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Messages from the Aalst Allergy Study
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Dirk Van Gysel, Elke Govaere, Katia M.C. Verhamme, Erenik Doli, Frans De Baets |
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Background: The prevalence of sensitization and allergic disease has increased significantly worldwide. The aim of the "Aalst Allergy Study" was to document prevalences of sensitization and allergic symptoms, and to evaluate the effect of personal and environmental influences on these prevalences in an unbiased Belgian pediatric population.
Methods: A cross-sectional study was performed in an unbiased population of 2021 Belgian schoolchildren (3.4-14.8 years). Skin prick testing with the most common aeroallergens was performed. Allergic symptoms as well as potential risk factors for sensitization and allergic disease were documented by a parental questionnaire.
Results: The prevalence of sensitization to the most common aeroallergens and the prevalence of allergic diseases (eczema, asthma and rhinoconjunctivitis) were in line with the data in the literature. The association of current allergic symptoms with sensitization was only significant in the children aged ≥6 years. Age, gender, body mass index, bedroom environment and exposure to pets were the factors significantly associated with sensitization and allergic symptoms.
Conclusions: Our study corroborates the reported prevalences of sensitization and allergic diseases. Moreover the study illustrates the complexity of the search for factors involved in the process of sensitization and allergic disease. The impact of different potential causative factors is not only influenced by mutual interactions of these factors, but also by the existence of distinct subtypes of disease.
Key words: Aalst Allergy Study; allergic symptoms; risk factors; sensitization; skin prick test
World J Pediatr 2009;5(3):182-190 |
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[Abstract] [Full Text] [PDF]
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Airway foreign body removal by flexible bronchoscopy: experience with 1027 children during 2000-2008
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Lan-Fang Tang, Ying-Chun Xu, Ying-Shuo Wang, Cai-Fu Wang, Guo-Hong Zhu, Xing-Er Bao, Mei-Ping Lu, Lian-Xiang Chen, Zhi-Min Chen |
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Background: Foreign body aspiration (FBA) into the tracheobronchial tree is a common problem in children necessitating prompt recognition and management. This study aimed to report our experience in airway foreign body removal by flexible bronchoscopy in children.
Methods: A total of 1027 patients with FBA were reviewed retrospectively. They were 626 boys and 401 girls aged from 5 months to 14 years with a median age of 17 months. The clinical manifestations, radiological findings, bronchoscopic findings and complications of the procedure were analyzed.
Results: Among the patients, only 53.4% had a definite history of FBA. The most frequent symptom was paroxysmal cough (84.3%), followed by stridor or wheezing, fever and dyspnea. Chest X-ray showed emphysema in 68.8% of the patients, atelectasis in 13.3% and bronchopneumonia in 56.3%. A bronchoscope was inserted intranasally in most children, but through mouth and endotracheal tube in 17 and 3 children, respectively. Foreign bodies were removed successfully by flexible bronchoscopy with disposable grasping forceps or biopsy forceps in 938 (91.3%) of the patients. The other 89 patients turned to rigid bronchoscopy. During the procedures, 132 (12.9%) of the patients showed transient hypoxia, which was alleviated by oxygen supplement and/or temporary cessation of the procedure. A small amount of bleeding was found in 17 patients and bradycardia in 3. Air leak and laryngeal edema were noted in 2 patients and relieved within 24 hours.
Conclusions: Flexible bronchoscopy is useful and safe in retrieving airway foreign bodies in children. With skilled personnel and perfect equipments, flexible bronchoscopy could be considered as the first choice for the removal of airway foreign body.
Key words: child; flexible bronchoscopy; foreign body; safety
World J Pediatr 2009;5(3):191-195 |
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[Abstract] [Full Text] [PDF]
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EEG and MRI findings and their relation with intellectual disability in pervasivedevelopmental disorders
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Özlem Ünal, Özlem Özcan, Özgür Öner, Melda Akcakin, Ayla Aysev, Gülhis Deda |
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Background: The diagnostic category pervasive developmental disorders (PDDs) refer to a group of five disorders: autism, Rett syndrome, childhood disintegrative disorder, Asperger syndrome, and pervasive developmental disorder not otherwise specified (PDD-NOS). EEG abnormalities and seizures are considered much frequent in autistic subjects with comorbid intellectual disability (ID). In this study, we aimed to evaluate the EEG and MRI findings and their relation with ID in pervasive developmental disorder.
Methods: A retrospective, cross-sectional and non-experimental study was performed. Subjects included 81 patients diagnosed with autism or PDD-NOS according to the DSM-IV criteria. The age range of the patients was 2-15 years (mean 6.6 years, SD 3.0). Among them, 21 (25.9%) were girls and 60 boys (74.1%).
Results: Patients with severe ID had a higher rate of EEG abnormalities (P=0.03) than patients without ID as well as patients with mild or moderate ID. The association remained significant after the structural MRI abnormalities were controlled (P=0.04). The severity of ID was not associated with abnormal MRI. The most frequent EEG and MRI abnormalities were active epileptic anomaly/paroxysmal abnormality and cerebral atrophy/periventricular leukomalacia, respectively. Almost a third of the EEG abnormalities were associated with temporal cortex and adjacent cortical structures.
Conclusions: Consistent with previous studies, almost a fourth of the patients in this relatively large sample of patients with pervasive developmental disorders had EEG and/or MRI abnormalities. EEG results indicate that temporal cortex may play a significant role in pervasive developmental disorders.
Key words: autism; electroencephalography; magnetic resonance imaging; pervasive developmental disorders
World J Pediatr 2009;5(3):196-200 |
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[Abstract] [Full Text] [PDF]
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Detection of intestinal bifidobacteria and lactobacilli in patients with Hirschsprung's disease associated enterocolitis
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Di-Hua Shen, Cheng-Ren Shi, Jing-Jing Chen, Shi-Yao Yu, Yan Wu, Wen-Bo Yan |
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Author Affiliations: Department of Pediatric Surgery, Xin Hua Hospital, School of Medicine, Shanghai JiaoTong University, 1665 Kongjiang Road, Shanghai 200092, China (Shen DH, Shi CR, Chen JJ, Yu SY, Wu Y, Yan WB)
Corresponding Author: Cheng-Ren Shi, Department of Pediatric Surgery, Xin Hua Hospital, School of Medicine, Shanghai JiaoTong University, 1665 Kongjiang Road, Shanghai 200092, China (Tel: 86-21-65790000 ext 8285; Fax: 86-21-65795173; Email: shicr629@163.com)
doi:10.1007/s12519-009-0038-x
Background: The etiology of Hirschsprung's disease associated enterocolitis (HAEC) is unknown. Previous investigations have suggested that several factors such as dilation of proximal bowel, changes in colonic mucosal defence, and overgrowth of toxigenic bacteria may be related with it. This study was to quantify bifidobacteria and lactobacilli in the feces of Hirschsprung's disease (HD) patients with or without enterocolitis and those of normal children.
Methods: Fresh stool specimens were collected at the first three days of the admission from 30 HD patients (aged 2 weeks to 2 years) and 15 healthy age- matched non-HD patients in the morning once a day for at least three days. All of them have not been given probiotics or antibiotics at least 7 days before stool collection. Hematoxylin-eosin and acetylcholinesterase histochemical staining on rectal biopsies of patients with HD confirmed the diagnosis of HD in all 30 patients. The 30 HD patients were divided into two groups based on the clinical history of enterocolitis: the HAEC group (n=10) and HD group (n=20). Fecal bifidobacteria and lactobacilli were consecutively quantified by SYBR Green I-based real-time PCR assay. Data were analyzed using SAS v. 12.6 for Windows. All tests were two-tailed, and P values <0.05 were considered statistically significant.
Results: The mean levels of bifidobacteria were 7.35±0.59, 8.16±1.17, and 8.35±0.74 in the HAEC, HD and control groups, respectively. The bifidobacteria colonization levels were lower in the HAEC group than in the HD and control groups (P<0.05, P<0.001 respectively). The mean level of lactobacilli in the HAEC (5.51±0.65) and HD groups (5.87±0.78) was significantly lower than that in the control group (6.39±0.56) (P<0.05). But there was no difference in log numbers of lactobacilli between HAEC and HD groups (P>0.05).
Conclusions: The scarcity of bifidobacteria and lactobacilli in HAEC patients may result in a decrease in epithelial barrier function and be a predisposing factor in the development of HAEC. This decline suggests that treatment with probiotics or prebiotics may be beneficial in these individuals. Further research will focus on whether probiotics can decrease the incidence of HAEC.
Key words: bifidobacteria; enterocolitis; Hirschsprung's disease; lactobacilli
World J Pediatr 2009;5(3):201-205 |
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[Abstract] [Full Text] [PDF]
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Expression and clinical significance of heparanase in neuroblastoma
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Li-Duan Zheng, Qiang-Song Tong, Shao-Tao Tang, Zhi-Yong Du, Yuan Liu,Guo-Song Jiang, Jia-Bin Cai |
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Author Affiliations: Department of Pathology (Zheng LD) and Department of Pediatric Surgery (Tong QS, Tang ST, Du ZY, Liu Y, Jiang GS, Cai JB), Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Corresponding Author: Qiang-Song Tong, PhD, MD, Department of Pediatric Surgery, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China (Tel: 86-27-63776478; Email: qs_tong@hotmail.com)
doi:10.1007/s12519-009-0039-9
Background: Previous studies indicate that heparanase (HPA), an endoglycosidase involved in tumor angiogenesis and metastasis, is up-regulated in a variety of malignancies. However, the expression of HPA in neuroblastoma (NB), one of the most common extra cranial solid tumors in children, remains unknown. This study was undertaken to explore the expression and clinical significance of HPA in NB.
Methods: Immunohistochemical staining was applied to detect the expression of HPA in 42 cases of NB. The relationships among HPA expression, international neuroblastoma staging system (INSS) stages, histopathological classification, and postoperative survival of the NB patients were analyzed.
Results: The expression rate of HPA in NB was 61.9% (26/42), mainly in the cytoplasm of neuroblastoma cells. The expression rates of stage 1-2, stage 3-4 and stage 4S were 35.7%, 80.0% and 62.5%, respectively. The differences between stage 1-2 and stage 3-4 were significant (P<0.01). The expression of HPA was significantly higher in the NB cases that had one of the histopathological factors: age more than 1 year (P<0.01), poorer differentiation (P<0.01), and higher mitosis karyorrhexis index (P<0.01). The survival time of HPA-negative patients was significantly longer than that of HPA-positive patients (P<0.05).
Conclusion: Although these results indicate that heparanase might be correlated with development and progression of NB, a larger series of patients with a longer follow-up are probably needed to strengthen its role in assessment of NB prognosis.
Key words: heparanase; neuroblastoma; risk; survival
World J Pediatr 2009;5(3):206-210 |
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[Abstract] [Full Text] [PDF]
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Expression and significance of TGF-β1/Smad signaling pathway in children with IgA nephropathy
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Wei Wu, Xiao-Yun Jiang, Qiao-Ling Zhang, Ying Mo, Liang-Zhong Sun, Shu-Mei Chen |
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Background: IgA nephropathy (IgAN) exhibits an indolent but slowly progressive course, and about 30% of children with IgAN are found to deteriorate to end-stage renal failure characterized by overaccumulation of extracellular matrix, diffuse glomerular sclerosis, and tubulointerstitial fibrosis. The TGF-β/Smad signaling pathway plays an important role in glomerulosclerosis and tubulointerstitial fibrosis. The present study aimed to elucidate the significance of expressions of TGF-β1, phosphorylated Smad3 (p-Smad3), Smad7 and fibronectin (FN) in the renal tissue of children with IgAN.
Methods: Forty-six children with IgAN were divided into 3 groups according to their clinical features: isolated hematuria group (IH group, 8 patients), hematuria and proteinuria group (HP group, 24), and nephritic syndrome group (NS group, 14). Patients were also divided into three groups according to their pathologic grade: grade I+II (22 patients), grade III (12) and grade IV (12) groups. Five normal renal specimens were used as the control group. The expression of TGF-β1, p-Smad3, Smad7 and FN in renal biopsy specimens was detected by two-step PowerVisionTM. The degrees of renal tubular injury and interstitial fibrosis were scored according to the Katafuchi semi-quantitative criteria.
Results: The expression of TGF-β1, p-Smad3, Smad7 and FN in children with IgAN was significantly higher than that in the control group (in glomeruli: P<0.05, P<0.01, P<0.05 and P<0.01, respectively; in tubulointerstitium: P<0.05, P<0.05, P<0.01 and P<0.05, respectively) and the highest expression levels were found in the NS and grade IV groups (P<0.05, P<0.01). The expression levels of the four proteins were not only positvely correlated with each other, but also with the grade of renal tubular injury and renal interstitial fibrosis (P<0.05).
Conclusion: The TGF-β1/Smad signaling pathway plays an important role in the progress of glomerular sclerosis, renal tubular injury and interstitial fibrosis in children with IgAN.
Key words: glomerulonephritis; IgA nephropathy; Smad protein; transforming growth factor
World J Pediatr 2009;5(3):211-215 |
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[Abstract] [Full Text] [PDF]
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Melatonin protects against oxidative damage in a neonatal rat model of bronchopulmonary dysplasia
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Li Pan, Jian-Hua Fu, Xin-Dong Xue, Wei Xu, Ping Zhou, Bing Wei |
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Author Affiliations: Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China (Pan L, Fu JH, Xue XD, Xu W, Wei B); Department of Pediatrics, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150086, China (Zhou P)
Corresponding Author: Xin-Dong Xue, MD, Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China (Tel: +86-24-83955509; Fax: +86-024-83955509; Email: xdxue@163.com)
doi:10.1007/s12519-009-0041-2
Background: Oxidative stress plays an important role in the pathogenesis of bronchopulmonary dysplasia (BPD). Melatonin (MT) has direct and indirect free radical detoxifying activity. The present study was to investigate whether treatment with MT would attenuate hyperoxia-induced lung injury and the effect of MT on imbalance of oxidants/antioxidants in the lung of neonatal rats.
Methods: BPD was induced by exposure to hyperoxia in neonatal rats (n=90). The rats were divided randomly into three groups (n=30 each): air-exposed control group, hyperoxia-exposed group, and hyperoxia-exposed MT-treated group. Lung specimens were obtained respectively on day 3, day 7, and day 14 after exposure (n=10 each). Activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT), and levels of myeloperoxidase (MPO), nitrite/nitrate, and malondialdehyde (MDA) were assayed. Histopathologic changes were observed in the tissues stained with hematoxylin and eosin and Masson's trichrome stain.
Results: Increased levels of MPO, nitrite/nitrate, and MDA in the hyperoxia-exposed rats were significantly reduced by MT (P<0.05). Activities of GSH-Px, SOD, and CAT which did not change after exposure to hyperoxia were increased by MT (P<0.05). Furthermore, BPD associated histopathological alterations such as reduced total number of alveoli and interstitial fibrosis were obviously abated in the MT-treated group.
Conclusions: MT can reverse oxidants/antioxidants imbalance in damaged lung tissue and thus exert a beneficial effect on hyperoxia-induced lung disease in neonatal rats. With regard to humans, there may be a protective effect of MT on BPD.
Key words: antioxidants; bronchopulmonary dysplasia; free radicals; lung damage;melatonin World J Pediatr 2009;5(3):216-221 |
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[Abstract] [Full Text] [PDF]
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Constitutional retinoblastoma gene deletion in Egyptian patients
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Amal M Mohammed, Alaa K Kamel, Saida A Hammad, Hanan H Afifi,Zeinab El Sanabary, Mostafa Ezz El Din |
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Author Affiliations: Department of Human Cytogenetics (Mohammed AM, Kamel AK, Hammad SA) and Department of Clinical Genetics (Afifi HH), National Research Centre, Cairo, Egypt; Department of Ophthalmology, Faculty of Medicine, Cairo University, Egypt (El Sanabary Z, Ezz El Din M)
Corresponding Author: Amal Mahmoud Mohamed, 33 El-Bohoos street, Department of Human Cytogenetics, Division of Human Genetics and Genome Research, National Research Centre, Dokki, 12311, Cairo, Egypt (Tel: +202-33389438; Fax: +202-33370931; Email: amalmahmoud15@yahoo.com)
doi:10.1007/s12519-009-0042-1
Background: Retinoblastoma is a neuroblastic tumor of childhood with an incidence of 1: 20 000. Retinoblastoma gene (Rb1) is a tumor suppressor gene that is located on the long arm of chromosome 13 at region 14. This study was to evaluate the constitutional monoallelic Rb1 deletion among retinoblastoma families.
Methods: Nine families with an affected Rb proband were evaluated. Clinical examination, pedigree analysis, and complete eye examination were given to patients, their sibs and parents. Standard cytogenetic and fluorescence in situ hybridization (FISH) analyses were carried out for all of them. Also, two sib fetuses were tested for Rb1 deletion.
Results: No dysmorphic features were detected in any patient. Developmental milestones were within normal limit except in one proband who had a mild delay. The age of onset ranged from one month to 4 years. Positive family history was found in two families. In one, the father and 3 sibs had retinoblastoma, and in the other, 2 sibs were affected, but the parents were free. Chromosomal study revealed no abnormalities in all parents and sibs. Two patients had mosaic chromosome 13 abnormalities, 46,XY/46,XY,del(13)(pter→q14:) and 46,XX/46,inv(13)(q14q22). FISH analysis detected mosaic Rb1 deletion in two patients and excluded Rb1 deletion in two fetuses.
Conclusions: The detection of genetic alterations affecting the Rb1 locus is important for the establishment of carriers, and prenatal and presymptomatic diagnosis. The search for deleted Rb1 mosaic cell lines is important for genetic counseling. Germline mutation may be considered as genetic transmission method of the Rb1 gene.
Key words: familial retinoblastoma; mosaic cell line; mutation; retinoblastoma gene (Rb1)
World J Pediatr 2009;5(3):222-225 |
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[Abstract] [Full Text] [PDF]
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