Removal of Blunt Esophageal Foreign Body Using Foley Catheter in Children

Purpose Foreign body ingestion is a common cause for children to visit the emergency department. Removal of esophageal foreign body was usually done by an endoscopy. After Bigler introduced the Foley catheter technique for esophageal foreign body in 1966, many studies were performed regarding such technique. However, only a few researchers in Korea have attempted to report this technique. This study reports a 10-year experience of the Foley catheter removal method for blunt esophageal foreign body at a single center in Korea. Methods Medical records of patients who were treated as esophageal foreign body with Foley catheters between March 2005 and February 2015 were retrospectively reviewed. Their clinical characteristics and outcomes were evaluated. Results A total of 73 patients were treated as esophageal foreign body impaction using the Foley catheter method. Foreign body removals were successful in 67 (91.8%) cases. Six failed cases were treated with esophagoscopy or endoscopy. The mean age was 3.7 years old. The most common foreign body was a coin (80.8%). Foreign bodies were lodged at the upper esophagus level most frequently (79.5%), followed by the middle esophagus (12.3%) and the lower esophagus (6.8%). During the removal procedure, 43.8% of patients were sedated, and 95.9% were treated with fluoroscopy. There were no positive correlations between the removal success and sedation (P=0.54) or using a fluoroscopy (P=0.23). In 69 cases (94.5%), there were no serious complications. However, in one patient, complications, such as vomiting, fever, and esophageal ulceration were observed. One patient complained fever and esophageal ulceration. In 3 (60%) of the total 5 patients with button battery ingestion, serious complications, such as fever or esophageal ulceration, occurred. Conclusion Removal of blunt esophageal foreign body using a Foley catheter in children is a useful and relatively safe method. However, patients with button battery ingestion need more attention when trying the Foley catheter removal technique

Comparisons of Pediatric Patients who Visited to the Pediatric Emergency Department and the General Emergency Department

Purpose In 2010 and 2011, the Korean Ministry of Health and Welfare designated 2 and 4 Pediatric Emergency Centers, respectively. This study was conducted to examine the characteristics of pediatric patients who visited the pediatric emergency department (PED) compared with the general emergency department (GED). Methods We used the National Emergency Medical Department Information System (NEDIS) data on pediatric visits (<19 years old), from July 1 to December 31, 2011. We analyzed patients' general characteristics, number, severity, and length of stay (LOS). Results A total of 709,050 children visited 132 GEDs and 6 PEDs during the study period. Male patients of PED was 57.6%, and the mean age of PED was younger than GED (4.7±5.0 yr vs. 5.7±5.5 yr). There were more numbers of patient visitations per center, number of critically ill or injured patients per center, number of admitted patients per center, and the number of operation per center in PED than GED. LOS of overall, discharged, and transferred patients was the same between PED and GED; however, LOS of admitted patients was longer in PED. Conclusion We observed that PEDs did not function as a tertiary referral center. Further research is needed to find the reason for such phenomenon and provide possible solutions

Therapeutic genome editing for Charcot-marie-tooth disease type 1a

Charcot-Marie-Tooth 1A (CMT1A) is the most common inherited neuropathy without a known therapy, which is caused by a 1.4 Mb duplication on human chromosome 17, which includes the gene encoding the peripheral myelin protein of 22 kDa (PMP22). Overexpressed PMP22 protein from its gene duplication is thought to cause demyelination and subsequently axonal degeneration in the peripheral nervous system (PNS). Here, we targeted regulatory region of human PMP22 to normalize overexpressed PMP22 level in C22 mice, a mouse model of CMT1A harboring multi copies of human PMP22. Direct local intraneural delivery of CRISPR/Cas9 designed to target TATA-box of PMP22 before the onset of disease, downregulates gene expression of PMP22 and preserves both myelin and axons. Notably, the same approach was effective in partial rescue of demyelination even after the onset of disease. Collectively, our data present a potential therapeutic efficacy of CRISPR/Cas9-mediated targeting of regulatory region of PMP22 to treat CMT1A. Please click Additional Files below to see the full abstract

Hypermethylation of p16INK4a in Korean Non-small Cell Lung Cancer Patients

Promoter hypermethylation of the p16INK4a gene was investigated in 81 sets of samples of tumor tissue and adjacent normal tissue from Korean patients with primary lung cancer, using the modified real-time polymerase chain reaction (PCR)/ SYBR Green detection method. The results showed hypermethylation of p16INK4a in 27.2% of tumor tissues, and in 11.1% of adjacent normal tissue. No significant association was found between the overall aberrant methylation in tumor and corresponding normal specimens (r=0.137, p=0.219). In 22 cases with p16INK4a hypermethylation in tumor tissues, only 4 (18.1%) cases were found to have a hypermethylated normal tissue specimen. The findings of this study show that smoking can influence the methylation level of the promoter region of p16INK4a, and that this occurs in tumor tissues more frequently than in normal tissues. Other clinicopathological characteristics, including age, sex, tumor stage, and histologic type were not found to be correlated with p16INK4a methylation

Relationship between insulin resistance, obesity and serum prostate-specific antigen levels in healthy men

Abstract The purpose of this study was to determine the relationship between insulin resistance, obesity and serum prostate-specific antigen (PSA) levels in healthy men with serum PSA level below 4 ng mL -1 . The men included in the study cohort were 11 827 healthy male employees of the Korea Hydro and Nuclear Power Co., LTD who had undergone medical checkups including fasting glucose, fasting insulin and serum PSA between January 2003 and December 2008. Insulin resistance was calculated by homeostasis model assessment (HOMA [fasting glucose × fasting insulin]/22.5) and quantitative insulin sensitivity check index (QUICKI; 1/[log (fasting insulin) + log (fasting glucose)]). Age-adjusted body mass index (BMI) was significantly increased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI, respectively, in analysis of variance (ANOVA) test and Duncan&apos;s multiple comparison test (P &lt; 0.001), but age-adjusted serum PSA concentration was significantly decreased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI (P &lt; 0.001). Age, BMI, insulin resistance by HOMA or QUICKI were significantly independent variables to serum PSA level in a multivariate linear regression analysis (P &lt; 0.001). Insulin resistance was a significant independent variable to serum PSA level along with BMI. Insulin resistance and BMI were negatively correlated with serum PSA level in healthy men. Insulin resistance was positively correlated with BMI

Spinal Cord Injury Markedly Altered Protein Expression Patterns in the Affected Rat Urinary Bladder during Healing Stages

The influence of spinal cord injury (SCI) on protein expression in the rat urinary bladder was assessed by proteomic analysis at different time intervals post-injury. After contusion SCI between T9 and T10, bladder tissues were processed by 2-DE and MALDI-TOF/MS at 6 hr to 28 days after SCI to identify proteins involved in the healing process of SCI-induced neurogenic bladder. Approximately 1,000 spots from the bladder of SCI and sham groups were visualized and identified. At one day after SCI, the expression levels of three protein were increased, and seven spots were down-regulated, including heat shock protein 27 (Hsp27) and heat shock protein 20 (Hsp20). Fifteen spots such as S100-A11 were differentially expressed seven days post-injury, and seven proteins including transgelin had altered expression patterns 28 days after injury. Of the proteins with altered expression levels, transgelin, S100-A11, Hsp27 and Hsp20 were continuously and variably expressed throughout the entire post-SCI recovery of the bladder. The identified proteins at each time point belong to eight functional categories. The altered expression patterns identified by 2-DE of transgelin and S100-A11 were verified by Western blot. Transgelin and protein S100-A11 may be candidates for protein biomarkers in the bladder healing process after SCI

Clinical practice guideline for the diagnosis and treatment of pediatric obesity: recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery

Cetaceans evolution:insights from the genome sequences of common minke whales

Background: Whales have captivated the human imagination for millennia. These incredible cetaceans are the only mammals that have adapted to life in the open oceans and have been a source of human food, fuel and tools around the globe. The transition from land to water has led to various aquatic specializations related to hairless skin and ability to regulate their body temperature in cold water. Results: We present four common minke whale (Balaenoptera acutorostrata) genomes with depth of ×13 ~ ×17 coverage and perform resequencing technology without a reference sequence. Our results indicated the time to the most recent common ancestors of common minke whales to be about 2.3574 (95% HPD, 1.1521 - 3.9212) million years ago. Further, we found that genes associated with epilation and tooth-development showed signatures of positive selection, supporting the morphological uniqueness of whales. Conclusions: This whole-genome sequencing offers a chance to better understand the evolutionary journey of one of the largest mammals on earth