Successful Sibling Cord Blood Stem Cell Transplantation for Relapsed Acute Mixed Lineage Leukemia / 대한혈액학회지

No abstract available.

Changes of Total Leukocytes and Leukocyte Types in Cerebrospinal Fluid and Peripheral Blood According to the Time Interval of Collection of Spinal Fluid after Onset of Illness in Aseptic Meningitis / 대한소아신경학회지

PURPOSE: We performed this study to evaluate the changes of total leukocytes and leukocyte types in CSF and peripheral blood (PB) in the early course of aseptic meningitis. METHODS: One hundred and eighty-nine children with aseptic meningitis, who were admitted to the Pediatric Department of Dong-A University Hospital during the period from June 1996 to October 1997 were included. Patients were divided into 4 groups by 12-hour intervals according to the time between the onset of illness and initial diagnostic lumbar puncture. We analyzed clinical pictures, total leukocytes and leukocyte types in CSF and peripheral blood (PB) in each group. RESULTS: 1) There was no significant difference in average total leukocyte counts in CSF between each group, and all groups were considered to be acute stage of illness. 2) The PMNL proportion of CSF leukocytes was 57.0+/-31.6% in group I, 44.1+/-32.3% in group II, 39.4+/-33.1% in group III and 26.9+/-27.9% in group IV. The PMNL percentage was significantly higher in group I than group III and IV and the proportion of patients with a predominance of PMNL was higher in group I than group III and IV (p<0.05) 3) The proportion of neutrophils in PB was highest in group I (76.5+/-15.7%) and significantly higher in group I and II than group III and IV (p<0.05). 4) Significant correlations were found between the proportion of PMNL in CSF and PB of patients (r=0.62, p<0.001) CONCLUSION: The change from a predominance of PMNL to a predominance of mononucler leukocytes was occurred 12-24 hours after onset, and there was a strong correlation between the proportion of neutrophils in CSF and PB.

A Case of Acute Motor Axonal Type Guillain-Barr Syndrome with Anti-GM1 Antibody and Anti-GD1 Antibody / 대한소아신경학회지

Acute motor axonal Guillain-Barr syndrome is a paralytic disorder of abrupt onset, characterized electrophysiologically by near-normal terminal latencies, preserved nerve conduction velocity with low CAMP amplitude without a conduction block, and early appearing nerve inexcitability and by sparing sensory fibers. Most cases have antecedental infection with Campylobacter jejuni and have antibodies directed toward GM1 ganglioside-like epitopes. We have experienced a case of primary axonal type of Guillain-Barr syndrome in a 14-year-old female patient, who has symptoms of difficulty in swallowing and progressive flaccid paralysis associated with anti-GM1 antibody and anti-GD1 antibody.

Postoperative Doppler Echocardiographic Study of Total Anomalous Pulmonary Venous Return

PURPOSE: We conducted this study to evaluate the efficacy of Doppler study by examining obstruction at the site of anastomosis in patients with total anomalous pulmonary venous return(TAPVR). METHODS: Retrograde analysis of the postoperative echocardiography results was done in 14 patients with simple TAPVR, who were operated at Dong-A University Hospital from January 1993 to July 1998. The peak systolic velocities, peak diastolic velocities and flow patterns of the 14 patients were compared with those of 9 control cases. Among the 14 patients, 2 cases showed evidence of obstruction at the anastomosis site. RESULTS: Pulmonary venous flow patterns of normal infants were biphasic, varying with the cardiac cycle. The peak velocities during systole and diastole were 40 to 60cm/sec(mean 51+/-9cm/sec) and 45 to 78cm/sec(mean 59+/-9cm/sec), respectively. The flow patterns of patients without postoperative stenosis were also biphasic. The peak velocities during systole and diastole was 38 to 115cm/sec(mean 71+/-27cm/sec) and 55 to 140cm/sec(mean 111+/-28cm/sec), respectively. The diastole peak velocity was significantly higher than normal(P=0.0002). The flow patterns of patients with postoperative stenosis was continuous, non-phasic or increased peak velocity even though it was phasic. CONCLUSION: Postoperative Doppler echocardiographic evaluation of pulmonary venous return in patients with TAPVR is useful in examining obstruction at the site of anastomosis. But a study on the Doppler echocardiographic normal range of postoperative patients will be needed.

Postoperative Doppler Echocardiographic Study of Total Anomalous Pulmonary Venous Return

PURPOSE: We conducted this study to evaluate the efficacy of Doppler study by examining obstruction at the site of anastomosis in patients with total anomalous pulmonary venous return(TAPVR). METHODS: Retrograde analysis of the postoperative echocardiography results was done in 14 patients with simple TAPVR, who were operated at Dong-A University Hospital from January 1993 to July 1998. The peak systolic velocities, peak diastolic velocities and flow patterns of the 14 patients were compared with those of 9 control cases. Among the 14 patients, 2 cases showed evidence of obstruction at the anastomosis site. RESULTS: Pulmonary venous flow patterns of normal infants were biphasic, varying with the cardiac cycle. The peak velocities during systole and diastole were 40 to 60cm/sec(mean 51+/-9cm/sec) and 45 to 78cm/sec(mean 59+/-9cm/sec), respectively. The flow patterns of patients without postoperative stenosis were also biphasic. The peak velocities during systole and diastole was 38 to 115cm/sec(mean 71+/-27cm/sec) and 55 to 140cm/sec(mean 111+/-28cm/sec), respectively. The diastole peak velocity was significantly higher than normal(P=0.0002). The flow patterns of patients with postoperative stenosis was continuous, non-phasic or increased peak velocity even though it was phasic. CONCLUSION: Postoperative Doppler echocardiographic evaluation of pulmonary venous return in patients with TAPVR is useful in examining obstruction at the site of anastomosis. But a study on the Doppler echocardiographic normal range of postoperative patients will be needed.

A Clinical Study of Migraine and Tension-type Headache in Children

PURPOSE: The purpose of this study is to help diagnosis migraine and tension-type headache in children with chronic recurrent headache by comparing clinical characteristics of migraine and tension-type headache. METHODS: We performed a clinical analysis of 89 children diagnosed as migraine and/or tension-type headache by using international headache society classification with the aid of Prenky's criteria of migraine and Jay's category of tension-type headache. RESULTS: The diagnosed group consisted of 39 children with migraine, 40 tension-type headache cases and coexisting migraine and tension-type headache in 10 cases. In the location of the headache, the incidence of temporal area was significantly higher in the migraine than in tension-type headache(P<0.001) and the incidence of occipital area was significantly higher in the tension-type headache than in migraine(P<0.01). In migraine, 27 cases(69.2%) had pulsating headache which was significantly higher than in the tension-type headache(P<0.001). In tension-type headache, 18 cases(45.0%) had dull headaches which were significantly higher than in migraine(P<0.01). Nausea, vomiting, dizziness, relief of headache after sleep, photophobia, and visual disturbance among associated symptoms with headache were significantly higher in migraine than tension-type headache(P<0.05). The incidence of family history of headache in migraine(71.8 %) was higher than in the tension-type headache(40.0%)(P<0.01). CONCLUSION: Diagnostic criteria are significant in diagnosis of migraine and tension-type headache. The characteristics of headache are overlapped in both headache types and there are differences of expression for headache in children, so there is a problem in diagnosing of headache type. The international Headache Society Classifications are useful for children, but there are problems that diagnostic criteria are too strictly applied to children.

A Case of Acute Transverse Myelitis Complicating Diffuse Spinal Cord Atrophy and Syrinx Formation / 대한소아신경학회지

A 4-year-old girl developed acute motor, sensory impairment, lower abdominal pain and urinary dysfunction after URI. In acute stage of disease, MRI showed diffuse spinal cord swelling and high signal intensity on T2WI below T2 body level. The patient did not improved and one month later, follow-up MRI showed diffuse spinal cord atrophy and syrinx formation as sequelae of ATM on T1WI below T9 level. To our knowledge, this is the first case showing the sequelae of acute transverse myelitis seen in Korea.