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Changes of Bax, Bcl-2, CCR-2, MCP-1, and TGF-β1 genes in the left ventricle of spontaneously hypertensive rat after losartan treatment. 氯沙坦治疗后自发性高血压大鼠左心室Bax、Bcl-2、CCR-2、MCP-1、TGF-β1基因的变化
Pub Date : 2019-03-01 Epub Date: 2018-10-24 DOI: 10.3345/kjp.2018.06856
Hyeryon Lee, Kwan Chang Kim, Young Mi Hong

Purpose: Increased apoptosis was recently found in the hypertrophied left ventricle of spontaneously hypertensive rats (SHRs). Although the available evidence suggests that apoptosis can be induced in cardiac cells by various insults including pressure overload, cardiac apoptosis appears to result from an exaggerated local production of angiotensin in adult SHRs. Altered expressions of Bcl associated X (Bax), Bcl-2, chemokine receptor (CCR)-2, monocyte chemoattractant protein (MCP)-1, transforming growth factor (TGF)-β1, phosphorylated extracellular signal-regulated kinases (PERK), and connexin 43 proteins, and kallikrein mRNA were investigated to explore the effects of losartan on the SHR model.

Methods: Twelve-week-old male rats were grouped as follows: control (C), SHR (hypertension: H), and losartan (L; SHRs were treated with losartan [10 mg/kg/day] for 5 weeks). Western blot and reverse transcription polymerase chain reaction assays were performed.

Results: Expression of Bax, CCR-2, MCP-1, TGF-β1, PERK, and connexin 43 proteins, and kallikrein mRNA was significantly increased in the H group compared to that in the C group at weeks 3 and 5. Expression of Bax, CCR-2, MCP-1, TGF-β1, and connexin 43 proteins and kallikrein mRNA was significantly decreased after losartan treatment at week 5. PERK protein expression was significantly decreased after losartan treatment at weeks 3 and 5. Bcl-2 protein expression was significantly decreased in the H group compared to that in the C group at weeks 3 and 5.

Conclusion: Losartan treatment reduced expression of Bax, CCR-2, MCP-1, TGF-β1, PERK, and connexin 43 proteins, and kallikrein mRNA in SHRs, along with decreased inflammation and apoptosis.

目的:在自发性高血压大鼠(SHRs)肥大的左心室中发现细胞凋亡增加。尽管现有证据表明,心肌细胞凋亡可通过各种损伤(包括压力过载)诱导,但心肌细胞凋亡似乎是由成人SHRs中过量的局部血管紧张素产生引起的。通过研究氯沙坦对SHR模型Bcl相关X (Bax)、Bcl-2、趋化因子受体(CCR)-2、单核细胞趋化蛋白(MCP)-1、转化生长因子(TGF)-β1、磷酸化细胞外信号调节激酶(PERK)、连接蛋白43和钾化因子mRNA表达的影响,探讨氯沙坦对SHR模型的影响。方法:12周龄雄性大鼠分为:对照组(C)、高血压组(H)、氯沙坦组(L);氯沙坦治疗SHRs (10 mg/kg/天)5周。Western blot和逆转录聚合酶链反应检测。结果:第3周和第5周,H组Bax、CCR-2、MCP-1、TGF-β1、PERK、connexin 43蛋白和kallikrein mRNA的表达明显高于C组。氯沙坦治疗第5周后,Bax、CCR-2、MCP-1、TGF-β1、connexin 43蛋白和kallikrein mRNA的表达显著降低。氯沙坦治疗第3周和第5周后,PERK蛋白表达明显降低。第3、5周时,H组Bcl-2蛋白表达较C组明显降低。结论:氯沙坦治疗可降低SHRs中Bax、CCR-2、MCP-1、TGF-β1、PERK、connexin 43蛋白和kallikrein mRNA的表达,减少炎症和细胞凋亡。
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引用次数: 2
A long-term subacute sclerosing panencephalitis survivor treated with intraventricular interferon-alpha for 13 years. 长期亚急性硬化性全脑炎幸存者接受脑室干扰素治疗13年。
Pub Date : 2019-03-01 Epub Date: 2018-09-18 DOI: 10.3345/kjp.2018.06730
Minsun Kwak, Hye-Ryun Yeh, Mi-Sun Yum, Hyun-Jin Kim, Su Jeong You, Tae-Sung Ko

Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, and fatal central nervous system disorder resulting from persistent measles virus infection. Long-term data are scarce, with a maximum follow-up period of 10 years. Interferon-alpha (IFN-α) is a protein that exerts its antiviral activity via enhancement of cellular immune response and is reported to be an effective drug for the treatment of SSPE. However, there is currently no consensus regarding the optimal duration of IFN-α therapy. Here, we present a case report of a patient with SSPE treated with long-term intraventricular IFN-α therapy, which facilitated clinical improvement and neurological stabilization without causing serious adverse effects. To the best of our knowledge, this is one of the longest follow-up studies investigating a patient with SSPE receiving intraventricular INF-α treatment. Further studies are necessary to validate the benefits and safety of long-term intraventricular IFN-α treatment in patients with SSPE.

亚急性硬化性全脑炎(SSPE)是一种罕见的、进行性的、致命的中枢神经系统疾病,由持续的麻疹病毒感染引起。长期数据缺乏,最长随访期为10年。干扰素-α (IFN-α)是一种通过增强细胞免疫反应发挥抗病毒活性的蛋白质,据报道是治疗SSPE的有效药物。然而,目前对于IFN-α治疗的最佳持续时间尚无共识。在这里,我们报告了一例SSPE患者接受长期脑室内IFN-α治疗,促进了临床改善和神经系统稳定,没有引起严重的不良反应。据我们所知,这是对接受脑室内INF-α治疗的SSPE患者进行的最长随访研究之一。需要进一步的研究来验证长期脑室内IFN-α治疗SSPE患者的益处和安全性。
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引用次数: 10
Rapidly growing pediatric trampoline-related injuries in Korea: a 10-year single center retrospective study. 韩国快速增长的儿童蹦床相关损伤:一项10年单中心回顾性研究。
Pub Date : 2019-03-01 Epub Date: 2019-03-11 DOI: 10.3345/kjp.2018.06814
Min Jeng Cho, Jihoon Kim, Sung Jeep Kim, Kyu Hyouck Kyoung, Min Ae Keum, Sung Kyun Park

Purpose: Several published policy statements have warned against the risks associated with trampoline use and recommended safety guidelines. However, few studies have focused on trampoline-related injuries in Korea. This study aimed to assess the incidence and characteristics of pediatric trampoline-related injuries presented to Ulsan University Hospital.

Methods: We retrospectively reviewed the medical records of children aged <16 years with trampoline-related injuries who visited our Emergency Department between 2008 and 2017.

Results: Over the 10-year period, 178 trampoline-related injuries were reported, which represented a significant increase (P=0.016). Most (87.6%) of the injuries occurred during the last 5 study years, and a rapid increase in injuries was observed in children aged <6 years. Lower extremity injuries (62.4%) were the most common, followed by injuries of the upper extremities, head and face, and trunk, including injuries to the neck and spine. Sixty-seven children (37.6%) had fractures, and proximal tibia fractures were the most common. Fractures were significantly more common in younger children (<6 years old) than in older children (P=0.026).

Conclusion: In Korea, the mechanism of trampoline injury is similar to that of injuries incurred in indoor trampoline parks but is characterized by smaller spaces and multiple users. Trampoline use and the incidence of trampoline-related injuries in children aged <6 years are increasing rapidly. Prohibiting the use of trampolines for children aged <6 years, restricting simultaneous use by multiple children, and ensuring adult supervision should be strictly emphasized. Public awareness and policy guidelines are needed to reduce the incidence of trampoline-related injuries.

目的:一些已发表的政策声明警告了使用蹦床的风险,并推荐了安全指南。但是,国内很少有关于蹦床相关伤害的研究。本研究旨在评估蔚山大学医院儿童蹦床相关损伤的发生率和特征。结果:10年间,共报告蹦床相关损伤178例,较上年同期显著增加(P=0.016)。大多数(87.6%)的损伤发生在最近5年的研究中,并且在儿童年龄段的损伤中观察到快速增长。结论:在韩国,蹦床损伤的机制与室内蹦床公园的损伤相似,但其特点是空间较小,使用者多。老年儿童蹦床使用及蹦床相关损伤发生率
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引用次数: 6
Central line-associated bloodstream infections in neonates. 新生儿中央静脉相关血流感染。
Pub Date : 2019-03-01 Epub Date: 2018-12-19 DOI: 10.3345/kjp.2018.07003
Hye Jung Cho, Hye-Kyung Cho

Newborn infants, including premature infants, are high-risk patients susceptible to various microorganisms. Catheter-related bloodstream infections are the most common type of nosocomial infections in this population. Regular education and training of medical staffs are most important as a preventive strategy for central line-associated bloodstream infections (CLABSIs). Bundle approaches and the use of checklists during the insertion and maintenance of central catheters are effective measures to reduce the incidence of CLABSIs. Chlorhexidine, commonly used as a skin disinfectant before catheter insertion and dressing replacement, is not approved for infants <2 months of age, but is usually used in many neonatal intensive care units due to the lack of alternatives. Chlorhexidine-impregnated dressing and bathing, recommended for adults, cannot be applied to newborns. Appropriate replacement intervals for dressing and administration sets are similar to those recommended for adults. Umbilical catheters should not be used longer than 5 days for the umbilical arterial catheter and 14 days for the umbilical venous catheter. It is most important to regularly educate, train and give feedback to the medical staffs about the various preventive measures required at each stage from before insertion to removal of the catheter. Continuous efforts are needed to develop effective and safe infection control strategies for neonates and young infants.

新生儿,包括早产儿,是各种微生物易感的高危患者。导管相关性血流感染是这一人群中最常见的医院感染类型。医务人员的定期教育和培训是预防中心静脉相关血流感染(CLABSIs)最重要的策略。在中心导管的插入和维护过程中采用集束入路和使用检查清单是减少clabsi发生率的有效措施。氯己定,通常用作导管插入和敷料更换前的皮肤消毒剂,不被批准用于婴儿
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引用次数: 20
Changes in the thyroid hormone profiles in children with nephrotic syndrome. 肾病综合征患儿甲状腺激素谱的变化。
Pub Date : 2019-03-01 Epub Date: 2018-10-04 DOI: 10.3345/kjp.2018.06891
Sun Hee Jung, Jeong Eun Lee, Woo Yeong Chung

Purpose: We compared thyroid hormone profiles in children with nephrotic syndrome (NS) during the nephrotic phase and after remission.

Methods: This study included 31 pediatric NS patients. The thyroid hormone profiles included serum levels of triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and free T4.

Results: Of the 31 patients, 16 (51.6%) showed abnormal thyroid hormone profiles: 6 had overt hypothyroidism, 8 had subclinical hypothyroidism, and 2 had low T3 syndrome. The mean serum T3, T4, and free T4 levels in the nephrotic phase and after remission were 82.37±23.64 and 117.88±29.49 ng/dL, 5.47±1.14 and 7.91±1.56 µg/dL, and 1.02±0.26 and 1.38±0.23 ng/dL, respectively; the levels were significantly lower in the NS nephrotic phase (P=0.0007, P<0.0001, and P=0.0002). The mean serum TSH levels during the nephrotic phase and after remission were 8.05±3.53 and 4.08±2.05 µIU/ mL, respectively; they were significantly higher in the nephrotic phase (P=0.0005). The urinary protein/ creatinine ratio during the nephrotic phase was significantly correlated with serum T3, T4, and free T4 levels (r=-0.5995, P=0.0032; r=-0.5797, P=0.0047; r=-0.5513, P=0.0078) as well as with TSH levels (r=0.5022, P=0.0172). A significant correlation was found between serum albumin and serum T3 levels during the nephrotic phase (r=0.5385, P=0.0018) but not between serum albumin and T4, TSH, or free T4 levels. These significant correlations all disappeared after remission.

Conclusion: Abnormal thyroid hormone profile findings were observed in 51.6% of pediatric patients with NS. Thyroid hormone levels normalized after remission, regardless of levothyroxine therapy.

目的:我们比较儿童肾病综合征(NS)在肾病期和缓解后的甲状腺激素谱。方法:本研究纳入31例小儿NS患者。甲状腺激素包括血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)和游离T4水平。结果:31例患者中,甲状腺激素异常16例(51.6%),其中明显甲状腺功能减退6例,亚临床甲状腺功能减退8例,低T3综合征2例。肾病期及缓解后血清T3、T4、游离T4均值分别为82.37±23.64、117.88±29.49 ng/dL、5.47±1.14、7.91±1.56µg/dL、1.02±0.26、1.38±0.23 ng/dL;结论:51.6%的小儿NS患者存在甲状腺激素异常。缓解后甲状腺激素水平恢复正常,无论左旋甲状腺素治疗。
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引用次数: 9
Iron status in small for gestational age and appropriate for gestational age infants at birth. 铁含量低于胎龄,适合胎龄婴儿出生。
Pub Date : 2019-03-01 Epub Date: 2018-10-24 DOI: 10.3345/kjp.2018.06653
Hyeon A Kim, Sook-Hyun Park, Eun Joo Lee

Purpose: This study compared the iron statuses of small for gestational age (SGA) and appropriate for gestational age (AGA) infants at birth.

Methods: The clinical data of 904 newborn infants admitted to the neonatal intensive care unit were reviewed. Blood samples were drawn from the infants within 24 hours after birth. Serum ferritin level was used as a marker of total iron status.

Results: In this study, 115 SGA (GA, 36.5±2.9 weeks; birth weight [BW], 1,975±594.5 g) and 717 AGA (GA, 35.1±3.5 weeks; BW, 2,420.3±768.7 g) infants were included. The SGA infants had higher hematocrit levels (50.6%±5.8% vs. 47.7%±5.7%, P<0.05) than the AGA infants. No difference in serum ferritin level (ng/mL) was found between the groups (mean [95% confidence interval]: SGA vs. AGA infants, 139.0 [70.0-237.0] vs. 141.0 [82.5-228.5]). After adjusting for gestational age, the SGA infants had lower ferritin levels (147.1 ng/mL [116.3-178.0 ng/mL] vs. 189.4 ng/mL [178.0-200.8 ng/ mL], P<0.05). Total body iron stores were also lower in the SGA infants than in the AGA infants (185.6 [153.4-211.7] vs 202.2 [168.7-241.9], P<0.05).

Conclusion: The SGA infants had lower ferritin and total body iron stores than the AGA infants. The SGA infants affected by maternal hypertension who were born at late preterm had an additional risk of inadequate iron store. Iron deficiency should be monitored in these infants during follow-up.

目的:本研究比较小胎龄(SGA)和适当胎龄(AGA)婴儿出生时的铁状况。方法:回顾性分析新生儿重症监护病房904例新生儿的临床资料。婴儿在出生后24小时内抽取血液样本。血清铁蛋白水平作为总铁状态的标志。结果:本研究中,115例SGA (GA, 36.5±2.9周;出生体重[BW], 1975±594.5 g)和717 AGA (GA, 35.1±3.5周);新生儿体重,2420.3±768.7 g)。SGA患儿红细胞压积(50.6%±5.8%)高于AGA患儿(47.7%±5.7%)。结论:SGA患儿的铁蛋白含量和体内总铁储量低于AGA患儿。受母亲高血压影响的晚期早产SGA婴儿有铁储存不足的额外风险。在随访期间应监测这些婴儿的缺铁情况。
{"title":"Iron status in small for gestational age and appropriate for gestational age infants at birth.","authors":"Hyeon A Kim,&nbsp;Sook-Hyun Park,&nbsp;Eun Joo Lee","doi":"10.3345/kjp.2018.06653","DOIUrl":"https://doi.org/10.3345/kjp.2018.06653","url":null,"abstract":"<p><strong>Purpose: </strong>This study compared the iron statuses of small for gestational age (SGA) and appropriate for gestational age (AGA) infants at birth.</p><p><strong>Methods: </strong>The clinical data of 904 newborn infants admitted to the neonatal intensive care unit were reviewed. Blood samples were drawn from the infants within 24 hours after birth. Serum ferritin level was used as a marker of total iron status.</p><p><strong>Results: </strong>In this study, 115 SGA (GA, 36.5±2.9 weeks; birth weight [BW], 1,975±594.5 g) and 717 AGA (GA, 35.1±3.5 weeks; BW, 2,420.3±768.7 g) infants were included. The SGA infants had higher hematocrit levels (50.6%±5.8% vs. 47.7%±5.7%, P<0.05) than the AGA infants. No difference in serum ferritin level (ng/mL) was found between the groups (mean [95% confidence interval]: SGA vs. AGA infants, 139.0 [70.0-237.0] vs. 141.0 [82.5-228.5]). After adjusting for gestational age, the SGA infants had lower ferritin levels (147.1 ng/mL [116.3-178.0 ng/mL] vs. 189.4 ng/mL [178.0-200.8 ng/ mL], P<0.05). Total body iron stores were also lower in the SGA infants than in the AGA infants (185.6 [153.4-211.7] vs 202.2 [168.7-241.9], P<0.05).</p><p><strong>Conclusion: </strong>The SGA infants had lower ferritin and total body iron stores than the AGA infants. The SGA infants affected by maternal hypertension who were born at late preterm had an additional risk of inadequate iron store. Iron deficiency should be monitored in these infants during follow-up.</p>","PeriodicalId":17863,"journal":{"name":"Korean Journal of Pediatrics","volume":"62 3","pages":"102-107"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3345/kjp.2018.06653","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36617953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Lymphocyte-monocyte ratio at day 14 of first cisplatin-doxorubicin chemotherapy is associated with treatment outcome of pediatric patients with localized osteosarcoma. 首次顺铂-阿霉素化疗第14天的淋巴细胞-单核细胞比率与局限性骨肉瘤儿童患者的治疗结果相关。
Pub Date : 2019-02-01 Epub Date: 2018-10-01 DOI: 10.3345/kjp.2018.06618
Jun Ah Lee, Hea Lin Oh, Dong Ho Kim, Jung Sub Lim

Purpose: We aimed to determine the prognostic significance of lymphocyte counts and the lymphocytemonocyte ratio (LMR) in pediatric patients with osteosarcoma.

Methods: We retrospectively reviewed the medical records of 27 pediatric patients with localized extremity osteosarcoma, treated at the Korea Cancer Center Hospital between May 2002 and March 2016. Leukocyte counts and LMR before treatment and on day 14 (LMR14) of the first cisplatin-doxorubicin chemotherapy round were evaluated. Patients were dichotomized according to the median value of these parameters, and survival rates were compared.

Results: The median age of the 27 patients was 9.9 years (range, 3.2-14.1 years) and tumor sites were: distal femur (n=14), proximal humerus (n=7), proximal tibia (n=2), proximal fibula (n=2), and elsewhere (n=2). Patients were followed up on for a median of 76.4 months (range, 4.5-174.7 months), and 5-year overall (OS) and event-free survival (EFS) rates were 66.0%±9.8% and 60.9%±9.7%, respectively. Patients with a higher pretreatment lymphocyte count (≥2,320/μL) had better OS (90.9% vs. 46.2%, P=0.04) and EFS (83.9% vs. 38.5%, P=0.02). However, the day 14 lymphocyte count was not associated with survival. While no survival difference was observed between patients grouped according to pretreatment LMR (median value, 6.3), patients with a higher LMR14 (≥5) fared better than those with lower LMR14 (5-year OS: 83.3% vs. 46.3%, P=0.04).

Conclusion: Pretreatment lymphocyte count and LMR during chemotherapy had prognostic significance in pediatric osteosarcoma patients. Further studies involving larger cohorts are necessary to validate our findings.

目的:探讨小儿骨肉瘤患者淋巴细胞计数和淋巴细胞比值(LMR)的预后意义。方法:回顾性分析2002年5月至2016年3月在韩国癌症中心医院治疗的27例小儿局限性肢体骨肉瘤患者的医疗记录。评估治疗前和第一轮顺铂-阿霉素化疗第14天的白细胞计数和LMR (LMR14)。根据这些参数的中位数对患者进行二分类,并比较生存率。结果:27例患者的中位年龄为9.9岁(范围3.2-14.1岁),肿瘤部位为:股骨远端(n=14)、肱骨近端(n=7)、胫骨近端(n=2)、腓骨近端(n=2)和其他部位(n=2)。患者的中位随访时间为76.4个月(范围4.5-174.7个月),5年总生存率(OS)和无事件生存率(EFS)分别为66.0%±9.8%和60.9%±9.7%。预处理淋巴细胞计数较高(≥2320 /μL)的患者有较好的OS(90.9%比46.2%,P=0.04)和EFS(83.9%比38.5%,P=0.02)。然而,第14天淋巴细胞计数与存活率无关。虽然根据预处理LMR分组的患者之间没有观察到生存差异(中位数为6.3),但LMR14较高(≥5)的患者的生存状况优于LMR14较低的患者(5年OS: 83.3% vs. 46.3%, P=0.04)。结论:化疗前淋巴细胞计数及LMR对小儿骨肉瘤患者预后有重要意义。需要更多的研究来验证我们的发现。
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引用次数: 2
Drug eruption by antihistamine mistaken for chronic urticaria in a child. 儿童抗组胺药疹误诊为慢性荨麻疹。
Pub Date : 2019-02-01 Epub Date: 2018-10-30 DOI: 10.3345/kjp.2018.06695
Gun Moo Lee, Shou-Yu Chu, Sung Yeon Kang, Hyo-Bin Kim, Jin-Sung Park, Ja Kyoung Kim

Although rare, antihistamines can cause adverse effects, including drug-induced eruptions or anaphylaxis. A 4-year-old child visited the pediatric department of a hospital for skin eruptions after administration of antihistamines, (e.g., ucerax [hydroxyzine] or leptizine [levocetirizine]), for cholinergic rashes; he did not have pruritus. Skin prick, intradermal, and drug provocation tests were performed to determine the relationship between the antihistamines and eruptions. Levocetirizine induced wheals in the skin prick test and a rash in the oral drug provocation test. In contrast, ketotifen induced no reaction in the skin prick test but showed a positive reaction in the oral provocation test. Our case report highlights that children can experience the same types of adverse reactions as seen in adults, and cross-reactivity between various antihistamines can occur.

虽然罕见,抗组胺药可引起不良反应,包括药物引起的皮疹或过敏反应。一名4岁儿童因胆碱能性皮疹服用抗组胺药(如ucerax[羟嗪]或leptizine[左西替利嗪])后皮肤出疹而到医院儿科就诊;他没有瘙痒。皮肤点刺,皮内和药物激发试验,以确定抗组胺药和皮疹之间的关系。左西替利嗪在皮肤点刺试验中引起皮疹,在口服药物激发试验中引起皮疹。酮替芬在皮肤点刺试验中无反应,而在口服激发试验中有阳性反应。我们的病例报告强调,儿童可能经历与成人相同类型的不良反应,各种抗组胺药之间可能发生交叉反应。
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引用次数: 1
Serum alanine aminotransferase levels are closely associated with metabolic disturbances in apparently healthy young adolescents independent of obesity. 血清丙氨酸转氨酶水平与代谢紊乱密切相关在明显健康的青少年独立于肥胖。
Pub Date : 2019-02-01 Epub Date: 2018-11-23 DOI: 10.3345/kjp.2018.06639
Ki Eun Kim, Kyung Suk Baek, Sol Han, Jung Hyun Kim, Youn Ho Shin
Purpose Liver metabolism plays a pivotal role in the development of metabolic disorders. We aimed to investigate the clinical and laboratory risk factors associated with alanine aminotransferase (ALT) levels in young adolescents from an urban population in Korea. Methods A population of 120 apparently healthy adolescents aged 12–13 years was included in the cross-sectional design study; 58 were overweight or obese and 62 were of normal weight. We estimated anthropometric and laboratory measurements, including waist-to-height ratio, blood pressure, insulin sensitivity, aspartate aminotransferases (AST), ALT, and lipid profiles. Results The mean ages of the overweight or obese and normal weight participants were 12.9±0.3 and 13.0±0.3 years, respectively. Height, weight, body mass index, waist circumference, waist-to-height ratio, systolic and diastolic blood pressure, AST, ALT, total cholesterol, low-density lipoprotein-cholesterol, triglyceride, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR) score were significantly higher and the high-density lipoprotein-cholesterol and quantitative insulin-sensitivity check index were significantly lower in the overweight/obese participants in comparison to the normal-weight participants (all P<0.05). In multivariate linear regression analysis, waist-to-height ratio, systolic blood pressure, and HOMA-IR score were independently and positively associated with serum ALT levels. Conclusion Screening for ALT levels in adolescents may help to differentiate those at risk of metabolic abnormalities and thus prevent disease progression at an early age.
目的:肝脏代谢在代谢性疾病的发生发展中起着关键作用。我们的目的是调查韩国城市青少年中与谷丙转氨酶(ALT)水平相关的临床和实验室危险因素。方法:采用横断面设计研究,选取120例12 ~ 13岁表面健康的青少年;其中58人超重或肥胖,62人体重正常。我们估计了人体测量和实验室测量,包括腰高比、血压、胰岛素敏感性、天冬氨酸转氨酶(AST)、ALT和脂质谱。结果:超重或肥胖和正常体重参与者的平均年龄分别为12.9±0.3岁和13.0±0.3岁。身高、体重、体重指数、腰围、腰高比、收缩压和舒张压、AST、ALT、总胆固醇、低密度脂蛋白-胆固醇、甘油三酯、胰岛素、超重/肥胖受试者的胰岛素抵抗稳态模型评估(HOMA-IR)评分显著高于正常体重受试者,高密度脂蛋白-胆固醇和定量胰岛素敏感性检查指数显著低于正常体重受试者。结论:筛查青少年ALT水平有助于区分代谢异常风险,从而在早期预防疾病进展。
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引用次数: 2
Renal replacement therapy in neonates with an inborn error of metabolism. 有先天性代谢缺陷的新生儿肾脏替代治疗。
Pub Date : 2019-02-01 Epub Date: 2018-11-07 DOI: 10.3345/kjp.2018.07143
Heeyeon Cho

Hyperammonemia can be caused by several genetic inborn errors of metabolism including urea cycle defects, organic acidemias, fatty acid oxidation defects, and certain disorders of amino acid metabolism. High levels of ammonia are extremely neurotoxic, leading to astrocyte swelling, brain edema, coma, severe disability, and even death. Thus, emergency treatment for hyperammonemia must be initiated before a precise diagnosis is established. In neonates with hyperammonemia caused by an inborn error of metabolism, a few studies have suggested that peritoneal dialysis, intermittent hemodialysis, and continuous renal replacement therapy (RRT) are effective modalities for decreasing the plasma level of ammonia. In this review, we discuss the current literature related to the use of RRT for treating neonates with hyperammonemia caused by an inborn error of metabolism, including optimal prescriptions, prognosis, and outcomes. We also review the literature on new technologies and instrumentation for RRT in neonates.

高氨血症可由几种遗传先天性代谢缺陷引起,包括尿素循环缺陷、有机酸血症、脂肪酸氧化缺陷和某些氨基酸代谢紊乱。高浓度的氨对神经有极大的毒性,会导致星形胶质细胞肿胀、脑水肿、昏迷、严重残疾,甚至死亡。因此,对高氨血症的紧急治疗必须在确定准确诊断之前开始。对于由先天代谢错误引起的高氨血症新生儿,一些研究表明,腹膜透析、间歇性血液透析和持续肾替代治疗(RRT)是降低血浆氨水平的有效方式。在这篇综述中,我们讨论了目前有关使用RRT治疗由先天代谢错误引起的新生儿高氨血症的文献,包括最佳处方、预后和结果。我们还回顾了有关新生儿RRT新技术和仪器的文献。
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引用次数: 9
期刊
Korean Journal of Pediatrics
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