IntroductionLeft ventricular hypertrophy and diastolic dysfunction in children and adolescents with essential hypertension tend to be underdiagnosed. The aims of this study were to investigate left ventricular hypertrophy and diastolic dysfunction in the subjects with essential hypertension defined by ambulatory blood pressure monitoring.MethodsA total of 38 Korean subjects aged 9–19 years without secondary causes of hypertension were reviewed. Ambulatory blood pressure monitoring was done in the 38 subjects to diagnose hypertension and gain the information of blood pressure pattern. The subjects were divided into two groups: a group with elevated blood pressure (BP) index (n = 29) and a group with normal BP index (n = 9). Two-dimensional ultrasound with M-mode imaging and tissue Doppler imaging were performed to measure left ventricular mass index and to assess the left ventricular diastolic dysfunction.ResultsLeft ventricular mass index(g/m2.7) was significantly higher in the group with elevated BP index than the group with normal BP index, but there were no differences in left ventricular diastolic dysfunction evaluated by E/A ratio and E/E’ ratio. Left ventricular mass index was related only with body mass index, while any of the ambulatory blood pressure monitoring parameters did not predict left ventricular hypertrophy. In terms of diastolic dysfunction in essential hypertension, E/E’ ratio in the subjects with left ventricular hypertrophy was higher than that in the other subjects without left ventricular hypertrophy.DiscussionLeft ventricular mass index is significantly correlated with body mass index in children and adolescents with essential hypertension, and the diastolic dysfunction could be in higher risk in subjects with left ventricular hypertrophy.
We evaluated whether blind subjects have advantages in auditory spectral resolution, temporal resolution, and speech perception in noise compared with sighted subjects. We also compared psychoacoustic performance between early blind (EB) subjects and late blind (LB) subjects. Nineteen EB subjects, 16 LB subjects, and 20 sighted individuals were enrolled. All subjects were right-handed with normal and symmetric hearing thresholds and without cognitive impairments. Three psychoacoustic measurements of the subjects’ right ears were performed via an inserted earphone to determine spectral-ripple discrimination (SRD), temporal modulation detection (TMD), and speech recognition threshold (SRT) in noisy conditions. Acoustic change complex (ACC) responses were recorded during passive listening to standard ripple-inverted ripple stimuli. EB subjects exhibited better SRD than did LB (p = 0.020) and sighted (p = 0.003) subjects. TMD was better in EB (p < 0.001) and LB (p = 0.007) subjects compared with sighted subjects. SRD was positively correlated with the duration of blindness (r = 0.386, p = 0.024). Acoustic change complex data for ripple noise change at the Cz and Fz electrodes showed trends toward significant correlations with the behavioral results. In conclusion, compared with sighted subjects, EB subjects showed advantages in terms of auditory spectral and temporal resolution, while LB subjects showed an advantage in temporal resolution exclusively. These findings suggest that it might take longer for auditory spectral resolution to functionally enhance following visual deprivation compared to temporal resolution. Alternatively, a critical period of very young age may be required for auditory spectral resolution to improve following visual deprivation.
PurposeTranscatheter device closure of patent ductus arteriosus (PDA) is challenging in early infancy. We evaluated PDA closure in infants less than 6 months old.MethodsWe performed a retrospective review of infants less than 6 months of age who underwent attempted transcatheter device closure in our institution since 2004. To compare clinical outcomes between age groups, infants aged 6–12 months in the same study period were reviewed.ResultsA total of 22 patients underwent transcatheter PDA closure during the study period. Patient mean age was 3.3±1.5 months, and weight was 5.7±1.3 kg. The duct diameter at the narrowest point was 3.0±0.8 mm as measured by angiography. The most common duct type was C in the Krichenko classification. Procedural success was achieved in 19 patients (86.3%). Major complications occurred in 5 patients (22.7%), including device embolization (n=1), acquired aortic coarctation (n=2), access-related vascular injury requiring surgery (n=1), and acute deterioration requiring intubation during the procedure (n=1). Two patients had minor complications (9.1%). Twenty-four infants aged 6–12 months received transcatheter device closure. The procedural success rate was 100%, and there were no major complications. The major complication rate was significantly higher in the group less than 6 months of age (P=0.045). There was a trend toward increased major complication and procedural failure rates in the younger age group (P<0.01).ConclusionA relatively higher incidence of major complications was observed in infants less than 6 months of age. The decision regarding treatment modality should be individualized.
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