Evaluation of Intellectual Development in Patients with Transient Congenital Hypothyroidism at Early School Age / 소아과

PURPOSE: Thyroxine is the hormone indispensible to the growth and development of infants. We made this study to confirm the influence of temporary depression of serum thyroxine levels on the development of intelligence. METHODS: I adopted as the study group 14 patients diagnosed with depression at the pediatrics department of Pusan National University Hospital from April of 1991 to October of 1997, and selected as the control group 24 infants born with normal functioning of thyroid glands in the same period. From August 18 to September 3 2003, a clinical psychologist carried out Korean Wechsler Intelligence Scale for Children on the patient group and the control group. According to the guidelines, they conducted 12 small tests, gave them marks and expressed the intelligent quotients by the conversion grade in seven articles. RESULTS:The patient group had meaningfully lower grades than the control group in three(similarity, vocabulary, digit scan) out of six articles of the small test of verbal scales, and the former had meaningfully lower grades in two(picture completion, object assembly) out of six articles of the small test of performance scales by K-WISC-III. The I.Q. shows the group of patients was meaningfully depressed in six(verbal IQ, performance IQ, global IQ, verbal comprehension, perceptional organization, working memory) out of seven articles; out of the six articles, the working memory was most depressed. CONCLUSION: Transient hypothyroidism can bring the mental retardation of children, so we think that there should be further studies for appropriate thyroid hormone replacement therapy on these patients.

A Case of Alternating Hemiplegia of Childhood / 대한소아신경학회지

Alternating hemiplegia of childhood(AHC) is a rare but clinically distinct syndrome characterized by onset before 18 months of age, frequent attacks of alternating paralysis, nystagmus transient ocular palsies, other autonomic dysfunction, and the development of cognitive impairment and a choreoathetotic movement disorder. The case is a 13 month-old boy who has presented repeated episodes of alternating hemiplegia from the age of 6 months at a frequency of several times per month, which was lasting for two or three days. Ths diagnosis was based on clinical features. Frequently such hemiplegic attacks were accompanied by irratability. He had mental retardation, neurodevelopmental delay, and seizure attacks. EEG, brain MRI, brain MR angiography, and Tc-99m HMPAO-brain single photon emission computed tomography(SPECT) failed to reveal any significant abnormal finding during the hemiplegic attacks. We tried calcium-entry block and flunarizine to relieve the hemiplegic attacks, but the frequency and severity of the hemiplegic attacks were not decreased by flunarizine therapy.

The Optimum Dose of Oral Diazepam to Reduce Seizure Attack in Febrile Seizure Patients During Febrile Illness

PURPOSE: Febrile seizure is the most common type of seizure affecting 3-4% of children. The recurrence rate of febrile seizure is approximately 33%. About 16% of children with a febrile seizure during the febrile illness have a recurrent seizure attack within 24 hours. This study aimed to investigate the optimum dose of diazepam to reduce the recurrence of febrile seizures in children who have had a febrile seizure attack. METHODS: The children with febrile seizure who were admitted to the Maryknoll hospital for in vestigation and treatment were retrospectively reviewed. The study group compromised 306 children. The febrile seizure was defined as seizure attack with fever(above 38degreeC) without evidence of intracranial infection or defined cause in children aged 6 months to 5 years. The children were divided into four groups according to dose of diazepam. Group I, 72 patients, received no diazepam therapy. Group II, 78 patients, received oral diazepam in a dose of 0.1 mg/kg every eight hours during the febrile illness, Group III, 87 patients, 0.2 mg/kg, and Group IV, 69 patients, 0.3 mg/kg, respectively. RESULTS: The seizure attack rate and the duration of admission were reduced in both Group III and Group IV. However, there was no difference in the side effects of the diazepam between group III and IV. CONCLUSION: Oral diazepam in a dose of 0.2 mg/kg effectively decreases both the seizure attack rate and the duration of admission.

The Effect of Diet Therapy on the Course of Acute Diarrheal Disease / 대한소아소화기영양학회지

PURPOSE: We studied to know the effect of early feeding on the course and the recovery of acute diarrheal disease. METHODS: The study was conducted on 76 patients who admitted to the Soonchunhyang university hospital for acute diarrhea. We divided 76 patients into 3 dietary groups (whole milk group (WMG): 35, diluted milk group (DMG): 29, breast milk group (BMG): 12). We compared three groups by numbers of diarrhea, numbers of vomiting, calory intake, weight increments, and duration of diarrhea. RESULTS: 1) The mean age was 16.45+/-18.20, 11.53+/-9.80, 5.38+/-5.01 months for WMG, DMG, and BMG, respectively. The mean weight was 9 kg and the mean duration of diarrhea was 2.29 days. 2) The numbers of diarrhea during admission was not significantly different in the three groups. 3) The calory intake during admission was significantly low in DMG. 4) The weight increments during admission was significantly low in DMG. 5) The duration of diarrhea during admission was not significantly different in the three gourps. CONCLUSION: Early refeeding with whole milk or breast milk did not prolong or worsen the course or symptoms of diarrhea compared with gradual reintroduction with diluted milk. But there were advantages of improved nutrition and weight increments. Futher study is necessary to demonstrate the effect of diet according to the causative organisms.

Association between Tuberculin Responses and Serum IgE

PURPOSE: Atopy is a state of allergic response, mediated by IgE, to common environmental allergens. In recent decades, there has been an increase in prevalence of atopic disorders in children in developed countries. The factor associated with the rise of atopy incidence may be declining exposure to some infection opportunities. The aim of this study is to determine if the immune response to Mycobacterium tuberculosis can suppress atopy by investigating the association between tuberculin responses and serum IgE. METHODS: We divided the patients into two groups according to tuberculin skin test. Group A showed positive response (induration diameter > or =10mm), while Group B showed negative response (induration diameter< l0mm). A comparison was made between the two groups in terms of age, sex, serum total IgE and allergen-specific IgE. RESULTS: Twenty-one patients comprised Group A and 72 comprised Group B. The mean serum total IgE concentration and the number of patients showing positive MAST in Group B was significantly higher than that of Group A (P<0.05). CONCLUSION: In our study, there was an inverse association between delayed hypersensitivity to Mycobacterium tuberculosis and atopy.