ABSTRACT
We describe two cases of alpha-thalassemia in girls from multicultural Korean-Vietnamese family, diagnosed by genetic testing, multiplex ligation-dependent probe amplification. To our knowledge, this is the first report of alpha-thalassemia in Korean. We hope that these cases will raise awareness of alpha-thalassemia among pediatricians who care for children with anemia.
Subject(s)
Child , Humans , alpha-Thalassemia , Anemia , Genetic Testing , Multiplex Polymerase Chain ReactionABSTRACT
We describe two cases of alpha-thalassemia in girls from multicultural Korean-Vietnamese family, diagnosed by genetic testing, multiplex ligation-dependent probe amplification. To our knowledge, this is the first report of alpha-thalassemia in Korean. We hope that these cases will raise awareness of alpha-thalassemia among pediatricians who care for children with anemia.
Subject(s)
Child , Humans , alpha-Thalassemia , Anemia , Genetic Testing , Multiplex Polymerase Chain ReactionABSTRACT
PURPOSE: Child sexual abuse is a significant and serious problem that affects public health and society. Pediatricians are responsible for preventing and detecting sexual abuse of children. The aim of this study was to examine clinical findings of child sexual abuse. METHODS: The authors retrospectively studied 292 patients between the ages of 0 and 18 who were referred for evaluation of sexual abuse to the Emergency Department of the National Police Hospital from Oct 1, 2001 to May 5, 2005. RESULTS: Sixty three (21.6 percent) of sexual abuse victims were younger than 6 years of age; 89 (30.5 percent) were 6-12 years of age; and 104 (47.9 percent) were 12-18 years of age. Attack time was the most common between noon and 6 pm. Victims were attacked in their home or nearby (51.4 percent). One hundred fifty six (53.6 percent) offenders were accquaitances, thirty nine (13.4 percent) of whom were family members. The disclosure of attack by parents with abnormal physical symptoms was more common in younger children than in adolescence. Eighty nine (30.5 percent) victims had no specific physical findings, 51 percent had injury to the hymen, 37.3% had injury to external genitalia, and 4 percent had anal injury. One case of gonorrhea and thirteen cases of chlamydia were found. Sperm was found in 19 cases and acid phosphatase was positive in 28 cases. The absence of physical findings and laboratory findings was more common in younger children than in those in adolescence. The time interval from attacks to hospital visits had a significant negative correlation with age. CONCLUSION: For younger victims, the time interval from attack to hospital visitis was more prolonged. Victims may have no physical evidence of sexual abuse. Therefore, a careful history should be obtained and a through physical examination should be performed. Pediatricians must play a leading role in evaluation and treatment of sexually abused children, considering children,s growth and development. Coordination with other professionals is necessary to provide consultation, medical treatment, and legal assistance for the sexually abused children and families.
Subject(s)
Adolescent , Child , Child , Female , Humans , Acid Phosphatase , Child Abuse, Sexual , Chlamydia , Criminals , Disclosure , Emergency Service, Hospital , Genitalia , Gonorrhea , Growth and Development , Hymen , Parents , Physical Examination , Police , Public Health , Retrospective Studies , Sex Offenses , SpermatozoaABSTRACT
PURPOSE: It is difficult to diagnose acute pyelonephritis(APN) in young children, because of their nonspecific symptoms. The younger the age, the higher the risk of renal scars after APN, which can be prevented by early diagnosis and treatment. We compare the significance of renal imaging studies by age for diagnosis of APN in febrile urinary tract infection(UTI) in children. METHODS: Fifty-three hospitalized children(34 patients under age 2 and 19 patients over age 2) with febrile UTI and who had undergone dimercaptosuccinic acid(DMSA) scan, renal ultrasonography(RUS) and voiding cystourethrography(VCUG) during the acute stage were reviewed. We compared the renal imaging studies between the different age groups. RESULTS: The DMSA scan showed cortical defects in 23.5% of patients under age 2, which was significantly lower than 63.2% of patents over age 2(P<0.05). The renal cortical defects on DMSA scan were associated only with a high peripheral leukocyte count, but not with fever duration, erythrocyte sedimentation rate(ESR), and C-reactive protein(CRP). And there was no correlation between the DMSA scan, VCUG or RUS findings. CONCLUSIONS: The DMSA scan is not sensitive for diagnosis of APN in children less than 2 years of age and the findings cannot predict the presence of vesicoureteral reflux(VUR). VCUG may be necessary for proper management in this age group.
Subject(s)
Child , Humans , Blood Sedimentation , Cicatrix , Diagnosis , Early Diagnosis , Fever , Leukocyte Count , Pyelonephritis , Succimer , Urinary TractABSTRACT
PURPOSE: Forward pulmonary blood flow may be absent in some neonates with Ebstein's anomaly by anatomical or functional pulmonary atresia in association with the elevated pulmonary vascular resistance, patent ductus arteriosus and tricuspid regurgitation. We reviewed the presentation and outcomes of symptomatic neonates with Ebstein's anomaly focusing on the pulmonary atresia. METHODS: Clinical presentation and outcome of 15 symptomatic neonates with Ebstein's anomaly seen at Asan medical center from 1998 to 2004 were reviewed. RESULTS: Ten (67%) of 15 patients showed no forward pulmonary blood flow and 6 of them had functional pulmonary atresia. O2 saturation and pH were lower and cardiothoracic (CT) ratio in chest radiography was more increased in the patients with pulmonary atresia than in the patients without pulmonary atresia (P< 0.05). pH and CT ratio were not different between the anatomical and functional pulmonary atresia group, but O2 saturation was lower in functional atresia group (P< 0.05). 13 patients (87%) were managed with PGE1. 4 of 6 patients with functional pulmonary atresia were treated with inhaled nitric oxide. Surgery was performed in 1 of 5 patients without pulmonary atresia and in 8 of 10 patients with pulmonary atresia during follow-up period (mean 37 months). 3 patients (20%) died and none of patients without pulmonary atresia died. CONCLUSION: We found that most symptomatic neonates with Ebstein's anomaly had functional or anatomical pulmonary atresia. The neonates with Ebstein's anomaly who had no forward pulmonary blood flow were more symptomatic and needed surgery earlier. Further studies will be needed to distinguish effectively functional and anatomical pulmonary atresia and to manage appropriately neonates with functional atresia.
Subject(s)
Infant, Newborn , HumansABSTRACT
Systemic air embolism occurs when air enters the pulmonary venous system as a result of a positive gradient caused by low pulmonary venous pressure or increased airway pressure, or both. Systemic air embolism has been frequently reported after penetrating thoracic trauma and can induce life-threatening complications. In blunt thoracic trauma, systemic air embolism has been rarely diagnosed. Because air embolism associated with blunt trauma is more insidious, diagnosis is usually not appreciated unless special circumstances allow discovery of air in major vessels or coronary arteries, such as during emergency resuscitative thoracotomy. We report a case of systemic air embolism in an 18-month-old girl after accidental thoracic blunt trauma and review related literature.
Subject(s)
Child , Female , Humans , Infant , Coronary Vessels , Diagnosis , Embolism, Air , Emergencies , Thoracotomy , Venous PressureABSTRACT
PURPOSE: Cepharanthin (R) has been reported to improve the symptoms of intractable or steroid-resistant chronic idiopathic thrombocytopenic purpura (ITP). We report the clinical efficacy of oral high dose Cepharanthin (R) in refractory chronic ITP. METHODS: We analyzed eleven patients who were diagnosed as chronic ITP at the Department of Pediatrics, Seoul National University Hospital from January, 2002 to February, 2004. After informed consent patients with platelet count below 20, 000/mm3 were treated with Cepharanthin (R) at the initial dose of 5 gm/day. The doses were increased up to 15 gm/day if there was no response. For the purposes of this study, complete remission was defined as an elevation of the platelet count > or =50, 000/mm3 from the baseline after 4 weeks of treatment. Partial remission was defined as an elevation of the platelet count 20, 000/mm3 and < = or50, 000/mm3 from the baseline. RESULTS: Seven boys and four girls with a median age of 10 were enrolled. Two to four weeks after the initiation of this therapy, 4 patients showed their platelet counts over 50, 000/mm3 1 patients reached partial remission state, 6 patients had no response. Side effects of Cepharanthin (R) were not observed in all patients. CONCLUSION: We suggest that the oral administration of Cepharanthin (R) could be a beneficial and a safe treatment strategy for the refractory chronic ITP patients. Further studies should be performed to elucidate the mechanism of responses.
Subject(s)
Child , Female , Humans , Administration, Oral , Informed Consent , Pediatrics , Platelet Count , Purpura, Thrombocytopenic, Idiopathic , SeoulABSTRACT
PURPOSE: Acute diarrhea in young children is a major problem in pediatric hospitals worldwide. We evaluated the clinical efficacy of orally administered Lactobacillus acidophilus in the treatment of acute diarrhea in children. METHODS: From September 2002 to July 2003 at National Police Hospital 41 children aged 3 months to 5 years with acute diarrhea were enrolled in this study. The patients were randomized to one of two groups to receive either 0.5 x 10(8) colony forming unit (CFU) of L. acidophilus or matching placebo on admission and every 8 hours during hospitalization. RESULTS: The mean duration of diarrhea in all 41 children was decreased (p=0.001) in the L. acidophilus (40.5 hours) group compared to the placebo (56.6 hours) group. Stool frequency was also reduced (p=0.01) on the 3rd day in the L. acidophilus group. Rotavirus was identified in 58% of the patients. The decrease of duration of diarrhea was more significant in rotavirus-negative patients (p=0.002) compared to the rotavirus-positive patients (p=0.027). CONCLUSION: L. acidophilus shows to be an effective therapeutic agent in acute diarrhea in children. Further studies are needed to confirm the present findings.
Subject(s)
Child , Humans , Diarrhea , Hospitalization , Hospitals, Pediatric , Lactobacillus acidophilus , Lactobacillus , Police , Probiotics , Rotavirus , Stem CellsABSTRACT
Kallmann syndrome is characterized by hypogonadotropic hypogonadism resulting from insufficient release of GnRH and associated with anosmia or hyposmia. We experienced two cases of Kallmann syndrome with abnormal brain MRI findings(olfactory bulb aplasia) & secondary sexual dysfunction.
Subject(s)
Brain , Gonadotropin-Releasing Hormone , Hypogonadism , Kallmann Syndrome , Magnetic Resonance Imaging , Olfaction DisordersABSTRACT
Kallmann syndrome is characterized by hypogonadotropic hypogonadism resulting from insufficient release of GnRH and associated with anosmia or hyposmia. We experienced two cases of Kallmann syndrome with abnormal brain MRI findings(olfactory bulb aplasia) & secondary sexual dysfunction.
Subject(s)
Brain , Gonadotropin-Releasing Hormone , Hypogonadism , Kallmann Syndrome , Magnetic Resonance Imaging , Olfaction DisordersABSTRACT
The efficacy of acetaminophen, sponging plus acetaminophen, and sponging alone as method of lowering body temperature was compared in 108 children aged 8 weeks to 5 years who presented with an axillary temperature of 38.5degrees C or greater during the period from January 1993 to April 1993. The following results were obtained. 1) The male to female ratio was 2.5:1 and clinical diagnosis in the order of frequency were upper respiratory infection, gastroenteritis, pneumonia, urinary tract infection, cellulitis, chickenpox and hand-foot-mouth disease. 2) At thirty minutes after treatment, there was no significant difference on the decrement of temperature among the three groups. 3) At sixty minutes, the temperature decrement was the greatest in the group of sponging plus acetaminophen and that was statistically significant (P<0.01). But there was no significant difference between the group of acetaminophen and that of sponging.
Subject(s)
Child , Female , Humans , Male , Acetaminophen , Body Temperature , Cellulitis , Chickenpox , Diagnosis , Fever , Gastroenteritis , Pneumonia , Urinary Tract InfectionsABSTRACT
The authors determined the value of performing urine microscopy on biochemically negative urine sepcimens in a pediatric population. The 746 urine specimens of patients who were either visited or admitted to the Department of Pediatrics, National Police Hospital, from March 1991 to July 1992 were reviewed on the basis of comparative evaluation of biochemical and microscopic urine analysis. Eight reactions of Clinitek(r) 200 were used as biochemical indicators, namely, pH, nitrite, albumin, glucose, ketone, urobilinogen, bilirubin, and blood. Out of 746 urine specimens studied, 186 were true positive. Thirty-six specimens reacted biochemically in the absence of positive microscopic findings (false postive), 492 specimens were true negatives. Thirty-two specimens had negative biochemical indicators, in spite of positive microscopy. The sensitivity of the biochemical parameters for predicting significant microscopy of urinary sediment is 85% and the specificity is 99%. The positive predictive value is 69.7% and the negative predictive value is 99.3%. The sensitivity of blood for RBC is 94%. and the specificity is 99%. The predictive value of a positive result is 84.6% and that of a negative result is 99.7%. We therefore conclude that urine microscopy is less necessary in biochemically negative urine specimens from asymptomatic pediatric patients, with hopefully resultant time and cost effectiveness.
Subject(s)
Humans , Bilirubin , Cost-Benefit Analysis , Glucose , Hydrogen-Ion Concentration , Microscopy , Pediatrics , Police , Sensitivity and Specificity , Urinalysis , UrobilinogenABSTRACT
No abstract available.