A case of intestinal tuberculosis complicated by miliary tuberculosis / 소아과

Intestinal tuberculosis presents with nonspecific and variable clinical manifestations. It is rarely seen in current clinical practice and the diagnosis may be missed or confused with many other disorders such as Crohns disease and intestinal neoplasms. The route of infection by tuberculous enteritis is variable and the treatment regimens used for treating pulmonary tuberculosis are generally effective for tuberculous enteritis as well. Uncomplicated tuberculous enteritis can be managed with a nine to 12- month course of antituberculous chemotherapy. If not treated early, the prognosis for intestinal tuberculosis is poor, with an overall mortality of between 19 percent and 38 percent. However, 90 percent of patients will respond to medical therapy alone if started early. Therefore, early detection and treatment is essential. Here we report a case of intestinal tuberculosis secondary to miliary tuberculosis.

A Case of Trichobezoar in a Child Who Visited with Intermittent Abdominal Pain, Nausea and Vomiting / 소아과

Bezoars are concretions commonly found in the stomach and small bowel, and four types of bezoars have been described based on their composition: trichobezoar, phytobezoar, lactorbezoar, and miscellaneous. Bezoars most often develop after gastric operations that alter the motility, emptying, and grinding of food in the stomach. Trichobezoars are most common in female children with normal gastrointestinal function and are usually associated with pica, mental retardation, and psychiatric disorders. Although uncommon, bezoars are a well-recognized cause of chronic abdominal complaints which, when undiagnosed, can result in serious complications including gastric ulceration, bleeding, perforation, intussusception and small bowel obstruction. Mortality rates of up to 30 percent have been reported in adults. Trichotillomania is behaviors surrounding hair-pulling, including stroking and playing with hair before pulling, or biting and swallowing the hair after it has been pulled(trichophagia). The most notorious of the medical sequelae of trichotillomania is the trichobezoar. We experienced a case of trichobezoar in an 11-year-old girl who frequently swallowed her hairs from age 4 years up to age 7 years, resulting in intermittent abdominal pain, nausea, and vomiting.

The Safety and Immunogenicity of a Trivalent, Live, Attenuated MMR Vaccine, Priorix (TM) / 소아과

PURPOSE: This multi-center, open-label, clinical study was designed to evaluate the safety and immunogenicity of a trivalent, live, attenuated measles-mumps-rubella (MMR) vaccine, Priorix (TM) in Korean children. METHODS: From July 2002 to February 2003, a total of 252 children, aged 12-15 months or 4-6 years, received Priorix (TM) at four centers: Han-il General Hospital, Kyunghee University Hospital, St. Paul's Hospital at the Catholic Medical College in Seoul, and Korea University Hospital in Ansan, Korea. Only subjects who fully met protocol requirements were included in the final analysis. The occurrence of local and systemic adverse events after vaccination was evaluated from diary cards and physical examination for 42 days after vaccination. Serum antibody levels were measured prior to and 42 days post-vaccination using IgG ELISA assays at GlaxoSmithKline Biologicals (GSK) in Belgium. RESULTS: Of the 252 enrolled subjects, a total of 199 were included in the safety analysis, including 103 from the 12-15 month age group and 96 from the 4-6 year age group. The occurrence of local reactions related to the study drug was 10.1 percent, and the occurrence of systemic reactions was 6.5 percent. There were no episodes of aseptic meningitis or febrile convulsions, nor any other serious adverse reaction. In immunogenicity analysis, the seroconversion rate of previously seronegative subjects was 99 percent for measles, 93 percent for mumps and 100 percent for rubella. Both age groups showed similar seroconversion rates. The geometric mean titers achieved, 42 days post- vaccination, were: For measles, in the age group 12-15 months, 3, 838.6 mIU/mL [3, 304.47, 4, 458.91]; in the age group 4-6 years, 1, 886.2 mIU/mL [825.83, 4, 308.26]. For mumps, in the age group 12-15 months, 956.3 U/mL [821.81, 1, 112.71]; in the age group 4-6 years, 2, 473.8 U/mL [1, 518.94, 4, 028.92]. For rubella, in the age group 12-15 months, 94.5 IU/mL [79.56, 112.28]; in the age group 4-6 years, 168.9 IU/mL [108.96, 261.90]. CONCLUSION: When Korean children in the age groups of 12-15 months or 4-6 years were vaccinated with GlaxoSmithKline Biologicals' live attenuated MMR vaccine (Priorix (TM) ), adverse events were limited to those generally expected with any live vaccine. Priorix (TM) demonstrated excellent immunogenicity in this population.