Relationship between vitamin D levels and intravenous immunoglobulin resistance in Kawasaki disease / 소아과

PURPOSE: Vitamin D is associated with various pathological conditions such as cardiovascular diseases and cancer. We investigated the relationship between vitamin D and Kawasaki disease (KD). METHODS: We performed a retrospective review of the medical records of patients with KD between February 2013 and March 2016 in Daegu Fatima Hospital. Study participants were grouped according to vitamin D serum concentration. Group 1 included patients with 25(OH)-vitamin D ≥20 ng/mL. Group 2 included patients with 25(OH)-vitamin D <20 ng/mL. We analyzed the clinical characteristics and laboratory data of the 2 groups. RESULTS: Of the 91 patients, 52 were included in group 1, and 39 in group 2. Group 1 patients had significantly higher levels of calcium, phosphate, albumin and sodium than group 2 patients did. There were no differences in clinical characteristics, but the proportion of patients with polymorphic rash was significantly higher in group 2. Resistance to intravenous immunoglobulin was more frequent in group 2 (P=0.023). No significant difference in the incidence of coronary artery complications was observed. CONCLUSION: Low vitamin D levels are associated with resistance to intravenous immunoglobulin therapy in KD. Vitamin D deficiency might be a risk factor for immunoglobulin resistance in KD.

Systemic primary carnitine deficiency with hypoglycemic encephalopathy

Acute hypoglycemia in children is not an uncommon disease that can be encountered in the Emergency Department. Most cases of childhood hypoglycemia are caused by ketotic hypoglycemia due to missed meals. Often, hypoketotic hypoglycemia can also occur, which suggests hyperinsulinemia or a defect in fatty acid oxidation. Carnitine is essential for long chain fatty acids transfer into mitochondria for oxidation. We present a case of systemic primary carnitine deficiency who presented with seizures due to hypoketotic hypoglycemia.

Systemic primary carnitine deficiency with hypoglycemic encephalopathy

Acute hypoglycemia in children is not an uncommon disease that can be encountered in the Emergency Department. Most cases of childhood hypoglycemia are caused by ketotic hypoglycemia due to missed meals. Often, hypoketotic hypoglycemia can also occur, which suggests hyperinsulinemia or a defect in fatty acid oxidation. Carnitine is essential for long chain fatty acids transfer into mitochondria for oxidation. We present a case of systemic primary carnitine deficiency who presented with seizures due to hypoketotic hypoglycemia.

Relationship between Total Serum IgE Level and Allergic Sensitization/Bronchial Hyperresponsiveness in Preschool Children with Asthma / 소아알레르기및호흡기학회지

PURPOSE: This study aimed to evaluate the relationship between the serum IgE level and allergic sensitization/bronchial hyperresponsiveness (BHR) in preschool children with asthma. METHODS: One hundred nine asthmatic children age 4-6 years were enrolled. Total serum IgE levels, and specific IgE level to food and inhalant allergens were tested using Pharmacia Auto CAP system RAST(R)FEIA, methacholine bronchial challenge test (PCw=Provocative concentration at wheezing. PCsat=Provocative concentration at 5% fall of oxygen saturation) were performed in all subjects. They were divided into 3 groups according to the serum IgE level:less than 120 IU/mL (group A, n=38), 120 to 1,000 IU/mL (group B, n=45), and greater than 1,000 IU/mL (group C, n=26). The relationships with allergic sensitization and BHR were evaluatied among the 3 groups. RESULTS: Sensitization to foods and inhalant allergens were related to a higher total serum IgE levels. However, BHR and severity of asthma were not related to higher total serum IgE levels, except in group B. Presence of atopic dermatitis, high serum eosinophil (>450/mm3), allergic sensitization to foods and inhalants were related to high serum IgE greater than 1,000 IU/mL. (odds ratio ; 95% confidence interval=4.4;1.7-11.2, 3.2;1.2-9.2, 4.8;1.7-13.2, 5.5;1.2-24.9) CONCLUSION: Moderately elevated total serum IgE was related to allergic sensitization, severity of asthma and BHR. However highly elevated total serum IgE was related to only allergic sensitization. This may be attributed to other factors in preschool children with asthma.

Normative data of penile length in Korean newborns / 소아과

PURPOSE: As modern society has became more open, interest in healthy internal and external growth has increased, including that pertaining to penile length in children. A micropenis is defined as one where penile length is more than 2 SD (standard deviation) below the mean, and it can be traced back to chromosome and endocrine disorders. The authors executed this study to suggest guidelines for the study of the micropenis and standard information for penile length in Korean newborns. METHODS: The subjects of this study were 168 male infants between 37 and 42 weeks of gestational age, none of whom had any complications during pregnancy or birth; each had been born in Daegu Fatima Hospital between February and June 2007. Penile length was measured using conventional stretched penile length measurement (CPLM) and syringe methods. RESULTS: Penile length was 3.02+/-0.25 cm (F=36.467, R(2)=0.180, P<0.001) when measured with CPLM, and 3.29+/-0.26 cm (F=9.149, R(2)=0.052, P<0.001) with the syringe method. There was no statistically significant difference in the penile length of newborn infants as a result of taking measurements with the two methods, and both methods showed significance at 0.631 in terms of Pearson's correlation coefficient, at the level of P=0.01. CONCLUSION: In this study, penile length tended to be longer when gestational age was longer, and a micropenis can be assumed to be one less than 2.5 cm using CPLM and less than 2.8 cm using the syringe method. In the case of a concealed penis, the syringe method is helpful. When a micropenis is assumed, close observation by outpatient department personnel, and additional endocrine and chromosome studies should be undertaken after sufficiently consulting the parents.

Normative data of penile length in Korean newborns / 소아과

PURPOSE: As modern society has became more open, interest in healthy internal and external growth has increased, including that pertaining to penile length in children. A micropenis is defined as one where penile length is more than 2 SD (standard deviation) below the mean, and it can be traced back to chromosome and endocrine disorders. The authors executed this study to suggest guidelines for the study of the micropenis and standard information for penile length in Korean newborns. METHODS: The subjects of this study were 168 male infants between 37 and 42 weeks of gestational age, none of whom had any complications during pregnancy or birth; each had been born in Daegu Fatima Hospital between February and June 2007. Penile length was measured using conventional stretched penile length measurement (CPLM) and syringe methods. RESULTS: Penile length was 3.02+/-0.25 cm (F=36.467, R(2)=0.180, P<0.001) when measured with CPLM, and 3.29+/-0.26 cm (F=9.149, R(2)=0.052, P<0.001) with the syringe method. There was no statistically significant difference in the penile length of newborn infants as a result of taking measurements with the two methods, and both methods showed significance at 0.631 in terms of Pearson's correlation coefficient, at the level of P=0.01. CONCLUSION: In this study, penile length tended to be longer when gestational age was longer, and a micropenis can be assumed to be one less than 2.5 cm using CPLM and less than 2.8 cm using the syringe method. In the case of a concealed penis, the syringe method is helpful. When a micropenis is assumed, close observation by outpatient department personnel, and additional endocrine and chromosome studies should be undertaken after sufficiently consulting the parents.