Intussusception and Jejunal Atresia Caused by an Ectopic Pancreas in a Newborn

Ectopic pancreas is defined as an abnormally located pancreatic tissue not sufficiently connected with the normal pancreas, which rarely occurs in neonates. To our knowledge, only a few cases of ectopic pancreas have been reported in newborns in South Korea. We report a case of ectopic pancreas as the cause of intussusception and jejunal atresia in a newborn. This clinical association is extremely rare, and this is the first report in South Korea.

Intussusception and Jejunal Atresia Caused by an Ectopic Pancreas in a Newborn

Ectopic pancreas is defined as an abnormally located pancreatic tissue not sufficiently connected with the normal pancreas, which rarely occurs in neonates. To our knowledge, only a few cases of ectopic pancreas have been reported in newborns in South Korea. We report a case of ectopic pancreas as the cause of intussusception and jejunal atresia in a newborn. This clinical association is extremely rare, and this is the first report in South Korea.

Analysis of factors affecting clinical feature and disease severity according to the subtypes of respiratory syncytial virus

Purpose@#Respiratory syncytial virus (RSV) is one of the most common causes of respiratory tract infections, especially in patients aged 39°C) was slightly higher in the RSV B group (13.6%) than in the RSV A group (11.7%), although the difference was not statistically significant. Laboratory findings, including the neutrophil-lymphocyte ratio, were similar between the groups. The incidence of systemic steroid therapy was higher in the RSV A group (12.6%) than in the RSV B (3.0%) group (P= 0.03). Patients aged < 12 months, the incidences of oxygen therapy (P= 0.03) and systemic steroid therapy (P= 0.04) were higher in the RSV A group, suggesting that patients aged < 12 months with RSV A infection may have clinically more severe disease. @*Conclusion@#We recommend intensive monitoring if RSV A infection is detected in young children under 12 months.

Interprofessional education for patient safety in health workers of various hospitals using active learning strategies / 의료커뮤니케이션

Background@#Patient safety has a direct impact on the patient’s health and life, so all members of the hospital should consider it first. Patient safety accidents are often occured by organizational problems rather than individual medical personnel. Therefore, effective interprofessional collaboration(IPC) among experts is essential, so interprofessional education(IPE) is considered important. @*Methods@#: A prospective study method of one-group pretest-posttest design was used that provides IPE using active learning-oriented teaching methods for health workers in various occupations of various hospitals, and evaluates self-efficacy, communication confidence, and attitude toward IPE. @*Results@#: 17 trainees from 8 hospitals were evaluated. First, the average of the awareness of patient safety culture was 3.62 points. Next, the score of each indicators increased in the pre-post evaluation. The average of communication confidence was from 3.73 to 3.95 points, self-efficacy was from 3.99 to 4.11 points, and attitude toward IPE was from 4.44 to 4.52 points, but not significant. @*Conclusions@#This study would have a great significance in that it was conducted on health workers in various occupations of various hospitals. As a result of a pre and post education survey conducted with trainees, the score was improved in communication confidence, self-efficacy, and attitude toward IPE. It seems to be due to the use of active learning teaching methods, and the active participation of trainees.

A Case of Hemolytic Disease of Newborn due to Anti-Di(a): Consideration of the Inclusion of Di(a) Antigen in Antibody Screening Test / 대한수혈학회지

The Diego blood group is expressed as the Di(a) antigen and Di(b) antigen, and the frequency of the Di(a) antigen among the Korean population is estimated to be 9.4~14.5%. We report here on a case of hemolytic disease caused by anti-Di(a) antibody. A full-term male infant was admitted due to hyperbilirubinemia on the first day of life. The total bilirubin level was decreased after phototherapy, but the hemoglobin level was decreased 6.9 g/dL and an exchange transfusion was then performed. The direct antiglobulin test was strongly positive, but the indirect antiglobulin test using screening blood cells without the Di(a) antigen was negative. After we suspected neonatal hemolytic disease caused by the anti-Di(a) antibody, it was confirmed using selected blood cells containing Di(a) antigen. The newborn and father had DI*A/DI*B and the mother had DI*B. The inclusion of Di(a) antigens in an unexpected antibody screening test should be actively discussed in Korea.

Clinical Significance of Asymmetric Minimum Intensity Projection Images of Brain Magnetic Resonance Imaging in Children

BACKGROUND AND PURPOSE: The susceptibility-weighted imaging form of brain MRI using minimum intensity projection (mIP) is useful for assessing traumatic brain injuries because it readily reveals deoxyhemoglobin or paramagnetic compounds. We investigated the efficacy of using this methodology in nontraumatic patients. METHODS: We retrospectively analyzed the asymmetric mIP findings in nontraumatic patients. Asymmetric mIP images were first verified visually and then using ImageJ software. We enrolled patients with a difference of >5% between hemispheres in ImageJ analysis. All patients underwent detailed history-taking and EEG, and asymmetric mIP findings were compared. RESULTS: The visual analysis identified 54 pediatric patients (37 males and 17 females) with asymmetric mIP findings. Ten patients were excluded because they did not meet the ImageJ verification criteria. The 44 patients with asymmetry comprised 36 with epilepsy, 6 with headache, and 2 with cerebral infarction. Thirty-one of the 36 epileptic patients showed definite partial seizure activities in semiology, while the remaining patients did not demonstrate a history of partial seizure manifestations. The MRI findings were normal in all patients except for five with periventricular leukomalacia unrelated to seizure symptoms. There was agreement between mIP images and semiology in 29 (93.5%) of the 31 epileptic patients with focal signs, while the other 2 demonstrated discordance. Twenty (64.5%) of the 31 patients showed consistent EEG abnormalities. CONCLUSIONS: Our data suggest that asymmetric mIP findings are an excellent lateralizing indicator in pediatric patients with partial epilepsy.

Escitalopram, a selective serotonin reuptake inhibitor, inhibits voltage-dependent K⁻ channels in coronary arterial smooth muscle cells

We investigated the inhibitory effect of escitalopram, a selective serotonin reuptake inhibitor (SSRI), on voltage-dependent K⁺ (Kv) channels in freshly separated from rabbit coronary arterial smooth muscle cells. The application of escitalopram rapidly inhibited vascular Kv channels. Kv currents were progressively inhibited by an increase in the concentrations of escitalopram, suggesting that escitalopram inhibited vascular Kv currents in a concentration-dependent manner. The IC₅₀ value and Hill coefficient for escitalopram-induced inhibition of Kv channels were 9.54±1.33 µM and 0.75±0.10, respectively. Addition of escitalopram did not alter the steady-state activation and inactivation curves, suggesting that the voltage sensors of the channels were not affected. Pretreatment with inhibitors of Kv1.5 and/or Kv2.1 did not affect the inhibitory action of escitalopram on vascular Kv channels. From these results, we concluded that escitalopram decreased the vascular Kv current in a concentration-dependent manner, independent of serotonin reuptake inhibition.

Nortriptyline, a tricyclic antidepressant, inhibits voltage-dependent K+ channels in coronary arterial smooth muscle cells

We demonstrated the effect of nortriptyline, a tricyclic antidepressant drug and serotonin reuptake inhibitor, on voltage-dependent K⁺ (Kv) channels in freshly isolated rabbit coronary arterial smooth muscle cells using a whole-cell patch clamp technique. Nortriptyline inhibited Kv currents in a concentration-dependent manner, with an apparent IC₅₀ value of 2.86±0.52 µM and a Hill coefficient of 0.77±0.1. Although application of nortriptyline did not change the activation curve, nortriptyline shifted the inactivation current toward a more negative potential. Application of train pulses (1 or 2 Hz) did not change the nortriptyline-induced Kv channel inhibition, suggesting that the effects of nortiprtyline were not use-dependent. Preincubation with the Kv1.5 and Kv2.1/2.2 inhibitors, DPO-1 and guangxitoxin did not affect nortriptyline inhibition of Kv channels. From these results, we concluded that nortriptyline inhibited Kv channels in a concentration-dependent and state-independent manner independently of serotonin reuptake.