Diagnostic Yield of Pediatric Colonoscopies Based on Presenting Symptoms in a Secondary Hospital / 대한소아소화기영양학회지

PURPOSE: We performed this study retrospectively to review the diagnostic yield of colonoscopies in children and adolescents with various gastrointestinal symptoms and to investigate the relationship between presenting symptoms and the colonoscopic findings in a secondary hospital. METHODS: We reviewed the medical records of patients under the age of 19-years who underwent ileocolonoscopy between January 2001 and December 2010. The total number of patients (n=238) were divided into three age groups and six symptom groups. We analyzed clinical characteristics and the colonoscopic findings, and compared the colonoscopic yield between each groups. RESULTS: The median age of the patients was 16.1 (3.1~18.9) years. The most common presenting symptoms were lower gastrointestinal (GI) bleeding (48.1%) in the or =16 years group (n=126). Positive colonoscopic findings were found in 21.4% of the bowel habit change group (n=28), 51.9% of the low GI bleeding group (n=54), 37.7% of the chronic diarrhea group (n=69), and 94.4% of the group with suspected inflammatory bowel disease (IBD) (n=18), 38.9% of the chronic abdominal pain group (n=54) and 13.3% of the anemia group (n=15). The diagnostic yield of the total examination was 42.0%. The suspected IBD group had a higher yield than the presenting symptom groups (p<0.001). CONCLUSION: Colonoscopy is a safe and useful investigation in children and adolescents with suspected colonic disease. The diagnostic yield of colonoscopy is higher in patients presenting with suspected IBD. Pediatricians practicing in primary or secondary care settings should recommend colonoscopy for patients with suspected IBD.

Immunomodulation Effect of the Allogeneic Cellular Components after Transfusion / 대한혈액학회지

BACKGROUND: Blood transfusion is important for life saving treatment in many patients with tolerable adverse effects. Some data suggest that transfusions might cause an increased risk for post-operative infections and a higher relapse or mortality rate in cancer patients. We investigated whether immune dysfunction might result after transfusions from the cellular components. METHODS: We studied 5-week-old mice BALB/c (H-2d, donor), C3H/He (H-2k, recipient), and C57/BL (H-2b, third party). We obtained irradiated spleen cells (SP) from the BALB/c or C57/BL, and injected them into the C3H/He with intraperitoneal IL-2 administration. After 24 hours, we obtained bone marrow (BM), thymus and SP. We identified mixed lymphocyte proliferation (MLR) by the BrdU method and we used irradiated BALB/c SP, as a stimulator for that trial. For the analysis of immune cells, we analyzed the cell surface markers from each organ. For cytokines, we identified TNF-alpha, IFN-gamma, TGF-beta, and IL-10 by ELISA from the supernatant of the MLR. RESULTS: The cell proliferation decreased according to specific H-2 complexes. There were increased CD4+CD25+ cells in the thymus. For the paracrine effects, the B-C3H SP showed ratio-dependent inhibitory effects, although the C-C3H SP inhibited some cell proliferation. There was no difference in the IFN-gamma, TNF-alpha and TGF-beta between the control and experimental groups. However, IL-10 was higher in the 1:10 ratio mixture in the control and transfused SP compared to the other groups. CONCLUSION: The results of this study suggested that the cellular components in transfusions might contribute to the immune regulatory effects by CD4+CD25+ cells after 24 hours.