ABSTRACT
Since the introduction of Rh-immune globulin in 1968, the incidence of Rh D hemolytic disease of the newborn(HDN) had become markedly reduced but in the contrary the HDN by minor blood group antibodies has become increased relatively. As anti-E is the most common minor blood group antibody identified in antenatal serology and because of the frequency of E-negative people in Korea is ranged from 38.8% to 50.3%, the probability of HDN caused by anti-E is expected relatively high. We had experienced antenatal therapy for a E-isoimmunized pregnant woman, who has the history of one previous stillbirth and one neonatal death. In addition to above obstetric history, she had a history of blood transfusion, in which she was given 7 units of whole blood during the operation of brain cyst 7 years ago, before her marriage. Therapeutic plasma exchanges were repeated from the 22nd to 25th weaks of gestation. During the period a mean volume of 350mL plasma volume was exchanged on average twice a week. After the period, therapeutic plasma exchange procedure was failed because of unsuccessful vascular access. So that we gave her intravenous immunoglobulin(IVIG), 0.4gm/kg for 5 days, and two intrauterine transfusion were given at 25th and 27th weeks of gestation to relief from grave HDN. The maximal antiglobulin titer of anti-E during the gestation period was 1:32. In spite of intensive therapy as above mentioned, she was delivered a severely hydropic fetus weighing 1,900g at 29th weeks of gestation under Cesarean section. The neonate died 2 days after the birth with severe erythroblastosis fetalis and disseminated intravascular coagulation (DIC). Even though we could not save the baby, we report this experience as a reviewable case of antenatal treatment modalities for Rh immunization and the serious consequence of blood transfusion before marriage.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Antibodies , Blood Transfusion , Blood Transfusion, Intrauterine , Brain , Cesarean Section , Disseminated Intravascular Coagulation , Erythroblastosis, Fetal , Fetus , Immunization , Immunoglobulins, Intravenous , Incidence , Korea , Marriage , Parturition , Plasma Exchange , Plasma Volume , Plasma , Pregnant Women , StillbirthABSTRACT
No abstract available.
ABSTRACT
Although embryonal rhabdomyosarcoma has been frequently reported in genitourinary tract, head and neck, embryonal rhabdomyosarcoma of the biliary tree is an extremely rarte. It must be considered in differential diagnosis of jaundice in childhood. About 35 cases have been reported in world literatures, since first description on 1875, by Moxon and Wilks. We present a case of embryonal rhabdomyosarcoma of the biliary tree in a 25 months old boy with brief review of literatures. Since chief complaints of this case were jaundice and loss of appetite, the first clinical diagnosis was infectious hepatitis. On ultrasound examination, there is a space occupying lesion in right lobe of liver and it was diagnosed as hepatoma. Choledochoduodenostomy with biopsy was done. The operation revealed dilated common bile dut and both hepatic ducts which were filled with light brown jelly like materials and diagnosed as embryonal rhabdomyosarcoma on frozen and permanent senions. In gross and histologic characteristics, this tumor resembles embryonal rhabdomyosarcoma(sarcoma botryoides) in other locations. In spite of chemo-and radiotherapy after operation, the boy was died.
Subject(s)
Child , Male , Female , Humans , Diagnosis, Differential , BiopsyABSTRACT
Breast carcinoma has been infrequently reported in children. About 25 cases have been reported in world literatures since first description in 1913, by Bryan. We present a case of juvenile breast carcinoma in a 17 months old girl with brief review of literatures. Grossly, the submitted specimen is grayish white and measured by 1.3x1.0x0.8 cm in size. It is not encapsulated and its cut surfaces are homogeneous. Microscopic examination showed a neoplastic proliferation of duct cells forming mainly glandular spaces with focal papillary pattern, solid sheets or cribriform pattern. The glandular spaces were filled with collections of PAS-positive eosinophilic secretory materials. The individual cell varied from columnar to polygonal and showed moderate hyperchromatism and variation of nuclear size. Mitoses and necrosis are not found. Tumor cell invasion into the stroma was found.
Subject(s)
Child , Male , Female , HumansABSTRACT
A case of papillary ependymoma in the left frontal lobe was presented, because in Korea the cerebral ependymoma with noattachment to the ventricles was very rare. The patient was 40 years old female who had complained of severe headache and experienced occasional generalized tonic convulsions for 2 years prior to admission. We could treat the patient successfully by surgery. The tumor mass was attached to a part of the wall of a large cystic cavity which located within the brain substance of left frontal lobe. The tumor tissue was soft and papillary, and looked like a choroid plexus in the ventricles or a mural nodule in the wall of a large cyst which we may find occasionally in cerebellar hemangioblastomas. The cyst was filled with clear limpid yellow fluid of about 120cc. The cyst-wall was not lined with any membrane, and was devoid of tumor tissue. The microscopic findings of tumor showed many papillary growths with the stroma having telangiectasias and irregular mixture of fibrous connective tissue and neuroglial cells.