ABSTRACT
We experienced a case of isolated fetal pleural effusion diagnosed by antenatal ultrasonogram in the 33th week of gestational age. Chest PA at birth showed massive pleural effusion in both lungs. The serous pleural fluid changed to a milky nature after feeding so we diagnosed it as congenital chylothorax. The infant was managed by chest tube drainage, NPO & TPN with good response and was discharged on the 28th hospital day. We report the case with a brief review of its related literature.
Subject(s)
Humans , Infant , Infant, Newborn , Chest Tubes , Chylothorax , Drainage , Gestational Age , Infant, Premature , Lung , Parturition , Pleural Effusion , Thorax , UltrasonographyABSTRACT
PURPOSE: Atopic dermatitis is a chronic, inflammatory skin disease characterized by intense pruritus and an immunologic profile consistent with allergic disease. It is associated with increased eosinophil and IgE level and decreased INF-gamma production. We describe the result of a treatment with INF-gammaand assess the clinical, immunologic, and laboratory data of 12 patients with atopic dermatitis. METHODS: Twelve patients were treated for 12 weeks with 2x106 units/m2 INF-gamma by subcutaneous injection. General hematologic tests were done, and total eosinophil counts, eosinophil fractions, neutrophil fractions, and IgE levels were measured before the treatment, 2 weeks after the treatment, 12 weeks after the treatment serially. We also followed up the patients for 12 weeks after discontinuing INF-gammatherapy. RESULTS: All patients showed clinically significant improvement after 12 weeks of the systemic INF-gammatherapy. There was no clinical aggravation during the therapy period and the follow-up 4 weeks without the therapy. But the recurrence rate in the 12 weeks after discontinuing the therapy was about 40%. Eosinophil counts and eosinophil fractions were significantly decreased after the therapy. And, eosinophil counts and eosinophil fractions were increased in clinically aggravated patients during the 12 weeks of off-therapy. CONCLUSION: We conclude that INF-gammais an effective therapy in atopic dermatitis without significant side effects. The eosinophil counts and eosinophil fractions were decreased during the INF-gamma therapy, and increased in clinically aggravated patients after the off-therapy. There was no aggravation during the therapy. But 5 patients were clinically aggravated during the 12 weeks of off-therapy. Further studies for a long-term maintenance therapy and its side effect might be needed in chronic atopic dermatitis.
Subject(s)
Humans , Dermatitis, Atopic , Eosinophils , Follow-Up Studies , Hematologic Tests , Immunoglobulin E , Injections, Subcutaneous , Interferon-gamma , Neutrophils , Pruritus , Recurrence , Skin DiseasesABSTRACT
BACKGROUND AND OBJECTIVE: The clinical manifestation of Henoch-Schonlein purpura and existance of renal involvement may influence on its course and prognosis. To verify prevention with early administration of steroid, we studied the efficacy of corticosteroid treatment. MATERIAL AND METHOD: We analysed 65 children under 15 years of age with Henoch-Scho nlein purpura according to their age, sex, and seasonal incidence. Forty children showed typical skin lesions, arthralgia and abdominal pain. We have divided them two groups. Group A consisted of 20 children who received 1 mg/kg of prednisolone/perday for 2 weeks and group B did not. We carried out their physical examination and urinalysis monthly for a year. RESULT: The main clinical manifestations were skin rash(100% ), abdominal symptoms(41.5 %), joint symptoms (49.2%), and renal involvement(34%). As for gastrointestinal symptoms, abdominal pain(66.7% ) was most commonly observed one and others were nausea or vomiting (44.7%) and melena(25.9%). The joint involvement was observed mostly in knee(56.3%) and ankle joint(31.3% ), Hematuria was observed in all cases with renal involvement and proteinuria, in 28% of them. The improvement of renal manifestations were noted in 84.2% of them within 4 months. Mild elevation of IgA was more frequently observed in renal involvement group than non-involved group (p< 0.01). There were no significant differences in immonologic parameters such as IgG, IgM, IgE, duration of the acute phase and severity of cutaneous symptoms between two growps. None of steroid treated growp showed progression of nephropathy. Of the 20 non-steroid treated growp, 2(10%) developed nephropathy. Conclusion We may suggest that existance of renal involvement in Henoch-Schonlein purpura influences its course and prognosis.
Subject(s)
Child , Humans , Abdominal Pain , Ankle , Arthralgia , Hematuria , Immunoglobulin A , Immunoglobulin E , Immunoglobulin G , Immunoglobulin M , Incidence , Joints , Nausea , Physical Examination , Prognosis , Proteinuria , Purpura , IgA Vasculitis , Seasons , Skin , Urinalysis , VomitingABSTRACT
Recently, some cases of paradoxical bronchoconsthction with the use of nebulized antiasthmatic respirator solutions have been reported. This study was performed to determine whether benzalkonium chloride, contained in several antiasthmatic respirator solutions as a preservative, may cause paradoxical bronchoconstriction. This was accomplished by comparing the FEV(1) change after Ventolin (benzalkonium containing salbutamol) nebulization with the FEV(1) change after Respolin autohaler (benzalkonium free sa1butamol) inhalation within the same patient. This study consisted thirty patients with stable asthma who regularly attend the allergy clinic at Wallace Memorial Baptist Hospital. Patients were excluded from the study if they had respiratory disease or were taking any other medications. The results are as knows: 1) The baseline FEV(1) in the Ventolin group was 73+/-1O(% predicted) and 74+/-10(% predicted) in the Respolin autohaler group, showing no statistical difference in baseline FEV(1) between the two groups. 2) FEV(1) was decreased in 9 subjects(3096) after Ventolin nebu1ization and in 1 subject(3396) after Respolin autohaler inhalation, showing that the incidence of FEV(1) fall was higher in the Vento1in group than in the Respo1in autohaler group(p<0.OO5, one-tailed t-test). 3) Considering the cases with increased FEV(1) after inhalation, FEVl was increased by 9+/-7 (% predicted) in the Vento1in group and 7+/-5(% predicted) in the Respolin autohaIer group, suggesting that bronchodi1ator effects of both medications are similar. 4) Mild coughing occurred in 4 subjects(13396), and mild chest tightness in 1 subject(33%) in the Ventolin group. These symptoms resolved without any treatment. No side effects were reported by subjects in the Respolin autohaler group. In conclusion, these results strongly suggest that the paradoxical bron-choconstriction occurring with nebulized antiasthmatic respirator solutions is due to the ingredient benzalkonium chloride. Therefore we recommend that a benzalkoniulm free salbutamol product should be used for asthmatic patients, or if a product such as Ventolin which contains benza1konium chloride must be used, we recommend that it should be administered cautiously.
Subject(s)
Humans , Albuterol , Asthma , Benzalkonium Compounds , Bronchoconstriction , Cough , Hypersensitivity , Incidence , Inhalation , Protestantism , Thorax , Ventilators, MechanicalABSTRACT
It has been reported that theophylline clearance is lower in Korean infants than in Americans, suggesting that dose requirements for theophylline in Korean infants will be 1ower than those in Americans. Therefore, we reviwed patients charts retrospectively to formulate the new theophylline dosing equation appropiate to Korean infants. We reviewed patient charts of 111 asthmatic infants who received intravenous aminophy1line and oral theophylline in Wa1lace Memorial Baptist Hospital. We set the therapeutic serum concentration at 5-15microgram/ml in Korean infants based on response rate to theophylline therapy, which is supported by National Institute of Health Expert Panel Recommendations. Doses required to achieve a therapeutic serum concentration increased with age. The mean dose among the infants less than 4 months of age was 578+/-154mg/kg/day and increased to 10.12+/-1.78mg/kg/day after 8 months (p<0.0001). The relationship between age and dosage requirements can be expressed by the least squares determination of the linear regression :Dose (mg/kg/day) = 557 + 0.14 X (age in weeks). The coefficient of correlation for this relationship is 0.67(p<0.0001). Half-lives of elimination among the infants studied correspondingly decreased with age. In conclusion, this study showed that the relationship between age and dosage requirements in Korean infants may be different from those in Americans. Therefore, we strongly suggest that it is required to formulate a new theophylline dosing equation appropriate for Korean infants through well-designed prospective studies.
Subject(s)
Humans , Infant , Asthma , Least-Squares Analysis , Linear Models , Protestantism , Retrospective Studies , TheophyllineABSTRACT
The aim of this study was to evaluate the risk factors of recurrences after their first febrile convulsions in infants and young children. Dlinical studies were made on 187 cases of febrile convulsions who were admitted to the Department of pediatrics of wallace Memorial Baptist Hospital from March, 1990 to December, 1992. 1) 63 cases of 187 cases had recurrences after their febrile convulsions. Thus, the recurrence rate was 33.7%. 2) The male to female ratio was 2.1:1. And there were no significant differences in recurrence rates between sexes. 3) The recurrence rate was significantly higher in those whose initial febrile convulsions were developed before first 18 months of life than those whose initial convulsions were after 18 months of age (49.5% vs. 12.5%). 4) The time interval from initial attack to recurrence was within 12 months in 80% of cases. 5) Our study revealed that the seizure characteristics of the initial febrile convulsion are not important as predictive factors about the probability of recurrences. 6) Among the total 187 cases, family history were present in 52 cases (27.8%). And there were significantly higher recurrence rates if their families show the same history of febrile convulsion (63.5% vs. 22.2%). 7) The risk of recurrence was much higher in patients whose first febrile history of febrile convulsion at the same time.
Subject(s)
Child , Female , Humans , Infant , Male , Pediatrics , Protestantism , Recurrence , Risk Factors , Seizures , Seizures, FebrileABSTRACT
Epstein's syndrome is a rare disease whish is characterized by the association of thrombocytopenia, macrothrombocytopathia, nephritis and deafness. We experienced a case of Epstein's syndrome in a 12 years old male patient who was presented with a life long history of bleeding, usually as epistaxis, bilateral sensorineural deafness and hematuria with proteinuria starting in late childhood. Hematologic studies showed thrombocytopenia with giant platelets and anemia. A bone marrow aspirate revealed the megakaryocytes to be adequate in number and many giant size platelets. Platelet do not respond to addition of A and epinephrine; collagen and ristocetin induced agglutination response is decreased. It is difficult to be certain the association of thrombocytopenia with giant platelets, nephritis and deafness constitutes a new hereditary disease with a distinct pathogenesis or if it is an expansion of the well recognized Alport's syndrome of hereditary nephritis deafness. We report a case of Epstein's syndrome syndrome with brief review of related literatures.
Subject(s)
Child , Humans , Male , Agglutination , Anemia , Blood Platelets , Bone Marrow , Collagen , Deafness , Epinephrine , Epistaxis , Genetic Diseases, Inborn , Hematuria , Hemorrhage , Megakaryocytes , Nephritis , Nephritis, Hereditary , Proteinuria , Rare Diseases , Ristocetin , ThrombocytopeniaABSTRACT
Clinical observations were made on 338 low birth weight infants, who were delivered at Pusan Wallace Memorial Baptist Hospital, during the 3 year periods from 1989 to 1991. The results were as follows; The incidence of LBWI was 5.6% and sex ratio was 1:1.09. Among them AGA was 62.7%. 2) Of all infants, 47.3% were in the birth weight range of 2251-2500 gm and 25.1% were in the gestational age group of 37-38 week. 3) LBWI were most prevalent among mothers under 20 years old and over 41 years old. 4) The Incidence of LBWI was higher in multiparity than primiparity and in multiple pregnancy than single pregnancy. 5) Vaginal delivery was 63.9% and c-section delivery was 36.1%. 6) The order or frequency of the etiology of LBWI was multiple pregnancy, premature rupture of membrane and toxemia. 7) The mortality rate of LBWI was 12.7% and mortality rate by weight-gestational age was lower in AGA group than SGA and LGA group. 8) A Higher mortality rate was noted in the group of lower birth weight infant, and in the group of more shortened gestational age. 9) 48.8% of death occured within ist day of birth. The common causes of death were respiratory distress syndrome, asphyxia, and apnea.
Subject(s)
Adult , Female , Humans , Infant , Infant, Newborn , Pregnancy , Young Adult , Apnea , Asphyxia , Birth Weight , Cause of Death , Gestational Age , Incidence , Infant, Low Birth Weight , Membranes , Mortality , Mothers , Parity , Parturition , Pregnancy, Multiple , Protestantism , Rupture , Sex Ratio , ToxemiaABSTRACT
No abstract available.