterial meningitis. Abnormal radiological findings were found in 44% of the group with bacterial meningitis. CONCLUSION: Although the clinical features between the groups were similar, the CSF analysis revealed significant differences statistically. Furthermore, BMS could be helpful to predict bacterial meningitis in children. During the outbreak of aseptic meningitis, it might reduce unnecessary hospital admissions and antibiotic treatments.