A Clinical Comparative Study of Mycoplasma Pneumoniae Pneumonia in Children under Three Years Old / 소아알레르기및호흡기학회지

PURPOSE: Mycoplasma pneumoniae pneumonia is rarely found in children under 3 years old. Nevertheless, infants have been recently and frequently diagnosed with M. pneumoniae pneumonia. Therefore, the clinical characteristics of such children were investigated in this study. METHODS: Subjects were 232 infants (group A: 0 to 11 months, group B: 12 to 23 months, group C: 24 to 35 months) who were diagnosed between January 2004 and December 2009 with M. pneumoniae pneumonia infection at Myongji Hospital. We reviewed their medical records, the early and monthly incidence of infection, clinical manifestations, and laboratory findings. RESULTS: Group A consisted of 28 patients (12.1%), group B 78 (33.6%), and group C 126 (54.3%). The younger patient group in the peak season, 2006, demonstrated a high incidence rate. Wheezing was more often auscultated in group A than in the other groups. Negative findings on chest X-rays were more often observed in group A. Serologically, high titers of mycoplasma-specific antibody (>1:1,280) were observed in lobar pneumonia and correlated with the severity of clinical manifestations. CONCLUSION: The age at which M. pneumoniae infection has been diagnosed has recently decreased and has been found with a particularly high frequency in infants. Despite shorter fever duration before hospitalization and uncertain radiological findings, including M. pneumoniae in the differential diagnosis of pneumonia is recommended for children under 1 year.

Relationship between Recurrence in Febrile Seizures and Serum Zinc Levels

PURPOSE: The etiology of febrile seizures is not yet ascertained but it is known that genetic factors, cytokines or trace elements are associated with pathogenesis of febrile seizures. Among them, zinc deficiency is known to play some role of pathogenesis of febrile seizures. We purposed to know the relation between recurrence of febrile seizures and serum zinc level. METHODS: The subjects were recurrent febrile seizures group who were admitted to our hospital from June 2003 to July 2005 because of more than 3 times febrile seizures. The other two control groups were simple febrile seizures and acute febrile illness groups admitted to our hospital in same period. Simple febrile seizures group showed no more seizure over 1 year after first onset. We investigated serum zinc level in each group. RESULTS: The number of patient in each group is 33 children. Recurrent febrile seizures group was composed of 20 boys and 13 girls (the ratio of 1.5:1) with an average age 30 months old. The mean serum zinc levels in the recurrent febrile seizures group (123.7+/-9.6 microgram/dL) were not statistically different from those of the simple febrile seizures group(112.5+/-8.9 microgram/dL). Both of the recurrent and simple febrile seizures groups had significantly lower serum zinc levels than the febrile illness group(154.1+/-6.8 microgram/dL). CONCLUSION: We suggested that serum zinc level is not relationship with recurrence of febrile seizures. Nevertheless, the fact remains that serum zinc level was decreased in recurrent and simple febrile seizures groups compared with acute febrile illness group.

A Case of Multiple Large Renal Abscesses Completely Resolved by Conservative Antibiotics Administration

Renal abscess in childhood is a rare disease, and generally treatment of renal abscesses in childhood follows the guidelines in adults. The guidelines of treatment of renal abscesses in adults include the following:renal abscesses smaller than 3 cm in size can be managed by antibiotics administration, while renal abscesses above 3 cm in size must be considered for percutaneous abscess drainage or open drainage. We experienced a case of a 2 year-old girl with multiple renal abscesses greater than 4 cm in size which resolved by oral antibiotics administration after 2 weeks of intravenous administration. We report this case with literature review.

A Case of Isolated Interhemisphere Fusion of Frontal Lobe with Intact Septum Pellucidum : A Variant of Holoprosencephaly

Holoprosencephaly is a rare CNS developmental defect with midline cleavage of embryonal forebrain during the fourth week of fetal development characterized with s single ventricle. Holoprosencephaly is divided into three types by the degree of the brain cleavage : alobar, semilobar, and lobar. Depending on the degree of defected regions, there exist variable clinical symptoms and signs such as stillbirth, hypotonia, apnea, convulsion, delayed development and visual disturbance. It was frequently associated with the deformity of the brain as well as the midline facial structures. Advances in neuroimaging over the past decades have led us to a better understanding of the pathogenesis and the variability of holoprosencephaly. As a result, a lot of cases of holoprosencephaly with various clinical and pathologic findings have been reported. We experienced a case of isolated interhemisphere fusion of frontal lobes with intact septum pellucidum in a child with febrile status epilepticus. Is it a variant of holoprosencephaly?

Assessment of Ventricular Function Using Tissue Doppler Imaging in Kawasaki Disease

PURPOSE: The purpose of this study is to evaluate ventricular functional changes in Kawasaki disease using tissue Doppler echocardiographic measures with conventional echocardiographic measures. METHODS: Tissue Doppler imaging and conventional Doppler echocardiography were performed in 69 patients with Kawasaki disease and 39 healthy children. Peak velocities of systolic(Sa) and early(Ea), late(Aa) diastolic motion of mitral annulus were obtained at the lateral and septal side from apical 4 chamber view. RESULTS: Sa(7.7+/-1.8 cm/s vs 8.8+/-2.1 cm/s, P=0.01) and Ea(15.7+/-3.2 cm/s vs 17.2+/-3.3 cm/s, P=0.03) measured at lateral mitral annulus were significantly lower in patients with Kawasaki disease. Aa(7.0+/-2.0cm/s vs 6.2+/-1.3 cm/s, P=0.01) measured at septal mitral annulus were statistically higher in patients with Kawasaki disease. There was no significant difference in coronary arteriopathy patients compared with non-coronary arteriopathy patients in Kawasaki disease. In conventional mitral and pulmonary venous flow velocities, there was significant difference of E in Kawasaki disease patients. The ratio of E/Ea and flow propagation velocity(Vp) demonstrated difference in Kawasaki disease patients. CONCLUSION: Peak mitral annular velocities obtained by tissue Doppler imaging were significantly altered in acute phase of Kawasaki disease. Tissue Doppler imaging with conventional Doppler echocardiography can be a promising method for evaluation of ventricular function in patients with Kawasaki disease.