ABSTRACT
PURPOSE: The purpose of this study is to evaluate the usefulness and limitation of QuantiFERON-TB Gold (QTB) for diagnosis of latent tuberculosis in children. METHODS: The medical records of 112 children who were tested by tuberculin skin test (TST) and QTB for detection of latent tuberculosis (TB) in Eulji General Hospital during the period from January 2007 to June 2009 were retrospectively reviewed. RESULTS: Of the 112 participants, the clinical TB group included 15 (13.4%), the contact group included 43 (38.4%), and the non-contact group included 54 (48.2%). Positive rates of TST and QTB were 100% and 80% in the clinical TB group, 64% and 14% in the close contact group, 27% and 0% in the casual contact group, and 52% and 2% in the non-contact group, respectively. Sensitivity of QTB was 80.0% and specificity was 92.6%. Agreement between QTB and TST was poor (kappa=0.209). We also confirmed that the positive rate of QTB increased as the age of the patient increased (P=0.011). A QTB indeterminate result was observed in 11 (9.8%) subjects. QTB was retested in 15 subjects. In 5 of the 6 subjects who had positive results initially, positive results persisted for a median 2.2 months after termination of treatment. CONCLUSION: Although QTB was associated with several problems, including low sensitivity and a high rate of indeterminate results, it had clinical importance due to its high specificity. We found good correlation with regard to exposure and QTB positivity, including that of young children under 5 years of age. However, clinical application of interferon-gamma releasing assay for young children for diagnosis of active and latent tuberculosis will require additional prospective studies.
Subject(s)
Child , Humans , Hospitals, General , Interferon-gamma , Interferons , Latent Tuberculosis , Medical Records , Retrospective Studies , Sensitivity and Specificity , Skin Tests , Tuberculin , TuberculosisABSTRACT
Townes-Brocks syndrome is an uncommon autosomal dominant condition first described by Townes and Brocks in 1972. We experienced a newborn female who presented with clinical findings of Townes-Brocks syndrome in an otherwise unaffected family. The patient showed the full spectrum of anomalies including anterior placed anus, triphalangeal thumb, preaxial polydactyly, pre-auricular tags, microtia without opening, sensorineural hearing loss and unilateral renal agenesis.
Subject(s)
Female , Humans , Infant, Newborn , Anal Canal , Hearing Loss, Sensorineural , Polydactyly , ThumbABSTRACT
A 16-month-old boy swallowed accidentally a button type lithium battery with diameter 23 mm. The battery impacted at the upper esophagus was removed by endoscpy in 9 hours. At the time of removal, dark-crust and erythematous mucosal lesion was noted where the battery impacted. At the first hospital day, fever over 38.5 degrees C developed, and NPO, antibiotics and H-2 blocker started. At the third hospital day, he had melena, and endoscopy revealed huge active esophageal ulceration ranging from upper esophagus and lower body of the esophagus. Steroid started. At the 10th hospital day, endoscopy revealed much smaller-sized ulceration, but mucosa where the battery impacted initially showed deep depression which might imply developing diverticulum. At the 17th hospital day, endoscopy revealed complete diverticulum. At the 27th hospital day, endoscopy revealed complete resolution of diverticulum.
Subject(s)
Child , Humans , Infant , Male , Anti-Bacterial Agents , Depression , Diverticulum , Endoscopy , Esophagus , Fever , Lithium , Melena , Mucous Membrane , UlcerABSTRACT
PURPOSE: It is important in asthmatic children to encourage ordinary physical activity. However physical activities in winter are limited excessively by their parents for fear of bronchospasm by cold air and exercise. Children's asthma camps help them to learn about asthma management, make new friends with other asthmatic children, have positive attitude about the disease and have a more active lifestyle. But there have been few asthma camps and appropriate asthma camp programs have not been developed in Korea. Our study was done to see how camp programs influenced on asthma patient by measuring of PEFR during camp programs and thereby to have the data be used for future development of asthma camp programs. METHODS: From January 19th to 22th 1998, we recruited for camp 17 asthmatic patients and 31 normal children who had no history of admission due to respiratory infection. The main camp programs consisted of skiing and sledding. PEFR was checked 5 times a day and we analyzed variation of PEFR in relation to daily activities, temperature, humidity of atmosphere. RESULTS: 1) The mean age was 8 years with a range of 5 years to 11 years with male predominance (male/female : 2.4/1) in asthma group and the mean age was 10 years with a range of 5 years to 16 years with female predominance (male/female: 1/2) in control group. 2) The mean PEFR (% predicted) was checked early morning, prior to breakfast, lunchtime, supper and at the end of the day's activities (before sleeping) were 90.43+/-24.15%, 93.48+/-19.42%, 98.99+/-25.89%, 96.77+/-21.23%, 100.9+/-20.86% in asthma group and 93.69+/-16.41%, 94.49+/-17.13%, 94.15+/-17.28%, 96.84+/-16.44%, 96.52+/-16.24% in control group. All values were within normal range and there was no significant change of the mean PEFR value in relation to daily activity. The values of PEFR were low at early morning. We have observed a significant difference of PEFR between early morning and before sleeping in asthma group (P<0.05). 3) In the asthma group, 2 cases had respiratory difficulty prior to lunchtime but symptoms were resolved after bronchodilator nebulization. CONCLUSION: We recommend ski or sledding to be safe as one of the programs for asthma camp but control of asthma attack is needed because lung function is decreased at night and appropriate warming up is needed before cold air sports.
Subject(s)
Child , Female , Humans , Male , Asthma , Atmosphere , Breakfast , Bronchial Spasm , Friends , Humidity , Korea , Life Style , Lunch , Lung , Meals , Motor Activity , Parents , Peak Expiratory Flow Rate , Reference Values , Skiing , Snow Sports , SportsABSTRACT
During The last 11 years from Jan. 1980 to Dec. 1990, 72 cases of salmonellosis has been admitted to the Department of Pediatrics of National Medical Center and evaluated clinical difference between typhoid fever and salmonella gastroenteritis. The results were as follows: 1) The annual incidence of salmonella gastroenteritis insalmonellosis was increased in the latter half of the eighties. 2) Both salmonellosis had its peak incidence in the summer. 3) Salmonella gastroenteritis was highest in the age of less than 5 year in contrast with the age of 6~9 year in typhoid fever. 4) The specimens isolated salmonellae were blood and stool in most cases, especially blood in typhoid fever and stool in gastroenteritis. 5) S.typhi was 16 cases, salmonella group A was 3 cases, group B was 16 cases and Group D and E were a case in each in isolated salmonellae. 6) On the antibiotic sensitivity test, S.typhi was sensitive to the most antibiotics. but the salmonella group B was relatively resisitant to Ampicillin, Carbenicillin, Tetracycline and Chloramphenicol.
Subject(s)
Ampicillin , Anti-Bacterial Agents , Carbenicillin , Chloramphenicol , Gastroenteritis , Incidence , Pediatrics , Salmonella , Salmonella Infections , Tetracycline , Typhoid FeverABSTRACT
Cow milk allergy can be defined as an adverse immunologic reactions to cow milk protein. The term is often mistakenly applied to other causes of milk intolerence, such as lactase deficiency and galactosemia, which must be differenciated and excluded. We have experienced 10 children of cow milk allergy at neonatal onset who had suffered from G-I symtoms, such as diarrhea, irritability, weight loss, vomiting and abdominal distension. One half of this patients had family history of allergic diseas. All patients have positive specific IgE RAST to cow's milk protein, milk elimination test and milk challenge test. Brest milk feeding and soy bean formula feeding and soy bean formula feeding have started after diagnosis and then gastrointestinal symtoms and signs of all patients are improved but other allergic diseases are combined in 5 children.
Subject(s)
Child , Humans , Infant , Diagnosis , Diarrhea , Galactosemias , Hypersensitivity , Immunoglobulin E , Lactase , Milk , Milk Hypersensitivity , Milk Proteins , Glycine max , Vomiting , Weight LossABSTRACT
Ninety two cases of culture proved neonatal sepsis who had been admitted to pediatric department, National medical Center, during 7 years from Jan. 1984 to Dec. 1990 were reviewed clinically and the following results were obtained. 1) The frequency of neonatal sepsis was 3.1% and male to female sex ratio was 1.9:1, Sepsis was more prevalent in premature infants (9.9%) than in full term infants (1.9%). 2) The seasonal incidence was more prevalent in summer (32.6%). 3) The weight distribution showed 50 cases with the weight less than 2500 gram and 42 cases more than 2500 gram. 4) In 76 cases the onset was before 7 days old and in 16 cases were developed after 7 days old. 5) The major associated perinatal conditions in neonatal sepsis were institutional baby (23.9%), premature rupture of membranes (11.9%) and placenta previa (4.3%) in the order of frequency. The clinical manifestations on admission were jaundice (50.0%), poor activity (46.7%), respiratory difficulty (35.9%), poor feeding (22.8%), cyanosis (22.7%), gastrointestional symptoms (21.5%), fever (15.2%) and convulsion (13.0%) in the order of frequency. 6) The associated diseases were urinary tract infection (31.5%), hyaline membrane disease (19.6%), congenital disorder (18.5%), pneumonia (15.2%), anemia (13.0%), meningitis (9.8%), omphalitis (7.6%), DIC (6.5%), necrotizing enterocolitis (5.4%) and intracranial hemorrhage (5.4%) in the order of frequency. 7) Causative organisms were gram positive organisms in 27 cases (25.7%) and gram negative organisms in 79 cases (74.3%). The main organisms were Serratia marcescens (18.5%). Enterobacter spp (17.4%), Klebsiella pneumoniae (12.0%), Staphylococcus aureus (10.9%), Acinetobactor calcoaceticus (8.7%), Coagulase (-) staphylococcus (8.7%), E. coli (8.7%), Enterococcus (6.5%), Group B beta-hemolytic streptococcus (5.4%) and Pseudomonas (5.4%) in the order of frequency. The sensitivity to antibiotics were: Serratia marcescens: 70.6% sensitive to Amikacin 58. 9% sensitive to Cefotaxime 59. Enterobacter spp: 87.5% sensitive to Amikacin 68.8% sensitive to Cefotaxime Klebsiella pneumoniae: 100% sensitive to Amikacin 91. 0% sensitive to Cefotaxime Staphylococcus aureus: 100% sensitive to Cefazolin 90. 0% sensitive to Cefotaxime Acinetobacter calcoaceticus: 88.9% sensitive to Amikacin Coagulase (-) Staphylococcus: 100% sensitive to Amikacin 87. 5% sensitive to Cefotaxime E. coli: 100% sensitive to Amikacin, Cefotaxime Enterococcus: 50% sensitive to Gentamicin, Ampicillin, Amikacin Group B beta-hemolytie Streptococcus: 100% sensitive to Ampicillin, Penicillin Pseudomonas: 100% sensitive to Amikacin, Gentamicin, Tobarmycin 8) Mortality cases were 32 cases (34.8%).
Subject(s)
Female , Humans , Infant , Infant, Newborn , Male , Acinetobacter calcoaceticus , Amikacin , Ampicillin , Anemia , Anti-Bacterial Agents , Cefazolin , Cefotaxime , Coagulase , Congenital, Hereditary, and Neonatal Diseases and Abnormalities , Cyanosis , Dacarbazine , Enterobacter , Enterococcus , Enterocolitis, Necrotizing , Fever , Gentamicins , Hyaline Membrane Disease , Incidence , Infant, Premature , Intracranial Hemorrhages , Jaundice , Klebsiella pneumoniae , Membranes , Meningitis , Mortality , Penicillins , Placenta Previa , Pneumonia , Pseudomonas , Rupture , Seasons , Seizures , Sepsis , Serratia marcescens , Sex Ratio , Staphylococcus , Staphylococcus aureus , Streptococcus , Urinary Tract InfectionsABSTRACT
No abstract available.
Subject(s)
Mycoplasma pneumoniae , Mycoplasma , Pneumonia , Pneumonia, MycoplasmaABSTRACT
This study included fifty two premature babies in whom EEG was performed at National Medical Center, from Jan. 1990 to Jun. 1991. clinical and EEG records of all subjects were analyzed and the following results were obtained. 1) The day of first EEG performed were;11 cases within 10 days, 20 cases from 11 days to days, 13 cases from 21 days to 30 days and 8 cases beyond 31 days. 2) The results of first EEG were; within normal limit in 34 cases, mild abnormality in 3 cases, moderate abnormality in 11 cases and marked abnormality in 4 cases. 3) The abnormal EEG ratio according to the sex was higher in female than in male (43.5% vs 27.6%). 4) The abnormal EEG ratio according to the gestational age was higher in shorter gestational age group than in longer gestational age group (40.9% under 32 weeks of G.A. vs 30.0% beyond 33 weeks of G.A.). 5) The abnormal EEG ratio according to the birth weight was not significant. 6) The abnormal EEG ratio according to the ventilator use was higher in used group than in not used group (38.5% vs 30.8%). 7) Combined diseases in 18 cases of abnormal EEG group were jaundice (14 cases), hyaline membrane disease (7 cases), asphyxia (4 cases), anemia (4 cases), hydrocephalus, sepsis, PDA, hypocalcemia, UTI and IVH. 8) The mean apgar score in abnormal EEG group was lower than normal EEG group both in one minute and five minute. 9) Two cases among 18 cases of abnormal EEG group showed abnormal brain sonographic findings, but one case among 34 cases of normal EEG group showed abnormal brain sonographic finding. 10) Ten cases were followed up with serial EEG, six cases of which were treated with anticonvulsant. We observed normalization of the EEG in 5 cases of anticonvulsant treated group.
Subject(s)
Female , Humans , Infant, Newborn , Male , Anemia , Apgar Score , Asphyxia , Birth Weight , Brain , Electroencephalography , Gestational Age , Hyaline Membrane Disease , Hydrocephalus , Hypocalcemia , Jaundice , Sepsis , Ultrasonography , Ventilators, MechanicalABSTRACT
This report is a clinical analysis and comparative study with previous report of bronchial asthma at National Medical Center on bronchial asthma in children who were admitted to the MP dept. of national Medical Center from January 1987 to December 1990. The results of the study were as follows: 1) The out-break ratio of bronchial asthma is 3.7% of hospitalized children which is no change that about 4% since 1980. 2) The children under 6 years of ge was 62.7% which among under 3 years was 33.1%. The rate of under 3 year children is increased as previous study. 3) The out-break of bronchial asthma was most common in September and October and so peak incidence was noted in fall and duration of hospitalization was most 2 week. 4) Familial allergic history was positive in 54.6% and bronchial asthma was most common. The presence of allergic past history was 52.2%) and atopic dermatitis was most common 5) Eosinophilia was found in 80.8% and elevated IgE was also in 61.6% of bronchial asthma. 6) We could get positive results of IgE RAST and skin test: D. pteronyssinus, D. farinae, Houst dust. 7) The most frequent findigs of the chest radiograph were within normal limits. 8) The clinical improvement rate of bronchial asthma is 52.5%.
Subject(s)
Child , Humans , Asthma , Child, Hospitalized , Dermatitis, Atopic , Dust , Eosinophilia , Hospitalization , Immunoglobulin E , Incidence , Radiography, Thoracic , Skin TestsABSTRACT
No abstract available.
ABSTRACT
No abstract available.
Subject(s)
Humans , Hepatitis B Surface Antigens , Hepatitis B , Hepatitis , PrevalenceABSTRACT
No abstract available.