Serum- and glucocorticoid-inducible kinase 3 is a potential oncogene in nasopharyngeal carcinoma / Quinase 3 sérica induzida por glicocorticoide é um potencial oncogene no carcinoma nasofaríngeo

Abstract Introduction: Serum- and glucocorticoid-inducible kinase 3, a serine/threonine kinase that functions downstream of the PI3K signaling pathway, plays a critical role in neoplastic processes. It is expressed by various tumors and contributes to carcinogenesis. Objective: The objective was to investigate serum- and glucocorticoid-inducible kinase 3 expression in nasopharyngeal carcinoma, to study the anti-tumor effects of serum- and glucocorticoid-inducible kinase 3 shRNA by inhibiting its expression in nasopharyngeal carcinoma cells and to discuss the potential implications of our findings. Methods: Serum- and glucocorticoid-inducible kinase 3 protein expression in nasopharyngeal carcinoma cell lines (CNE-1, CNE-2, HNE-1, HONE-1, and SUNE-1) and the human immortalized nasopharyngeal epithelium cell line NP69 were assayed by western blotting. Serum- and glucocorticoid-inducible kinase 3 expression in 42 paraffin-embedded nasopharyngeal carcinoma tissues were performed by immunohistochemistry. MTT assay, flow cytometry, and scratch tests were performed after CNE-2 cells were transfected with the best serum- and glucocorticoid-inducible kinase 3 shRNA plasmid selected by western blotting using lipofectamine to study its effect on cell proliferation, apoptosis, and migration. Results: Serum- and glucocorticoid-inducible kinase 3 was overexpressed in human nasopharyngeal carcinoma tissues and cells. Serum- and glucocorticoid-inducible kinase 3 expression decreased markedly after CNE-2 cells were transfected with the serum- and glucocorticoid-inducible kinase 3 shRNA, leading to strong inhibition of cell proliferation and migration. In addition, the apoptosis rate increased in CNE-2 cells after serum- and glucocorticoid-inducible kinase 3 knockdown. Conclusion: Serum- and glucocorticoid-inducible kinase 3 expression was more frequently observed as the nasopharyngeal epithelium progresses from normal tissue to carcinoma. This suggests that serum- and glucocorticoid-inducible kinase 3 contributes to the multistep process of NPC carcinogenesis. Serum- and glucocorticoid-inducible kinase 3 represents a target for nasopharyngeal carcinoma therapy, and a basis exists for the further investigation of this adjuvant treatment modality for nasopharyngeal carcinoma.

Resumo Introdução: A quinase 3 sérica induzida por glicocorticoide, uma serina/treonina quinase que funciona downstream da via de sinalização PI3K, desempenha um papel crítico nos processos neoplásicos. É expressa por vários tumores e contribui para a carcinogênese. Objetivo: Investigar a expressão de quinase 3 sérica induzida por glicocorticoide no carcinoma nasofaríngeo, estudar os efeitos antitumorais do shRNA da quinase 3 sérica induzida por glicocorticoide, que inibem sua expressão em células de carcinoma nasofaríngeo, e discutir as implicações potenciais de nossos achados. Método: A expressão de proteína quinase 3 sérica induzida por glicocorticoide em linhagens de células de carcinoma nasofaríngeo (CNE-1, CNE-2, HNE-1, HONE-1 e SUNE-1) e a linhagem de células humanas imortalizadas do epitélio nasofaríngeo NP69 foram avaliadas por Western blot. A expressão da quinase 3 sérica induzida por glicocorticoide em 42 tecidos de CNF embebidos em parafina foi feita por imuno-histoquímica. Testes com MTT, citometria de fluxo e testes de raspagem foram feitos após as células CNE-2 terem sido transfectadas com o melhor plasmídeo shRNA da quinase 3 sérica induzida por glicocorticoide selecionado por Western blot, com o uso de lipofectamina para estudar seu efeito na proliferação, apoptose e migração celular. Resultados: Foi observada uma sobre-expressão da quinase 3 sérica induzida por glicocorticoide em tecidos e células de carcinoma nasofaríngeo humanas. A expressão de quinase 3 sérica induzida por glicocorticoide diminuiu acentuadamente após as células CNE-2 terem sido transfectadas com o shRNA da quinase 3 sérica induzida por glicocorticoide, conduzindo a forte inibição de proliferação e migração celular. Além disso, a taxa de apoptose aumentou nas células CNE-2 após o knockdown da quinase 3 sérica induzida por glicocorticoide. Conclusão: A expressão de quinase 3 sérica induzida por glicocorticoide foi observada com maior frequência à medida que o epitélio nasofaríngeo progride de tecido normal para carcinoma. Isso sugere que a quinase 3 sérica induzida por glicocorticoide contribui para o processo multietapas da carcinogênese do carcinoma nasofaríngeo. A quinase 3 sérica induzida por glicocorticoide representa um alvo para a terapia do carcinoma nasofaríngeo e há uma base para a investigação adicional dessa modalidade de tratamento adjuvante para o carcinoma nasofaríngeo.

Efficacy and Safety of Secukinumab for the Treatment of Moderate to Severe Psoriasis in Korea / 대한피부과학회지

BACKGROUND: Secukinumab, a fully human monoclonal antibody that targets interleukin (IL)-17A, which is a central cytokine in the pathogenesis of psoriasis, has emerged as a promising treatment for moderate to severe psoriasis. However, to date, there are no real-world data for secukinumab in Korean patients with psoriasis. OBJECTIVE: To assess the clinical efficacy and safety of secukinumab in Korean patients with psoriasis. METHODS: Prospective data were gathered during follow-up from 28 consecutive patients with chronic plaque-type psoriasis treated with secukinumab for minimum of 12 weeks at a single referral center. Patient demographics, Psoriasis Area Severity Index (PASI) score, Physicians' Global Assessment (PGA), Dermatologic Life Quality Index (DLQI), and adverse events were investigated. RESULTS: The mean PASI score was significantly decreased after the induction period of secukinumab treatment (paired t-test, p<0.05). Of the 28 patients, 17 (60.7%) had obtained near complete clearance (PASI 90) at the last follow-up visit. No unexpected adverse events, other than nasopharyngitis, were observed. CONCLUSION: Secukinumab can be of benefit for the treatment of Korean patients with psoriasis, as the treatment was associated with a rapid and satisfactory response and safety profile.

Systematic Review on the Efficacy and Safety of Erenumab for the Prevention of Migraine

OBJECTIVE: This study aimed to provide efficacy and safety information on the use of erenumab for prevention of episodic and chronic migraines. METHODS: The keywords “Erenumab and migraine” were used to search the PubMed database to then compile efficacy and safety data for erenumab. Data from relevant Phase 2 and Phase 3 clinical trials were analyzed, using RevMan for statistical analysis. RESULTS: Three clinical trials (one Phase 2 and two Phase 3 studies) were retrieved. All three trials used the same primary endpoint (change from baseline in monthly migraine days (CBMD)) to evaluate efficacy and safety of erenumab use for prevention of episodic and chronic migraines. Subcutaneous doses of erenumab (70 or 140 mg) were administered monthly in each trial, for 3 months (Studies 2, and 3) or 6 months (Study 1). The mean differences in CBMD in the 70 mg and 140 mg erenumab arms were −1.36 and −1.98, respectively, compared to that in the placebo arm. Some adverse events, such as nasopharyngitis and upper respiratory tract infection, were reported, but no differences in safety between erenumab and placebo were found to be significant. CONCLUSIONS: Erenumab showed superior efficacy in prevention of migraines compared to placebo. However, additional information regarding the long-term safety of erenumab should be collected. Therefore, post-marketing surveillance for adverse events is needed.

Nasopharyngeal linguatulosis or halzoun syndrome: clinical diagnosis and treatment

SUMMARY Halzoun syndrome, also known as nasopharyngeal linguatulosis, is a rare entity that is mostly prevalent in Eastern Mediterranean countries. The consumption of raw ovine liver and lymph nodes infested with Linguatula serrata nymphs remains a major cause of the nasopharyngeal symptoms and discomfort associated with the disease. Halzoun syndrome is a clinical diagnosis based on history and presentation. Treatment of this disease is still debated; however, our experience reveals that alcohol gargle can be a good option. Proper counselling on the hazards of eating raw liver in endemic areas is needed. Moreover, physicians should be aware of the sequence of events in the disease in order not to delay or miss the diagnosis. This communication presents a rare Lebanese case of Halzoun syndrome that offers medical implications in the clinical diagnosis and treatment of the nasopharyngeal symptoms of this syndrome, with a review of the literature.

RESUMO Esta comunicação apresenta um caso libanês raro de síndrome de Halzoun que oferece implicações médicas no diagnóstico clínico e no tratamento dos sintomas nasofaríngeos desta síndrome, com uma revisão da literatura. A síndrome de Halzoun, também conhecida como linguatulose nasofaríngea, é uma entidade rara predominante nos países do Mediterrâneo Oriental. O consumo de linfonodos ovinos e linfáticos ovinos infestados com ninfas Linguatula serrata continua a ser uma das principais causas dos sintomas nasofaríngeos e do desconforto associado à doença. A síndrome de Halzoun é um diagnóstico clínico baseado na história e na apresentação. O tratamento dessa doença ainda é debatido; no entanto, nossos resultados revelam que o gargarismo de álcool pode ser uma boa opção. É necessário um aconselhamento adequado sobre os perigos de comer fígado cru em áreas endêmicas. Além disso, os médicos devem estar cientes da sequência de eventos na doença, a fim de não atrasar ou perder o diagnóstico.

Estudio piloto del efecto terapéutico de algunos medicamentos homeopáticos indicados en la rinofaringitis aguda / Pilot study of therapeutic effect of some homeopathic medicines indicated for acute nasopharyngitis

El presente trabajo tiene el objetivo de mostrar el efecto terapéutico de algunos medicamentos homeopáticos en la rinofaringitis aguda o resfriado común, enfermedad aguda de vías respiratorias superiores de tipo viral de baja patogenicidad (VRSBP) y gran incidencia en la actualidad, en una muestra piloto de tipo clínico, longitudinal y prospectiva, conformada por 22 pacientes captados en la Unidad Médica de la Escuela Nacional de Medicina y Homeopatía (ENMH) del Instituto Politécnico Nacional (IPN); 15 pacientes del sexo femenino y 7 del masculino, en un rango de entre 4 y 11 años de edad. La elección de los medicament s homeopáticos se realizó con base en lasemiología de los síntomas presentados, enfatizando particularmente en las modalidades, el color del moco, ataque al estado general y la exploración física.

This paper aims to show the therapeutic effect of some homeopathic medicines in acute nasopharyngitis or common cold , acute upper respiratory disease of viral type low pathogenic ( VRSBP ) and high incidence currently in a pilot sample clinical , longitudinal and prospective type , consisting of 22 patients recruited in the Medical Unit of the National School of Medicine and Homeopathy ( ENMH ) of the National Polytechnic Institute ( IPN) ; 15 female patients and 7 male , ranging between 4 and 11 years old. The choice of homeopathic medicament s was made based on thesemiotics of the symptoms presented , emphasizing particularly on the modalities , the color of mucus, malaise and physical examination.

Efficacy and Safety of Ustekinumab in Korean Patients with Moderate-to-severe Psoriasis / 대한피부과학회지

BACKGROUND: Psoriasis is a chronic, relapsing inflammatory disease that affects approximately 2~3% of the population worldwide and often requires lifelong care. Recent advances in understanding the immunogenesis of psoriasis has led to the development of biological agents that target specific immunological pathways. Ustekinumab is a human monoclonal antibody that binds to the p40 subunit common to interleukin-12 and 23, key cytokines in the pathogenesis of psoriasis. OBJECTIVE: This study aims to address the efficacy and safety of ustekinumab in Korean patients with moderate-to-severe psoriasis. METHODS: The clinical records of 32 consecutive patients treated with ustekinumab were reviewed retrospectively. Treatment effectiveness was estimated based on reported Psoriasis Area and Severity Index (PASI) 50, 75, and 90 response rates, defined as a > or =50%, > or =75%, or > or =90% reduction from baseline PASI scores, respectively. A stereotyped questionnaire was completed by the physician, and information about adverse events and quality of life was collected. RESULTS: The average baseline PASI score was 25.7. Overall 38%, 56%, and 80% patients achieved PASI 75 response rates at weeks 4, 16, and 52 respectively. Thirteen patients (41%) experienced a mild adverse event such as upper respiratory infection, pruritus, urticaria, nasopharyngitis, headache, hyperglycemia, abnormal hepatic function, or arthralgia. CONCLUSION: Ustekinumab provides an effective, safe, and well-tolerated alternative for the symptomatic treatment of Korean patients with moderate-to-severe psoriasis.

Expression of phosphofructokinase 1 protein and it's enzyme activity on nasopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The aim of this study is to investigate the expression of phosphofructokinase 1 and it's enzyme activity in nasopharyngeal carcinoma biopsy samples.@*METHOD@#Sixty-one biopsy samples were detected, including 41 tissues from patients with nasopharyngeal carcinoma as experimental group and 20 tissues from patients with chronic nasopharyngitis as control group. Phosphofructokinase 1 protein was detected by Western blot and it's enzyme activity was detected.@*RESULT@#It was observed that the expression levels of phosphofructokinase 1 protein and it's enzyme activities in the experimental group were higher than that in the control group (P < 0.01). In the experimental group, the expression levels of phosphofructokinase 1 protein and it's enzyme activities in patients with lymph node metastasis were higher than that in patients without lymph node metastasis (P < 0.01).@*CONCLUSION@#Phosphofructokinase 1 may be a marker in occurrence and metastasis of nasopharyngeal carcinoma.

Expression of FOXC1 and its relationship with E-cadherin in nasopharyngeal carcinoma tissues / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the significance and relationship between the expression of FOXC1 and clinicopathological features, and to explore its correlation with E-cadherin.@*METHOD@#Immunohistochemical SP method was used to detected the expression of FOXC1 in nasopharyngeal carcinoma tissues and nasopharyngitis tissues.@*RESULT@#(1) Immunoreaction to FOXC1 was mainly located in nucleus of nasopharyngeal carcinoma cells. The positive expression rate of FOXC1 in nasopharyngeal carcinoma tissues was 85.3% (81/95), which was significantly higher than that in nasopharyngitis tissues (59.4%) (P 0.05). (3) There was a correlation between the expression of FOXC1 and down-regulated expression of E-cadherin in nasopharyngeal carcinoma tissues (P < 0.05).@*CONCLUSION@#FOXC1 may play an important role in generation and progression of nasopharyngeal carcinoma, there may be a correlation between the expression of FOXC1 and down-regulated expression of E-cadherin, also FOXC1 may play an important role in the process of EMT in nasopharyngeal carcinoma by regulating E-cadherin.

Indications actuelles de l'adenoidectomie; de l'amygdalectomie et de l'adenoamygdalectomie a l'Hopital General de Douala

"Sur une serie de patients operes dans le service ORL de l'Hopital General de Douala; evaluer les indications de la chirurgie des vegetations adenoidiennes et de l'amygdale en fonction des criteres de l' "" Evidence Based Medecine "". MATeRIELS ET MeTHODES etude retrospective colligeant les cas d'amygdalectomie; d'adenoidectomie et d'adenoamygdalectomie sur une periode de six ans a ete entreprise. Ont ete inclus les enfants de 0 a 15 ans. Les indications operatoires ont ete repertoriees. Pour l'analyse l'utilisation de la grille standardisee d'evaluation selon les criteres de l' "" Evidence Based Medecine "" en quatre niveaux de preuve suivant le type d'etude effectue pour la pertinence des indications. ReSULTATS 100 dossiers ont ete colliges repartis en 43 adenoidectomies; 40 adenoamygdalectomies et 17 amygdalectomies. L'age moyen des adenoidectomies etait de 3;5 ans ; 5;4 ans pour l'adenoamygdalectomie et 9 ans pour l'amygdalectomie. Pour l'adenoidectomie 3 indications ont ete relevees; le syndrome d'apnee du sommeil (SAS) dans 48;8 des cas; les rhinopharyngites a repetition dans 34;8 des cas et l'otite des cas. L'adenoamygdalectomie a concerne dans 80 seromuqueuse dans 16;2 des cas le SAS et dans 20 une notion d'angine a repetition. L'amygdalectomie isolee etait plus rare que les deux autres interventions et a ete principalement realisee pour les angines a repetition. CONCLUSION Suivant les criteres de l'EBM le SAS; les rhinopharyngites a repetition et l'otite seromuqueuse sont des indications majeures des adenoamygdalectomies. Les angines a repetition sont en regression."

Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA) / 소아과

PURPOSE: Previous studies suggest that the concentration of 25-hydroxyvitamin D [25(OH)D] in cord blood may show an inverse association with respiratory tract infections (RTI) during childhood. The aim of the present study was to examine the influence of 25(OH)D concentrations in cord blood on infant RTI in a Korean birth cohort. METHODS: The levels of 25(OH)D in cord blood obtained from 525 Korean newborns in the prospective COhort for Childhood Origin of Asthma and allergic diseases were examined. The primary outcome variable of interest was the prevalence of RTI at 6-month follow-up, as diagnosed by pediatricians and pediatric allergy and pulmonology specialists. RTI included acute nasopharyngitis, rhinosinusitis, otitis media, croup, tracheobronchitis, bronchiolitis, and pneumonia. RESULTS: The median concentration of 25(OH)D in cord blood was 32.0 nmol/L (interquartile range, 21.4 to 53.2). One hundred and eighty neonates (34.3%) showed 25(OH)D concentrations less than 25.0 nmol/L, 292 (55.6%) showed 25(OH)D concentrations of 25.0-74.9 nmol/L, and 53 (10.1%) showed concentrations of > or =75.0 nmol/L. Adjusting for the season of birth, multivitamin intake during pregnancy, and exposure to passive smoking during pregnancy, 25(OH)D concentrations showed an inverse association with the risk of acquiring acute nasopharyngitis by 6 months of age (P for trend=0.0004). CONCLUSION: The results show that 89.9% of healthy newborns in Korea are born with vitamin D insufficiency or deficiency (55.6% and 34.3%, respectively). Cord blood vitamin D insufficiency or deficiency in healthy neonates is associated with an increased risk of acute nasopharyngitis by 6 months of age. More time spent outdoors and more intensified vitamin D supplementation for pregnant women may be needed to prevent the onset of acute nasopharyngitis in infants.

Leukocytoclastic Vasulitis Induced by Methoxy Polyethylene Glycol-Epoetin Beta / 대한피부과학회지

Methoxy polyethylene glycol-epoetin beta (Mircera(R), Roche), a third-generation erythropoiesis-stimulating agent (ESA) is known as a continuous erythropoietin receptor activator (CERA). In patients with anemia associated with chronic kidney disease (CKD), it is administered intravenously or subcutaneously. Treatment-related adverse events induced by methoxy polyethylene glycol-epoetin beta occurred in 6%. Hypertension, diarrhea and nasopharyngitis were the most commonly reported adverse events. Cutaneous adverse reactions are rarely experienced with methoxy polyethylene glycol-epoetin beta including maculopapular eruption, facial erythema, and tinea pedis. To the best of our knowledge, no cases of leukocytoclastic vasculitis associated with methoxy polyethylene glycol-epoetin beta have ever been published in medical literature. Herein, we report on a case of leukocytoclastic vasulitis induced by methoxy polyethylene glycol-epoetin beta in a patient with anemia associated with chronic kidney disease.

Expression and correlation of cyclooxygenase-2 and vascular endothelial growth factor in nasopharyngeal carcinoma- / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the Expression and correlation of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor receptor (VEGF) in nasopharyngeal carcinoma.@*METHOD@#In this study, expression levels of COX-2, VEGF were examined in 58 patients with nasopharyngeal carcinoma and 38 patients with inflammation in nasopharyngeal mucosa by immunohistochemistry method.@*RESULT@#The expression of COX-2, VEGF were higher in nasopharyngeal carcinoma than those in nasopharyngeal mucosa (P < 0.05), and they had some correlation with the invasion and lymphatic metastasis and with the clinical stage of nasopharyngeal carcinoma (P < 0.05). The expression of COX-2 was positively correlated with that of VEGF (P < 0.05).@*CONCLUSION@#The coexpression of COX-2 and VEGF may play animportant role in the carcinogenesis and development of nasopharyngeal carcinoma, and they may prom (see text) lymph node metastasis of nasopharyngeal carcinoma.

Nasopharyngeal Gram-negative bacilli colonization in Brazilian children attending day-care centers

This study aimed at determining prevalence and resistance profile of Gram-negative bacilli isolated from nasopharynx of children attending day-care centers in Goiânia (Brazil). P. aeruginosa (100.0 percent), E. coli (50.0 percent), K. pneumoniae (35.3 percent), and E. aerogenes (16.7 percent) were the most frequent multi-drug resistant microorganisms isolated. No production of ESBL was detected.

Upper Respiratory Infections in Children

Upper respiratory tract infection is one of the most common illnesses affecting children. On average, children experience around six to eight upper respiratory tract infections (URTIs) each year. Although these infections usually are mild and self limiting, they occasionally lead to complications that can be life threatening. Most URTIs can be placed within four main categories of infection: nasopharyngitis, pharyngitis, sinusitis and otitis media. Within each category of illness, there is a range of related conditions that may have similar or overlapping clinical presentations. A sound judgment is required to determine the most affected part of the respiratory mucosa. The clinical features, diagnosis and treatment of URTIs in children will be reviewed here.

Expression, genetic and epigenetic alterations of LTF gene in nasopharyngeal carcinoma cell lines / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression of LTF mRNA in several nasopharyngeal cancer (NPC) cell lines, and analyze the relationship between the genetic and epigenetic changes and expression of LTF gene.</p><p><b>METHODS</b>The expression level of LTF was detected in NPC cell lines HNE1, HNE2, HNE3, CNE1, CNE2, 5-8F, 6-10B cells and tissues of 15 cases of chronic nasopharyngitis by RT-PCR. The LTF protein level was analyzed by Western blotting in 6-10B cells. Then LOH, mutation and methylation status of LTF was examined by microsatellites analysis, PCR-SSCP, MSP and bisulfite genomic sequencing, respectively.</p><p><b>RESULTS</b>15 chronic nasopharyngitis tissues showed stable LTF expression, while there were weak expression in 6-10B cells and absent expression in remaining detected NPC cell lines. There was a significantly lower LTF expression in chronic nasopharyngitis tissues (Z = -3.738, P = 0.000). No LTF protein expression was observed in 6-10B cells. LOH analysis demonstrated that allele loss of LTF wasn't found in NPC cell lines. LTF mutation was noted in 14.3% (1/7) of NPC cell lines. DNA sequencing confirmed the mutation point in the promoter region (-305 bp to -50 bp) was at -218 bp (del T) of LTF gene in the HNE1 cell line. Methylation of LTF gene was not found in chronic nasopharyngitis. However, methylation of LTF promoter was detected in all NPC cell lines. LTF mRNA expression was increased in 5-8F and 6-10B cell lines after treatment with 5-aza-2-deoxycytidine.</p><p><b>CONCLUSION</b>There is an inactivation of expression of LTF gene in the NPC cell lines. Its molecular mechanism may be related with methylation of promoter region and deletion mutation.</p>

[Adenoid tissue: a comparative bacteriological study]

Adenoid hypertrophy and its complications such as otitis media and sinusitis are common problems in childhood. Rapic and appropriate detection of interfering microorganisms in chronic nasopharyngitis is very important for better medical and surgical interventions. The aims of this study were to detect major core adenoidal microorganisms and to compare similarity of pernasal and oropharyngeal cultures with adenoidal culture, and also to compare bacteriological resistance in patients with and without complications. In this descriptive study, 50 patients with adenoid hypertrophy and chronic nasopharyngitis were recruited and divided into 2 groups: group I [n=25] with complications such as otitis media with effusion and group II [n=25] without complication. All patients underwent adenoidectomy. A pressure equalizing tube was inserted for patients in group I. The smear and culture specimens were collected for bacteriological study. After 26 months of prospective bacteriological study on 50 patients with adenoidal enlargement, major results were as follow: the most common adenoidal growing microorganisms in two groups of patients, in decreasing frequency were hemophilus influenza. Type B beta hemolytic streptococcus and staphylococcus auresus. Pernasal smear and culture results were more similar than oropharyngeal results to core adenoidal cultures [p<0.01]. 70.1% of adenoidal microorganisms in group I patients and 21.2% in group II patients were resistant to ordinary antibiotics [without anti-betalactamase activity] [P<0.0001]. For better medical management of chronic nasopharyngitis [pre and/or post adenoidectomy], were recommend that in antibiotic selection, the hemophilus influenza type B should be considered as the major growing organism. Pernasal culturing is more appropriate for detection of interfering microorganisms. In complicated patients [cases or otitis media with effusion and /or sinusitis] it is advisable to use more potent antibiotics with anti-betalactamase activity. For infection control in non-complicated patients, use of ordinary antibiotics can reduce the resistance to potent antibiotics in general population

Prevalencia de bacterias potencialmente patógenas en la nasofaringe de niños sanos de un círculo infantil de Ciudad de La Habana / Prevalence of potentially pathogenic bacteria in nasopharynx of healthy children attending a day care center in Havana City

Se realizó durante el primer semestre de 2001, un estudio transversal descriptivo de portadores en niños sanos de un círculo infantil de Ciudad de La Habana, con el objetivo de conocer la prevalencia de bacterias potencialmente patógenas y su relación con posibles factores de riesgo asociados. En el diseño se tuvieron en cuenta las exigencias bioéticas regulatorias nacionales e internacionales. Se tomó exudado a 160 niños de la nasofaringe posterior, la muestra se sembró directamente en agar cerebro corazón más sangre de carnero desfibrinada y agar cerebro corazón más NAD, hemina y bacitracina; se incubó 18-24 h. La identificación de los aislamientos obtenidos se realizó por técnicas convencionales y el sistema API NH. Predominó el grupo de niños de 3-4 años de edad y sexo masculino. Se detectó un porcentaje elevado de portadores y entre estos, Haemohilus se aisló en 92,50 por ciento, correspondiendo a Haemophilus influenzae 54,72 por ciento. Otros patógenos observados fueron: Streptococcus pneumoniae, Streptococcus β-hemolítico, Staphylococcus aureus y Moraxella catarrhalis. Existió diferencia estadísticamente significativa cuando se compararon portadores y no portadores de S. pneumoniae en los menores de 2 años. Se pudieron conocer los patrones de colonización de bacterias potencialmente patógenas en niños de un círculo infantil de Ciudad de La Habana.

Corneal Perforation Caused by Noninfectious Corneal Ulcer in a Patient with Toxic Epidermal Necrolysis

PURPOSE: To report a case of corneal perforation caused by non-infectious corneal ulcer in a patient with toxic epidermal necrolysis (TEN). METHODS: A 29-year-old female visited the hospital with bullous lesions on the erythematous body surface. She also had severe conjunctivitis and keratitis in both eyes. She had been taken antibiotics and analgesics for nasopharyngitis. The patient was diagnosed with TEN. Although she was hospitalized and treated in the department of internal medicine, the left cornea was severely necrotized and became thinner. Slit-lamp examination showed focal descematocele in the central cornea. The result of corneal culture was negative and corneal infiltration that would suggest an infectious ulcer was not observed. RESULTS: The patient was in poor general health because of pneumonia. We performed tectonic amniotic membrane transplantation to prevent corneal perforation. Fibrovascular tissues were growing on the amniotic membrane from the surrounding conjunctiva. However, they did not cover the descemetocele area. Her general condition continued to worsen and she was transferred to the intensive care unit. The cornea was perforated and the patient died of septic shock. CONCLUSIONS: Corneal perforation may occur in a patient with TEN without secondary bacterial infection. Therefore, patients with TEN need to be informed of this serious complication and the possible need for more intensive treatment.

Clinical analysis of febrile infants and children presenting to the pediatric emergency department / 소아과

PURPOSE: We studied clinical patterns of the febrile infants and children presenting to the Pediatric Emergency Department(ED) in the general pediatric population. METHOD: We analyzed 1,764 infants and children who had a history of measured body temperature of 38.3degrees C or higher, before or after arrival at Pediatric ED of Ilsan Paik Hospital from September 2004 to August 2005. We analyzed their clinical patterns, such as the frequency of febrile illness, age distribution, monthly distribution, diagnosis. RESULT: The frequency of the febrile illness at Pediatirc ED was 19.9 percent (1,764/8,881 cases). The percentage of admission into hospital was 26.4 percent. The most common age group presenting to Pediatric ED with febrile illness was the 12-23 months group(22.8 percent) followed by the 4-11 months group and the 2 years group. In May, the most numerous patients presented to the Pediatric ED with febrile illness. The frequency of febrile illness was significant higher in the 'Spring & Summer group' compared to the 'Autumn & Winter group'. The ratio of male to femal was 1.4:1. The most common diagnosis was acute pharyngitis(42.5 percent), followed by acute gastroenteritis (15.3 percent), pneumonia(7.0 percent). CONCLUSION: The frequency of the febrile illness at Pediatirc ED was 19.9 percent. The most numerous patients visited Pediatric ED in May. And, the most common age group was 12-23 months. The proportion of non-urgent disease, such as acute pharyngitis, acute gastroenteritis, acute nasopharyngitis and acute bronchitis, was high. There is a need to educate parents and improve the medical system in Korea.

Clinical Analysis of the Pediatric Patients Seen in the Emergency Medical Center / 소아과

PURPOSE: We studied a clinical analysis of pediatric patients who visited the emergency medical center of Yeungnam University Hospital to compare the characteristics of pediatric emergency patients after year 2000 with the previous studies. METHODS: We reviewed 7, 034 children under the age of 15 years who visited the emergency medical center of Yeungnam University Hospital during the 2 year period from January 2001 to December 2002, and then we performed a clinical and statistical analysis. We analyzed the pediatric patients according to gender, age, season, day of the week, time of the visit, the disease classification and the final disposition of the patients. RESULTS: Among the patients who visited the emergency room, 15.6% of the total emergency patients were under the age of 15. The male to female ratio was 1.6: 1. Among the 7, 034 pediatric patients, the most common age group was between 1 year and under 3 years of age (26.9%). The peak seasonal incidence was early summer and spring, especially during June (11.2%) and May (10.6 %). The peak incidence day of the week was Sunday (24.8%) and the peak time when the emergency pediatric patients visited the emergency room was between 20 and 24 o'clock (28.8%). The distribution of diseases, according to ICD-10 system, were injury and poisoning (30.4%), diseases of the respiratory system (22.8%), and diseases of the digestive system (14.6%). 30% of total pediatric patients were admitted to the hospital. CONCLUSION: After year 2000, as compared with the previous studies, the proportions of emergency pediatric patients has decreased. The distribution of diseases was not much different from the previous studies and the proportions of non-urgent diseases, such as acute nasopharyngitis or acute gastroenteritis, were still high. These result have come about due to the declining birth rate and changes of the medical system in Korea.