A Clinical Study of Adenoviral Respiratory Infection in Children

PURPOSE: Adenoviral respiratory infection can develop a life threatening condition similar to severe bacterial pneumonia. Despite adequate intensive care, this infection progresses to acute respiratory distress syndrome and causes permanent lung damage in some patients. In this study, we analyzed clinical features and long-term follow-up clinical data of this infection in children. METHODS: Forty-seven cases of inpatients were diagnosed as adenoviral respiratory tract infection by viral culture of nasal aspirates or histopathological diagnosis at Samsung Medical Center during the period from February 1995 to July 1998. We reviewed medical records retrospectively. RESULTS: During this study, 1301 cases of acute respiratory tract infection were investigated, of which 47 cases were confirmed as adenoviral infection. Age ranged from 2 months to 6 years. Initial symptoms were productive cough(100%), fever(91%), dyspnea(62%), diarrhea(40%), and conjunctival injection(30%). Thirty-nine cases(83%) were pneumonia and 7 cases(15%) were bronchiolitis. The radiologic findings were pneumonic consolidation(60%), effusion(36%), infiltration(19 %), and atelectasis(13%). Five cases developed acute respiratory distress syndrome and 3 cases expired. In 31 cases of recovered patient, follow-up evaluation was done at a minimum of 3 months(mean duration 9.9+/-9.3 months). Under the follow-up evaluation, 13 patients(42%) showed physical and radiologic findings that consisted with bronchiolitis obliterans or bronchiectasis. CONCLUSION: Because of severe clinical manifestations and pulmonary complications, early diagnosis, adequate management, and long-term follow-up are needed for adenoviral respiratory tract infection.

Congenital Intrahepatic Portosystemic Shunt in a Newbom Successfully Treated with Coil Embolization Via Umbilical Vein

Congenital intrahepatic portosystemic shunt is a rare entity and is mostly reported in adults. In embryonic period, the vitelline vein is broken up into the vitelline sinusoids, which become the intrahepatic portal vein branches and the hepatic veins. The portosystemic venous shunts may develop from embryonic vascular remnants, including the vitelline vein and ductus venosus. We report for the first time in Korea a case of congenital intrahepatic portosystemic shunt in a newbom infant presenting with congestive heart failure and hepatomegaly, successfully treated by coil embolization via umbilical vein.

Memory Functions of Temporal Lobe Epileptic Patients in the Intracarotid Amobarbital Procedure:I. Lateralizing Value

BACKGROUNDS: To examine the effects of seizure laterality and stimulus type on Wada memory performance in patients with temporal lobe epilepsy(TLE). METHODS: The subjects were 43 patients with medically intractable TLE (left TLE 26, Right TLE 17) who had no or rare seizures after surgery. The memory stimuli were concrete figures for some subjects and abstract figures for the other subjects. RESULTS: A clinical criterion of at least 2-points difference between left and right injections correctly classified 31(72%) patients into left and right TLE groups, with 4(9%) patients falsely classified. A discriminant function analysis(DFA) based on left and right injection scores allowed for a correct classification of 37(86%) patients into left and right TLE groups. When the memory stimuli were concrete figures, the correct classification rate was greater for right than left TLE patients. In contrast, with abstract figures, the correct classification rate was greater for left than right TLE patients. CONCLUSIONS: The Wada memory test is a valuable diagnostic aid in lateralizing temporal epileptogenic foci. Stimulus type as well as seizure lateralization is a major determinant of Wada memory asymmetries.

A Case Report of Crohn's Disease / 대한소화기내시경학회지

Crohn's disease is an acute or chronic inflammatory disorder, characteristically non- specific granuloxaatous neerotiziag, cicatrical low grade inflammation, occuring in various portions of the entire oro-gastraintestinal tract. The etiology is not clearly defined and rather uncertain. The disease is a heterogenous & dubious entity with multiple systemic manifestations. The incidence of the disease is geographically unequal in world wide distrihution. And male and female are equally involve. In June, 1985, a case of 17-year-old female patient, who was diagnosed by clinico-micro- scopic examination at Han Yang Univ. hospital. And then, we report with a review of world literatare.