A Case of Basaloid Squamous Cell Lung Carcinoma in an 11-year-old Boy / 소아과

Primary lung cancer is unusual in children; the squamous cell variant is extremely rare. Lung cancer is classified by histologic types into small-cell lung cancer, non-small cell lung caner, carcinoid, mucoepidermoid carcinoma, and adenoid cystic carcinoma. Furthermore, non-small cell lung cancer is subclassified into adenocarcinoma, large-cell carcinoma, and squamous cell carcinoma. The incidence of lung cancer is influenced by smoking, especially in squamous cell carcinoma, and large cell carcinoma. The present treatments for these tumors are chemotherapy, radiation therapy, and surgical resection depending on their histologic types or stages, but yield very poor survival rates. In this article, we report a case of basaloid squamous cell lung carcinoma in an 11-year-old boy who had symptoms of both leg weakness and back pain radiating to both legs. We confirmed the primary lung carcinoma cells by percutaneous transthoracic needle biopsy. The metastatic carcinoma cells were identified at the bone marrow and lumbar spine. We treated with a combination chemotherapy and radiation therapy. However, he expired 4 months after the onset of disease.

Two cases of Creosote Induced Gastric Ulcer / 대한소아소화기영양학회지

Secondary peptic ulceration and gastritis have been known to be associated with stress, exogenous agents, drugs or infection. Salicylate (aspirin) ingestion has been known to be associated with increased incidence of gastric ulcer and more frequently as the cause of hemorrhagic gastric erosions and gastritis. Some medications such as tetracyclines and iron preparations have been associated with ulceration of the gastrointestinal tract. Chemotherapeutic agents including cytoxan and methotrexate also have been implicated in the development of mucosal and gastrointestinal ulcers. We have experienced two cases of hemorrhagic gastric ulcers due to creosote ingestion in a 13 month and a 45 year old boys. Creosote is a main component of one of the popular digestives, Jungrohwan in Japan and Korea.

A Case of Duodenal Web Associated with Intestinal Malrotation / 대한소아소화기영양학회지

Duodenal web is an uncommon lesion that infrequently cause partial or complete intestinal obstruction. If the duonenal web is incomplete and only partially obstructs the duodenal lumen, the onset of symptoms may be delayed for years, and obstructive symptoms will be only minimal and intermittent. Congenital duodenal obstruction is occasionally associated with intestinal malrotation. We experienced a case of duodenal web associated with intestinal malrotation in a 9-year-old girl who had been suffered from intermittent projectile vomiting since birth without failure to thrive. The diagnosis was made by UGI series & abdominal CT. Patient remained asymptomatic after operation.

A Case of Acrodermatitis Enteropathica Associated with CMV Hepatitis / 대한소아소화기영양학회지

Acrodermatitis enteropethica (AE) is a rare autosomal recessive disorder of zinc absorption leading to chronic diarrhea and characteristic skin lesion. The term is also applied to any acquired zinc deficiency state resulting in the same clinical pictures. We experienced one case of AE in 1 month old male infant who had bacterial enterocolitis. The skin around mouth, anus, eyes, ears, hands and legs became reddish, vesicular and eczematoid. Serum zinc level was decreased to 51.4 microgram/dL (N=70~150). Endoscopic finding revealed pale gastric mucosa and villous atrophy of small intestine. Biopsy finding of small intestine showed no villi due to mucosal atrophy. On 13 day of admission jaundice with DIC were noted and AST & ALT were elevated to 110 & 36.8 IU/L, respectively. Diarrhea was improved but jaundice and liver function were not recovered until discharge from hospital. After discharge when the patient was 4 months of age serum bilirubin and AST/ALT had not been normalized. CMV shell vial culture of urine and CMV Ig G antibody were positive. So intravenous ganciclovir injection of 7.5 mg/kg, two times a day for 2 weeks and then 10 mg/kg/day for 3 months was done from 4 to 6 months of age. No virus was found in the urine and AST & ALT were normalized at 2 months after stopping ganciclovir treatment.

Gastroesophageal Reflux Disease in Children with Chronic Cough

PURPOSE: We investigated the incidence of gastroesophageal reflux disease (GERD) by 24-hour esophageal pH monitoring in patients who had chronic cough for more than 3 weeks. METHODS: From January 1995 to August 1996, 33 patients with chronic cough which had lasted for more than 3 weeks were enrolled in the 24-hour esophageal pH monitoring. The result was interpreted with the standard value which was suggested by Yvan Vandenplas in 1991 for patients younger than 15 months and with the De Meester Score for patients older than 15 months. We performed esophagoscopy and lower esophageal biopsy for patients who proved to have gastroesophageal reflux disease by 24-hour esophageal pH monitoring. RESULTS: Among 33 cases, 13 cases (39.4%) were proved to have GERD. Comparing between the normal group and the GERD group, there was no difference of gastroesophageal reflux incidence according to meal or position. We performed esophagoscopy in 10 patients among 13 GERD cases. There were 3 cases of gross esophagitis. Papillary height was elongated by more than 50% of normal in 7 cases, and basal cell layer increased by more than 20% of normal in 6 cases. Neutrophil or eosinophil infiltration was found in 2 cases, and lymphocyte infiltration was found in 7 cases. CONCLUSION: We suggest that 24-hour esophageal pH monitoring and appropriate treatment should be considered in prolonged unexplained chronic cough.

Korean Gaucher Disease Patient Registry / 대한소아혈액종양학회지

BACKGROUND: This study is aimed to identify Gaucher disease(GD) patients(pts.) in Korea in order to better understand the incidence, clinical phenotype and its natural history and to establish pt. registry. The registry is to provide collective data, which will lead to early diagnosis, effective treatment and better management of pts. METHODS: (1)Questionnaires designed to identify GD pts. were sent to all members of Korean Pediatric Hemato-Oncology Society in 1997 and other inquiring physicians. (2) All published papers on GD were searched in Korean Medical Journals to Feb. 1988. RESULTS: Review of data obtained from questionnaire survey and literature search yielded a total of 44 pts. in 31 pedigrees. 33 of them were reported as type I(chronic, non- neuronopathic), 6 pts. as type II(acute, neuronopathic) and 5 pts. as type III(subacute, neuronopathic). As for the most common type I pts, all 33 but one were diagnosed in infancy and childhood(7mon~18y.o), 11 of them died during childhood(1yr~18y.o), 10 pts. were not known whether alive or dead and 12 pts. are alive and followed up. All 6 type II pts. were diagnosed during infancy and 4 of them died before age of two. All 5 type III pts. in 2 families developed myoclonic seizures in late teens and two died in early twenties and three of them being followed up by neurologists. CONCLUSION: A total of 44 GD pts. in 31 Korean families are identified, which is consistant with autosomal recessive mode of inheritance pattern in all three clinical phenotypes. As of Feb. 1988, 18 pts. were registered in Korean Gaucher Registry; 12 type I pts, 2 type II pts. and 4 type III pts. In case of type I pts., early onset in younger age and rapid progression of disease resulted in high mortality and morbidity compare to GD pts. among Caucasian esp. the most prevalent Ashkenazi Jewish population. Therefore, early diagnosis and effective treatment with Enzyme Replacement Therapy will be desirable for better management of Korean GD pts.

Serum Lipids and Fatty Acids According to the Type of Feeding in Children

PURPOSE: Lipids and fatty acids are very important for brain and nervous system in growing children. This study was carried out to compare the composition of serum lipids and fatty acids according to the type of feeding in children. METHODS: One hundred and twenty two children aged from 5 month to 24 month who visited Soonchunhyang University Hospital from Mar. 1995 to Jan. 1996 with no gastrointestinal or nutritional problems were selected to compare the composition of serum lipids and fatty acids according to the type of feeding. They were divided into 3 groups according to type of feeding. Thirty three cases were breast milk fed group (BF), 48 cases were formula fed group and 41 cases were whole cow's milk fed group. Serum lipids were analysed by Folch method. Fatty acid methyl ester was made with BF3-methanol solution. Fatty acid contents (area%) were calculated by automatic analyser. RESULTS: 1) The mean serum cholesterol level was 144.14mg/dl and it was significantly higher in breast milk fed group (BF). 2) The mean serum low density lipoprotein (LDL) level was 88.82mg/dl and it was significantly higher in breast milk fed group (BF) (p<0.05). 3) Serum polyunsaturated fatty acid (PUFA) level was 39.13% and it was significantly higher in BF. 5) Mean serum omega6 fatty acid level was 35.43% and there was no significant difference between three groups. 6) Mean serum omega3 fatty acid level was 3.70% and it was significantly higher in BF (p<0.05). 7) Mean serum arachidonic acid (AA) level was 5.28% and it was significantly higher in BF (p<0.005). 8) Mean serum eicosapentaenoic acid (EPA) level was 0.51% and there was no significant difference between three groups. 9) Mean serum docosahexaenoic acid (DHA) level was 2.00% and it was significantly higher in BF (p<0.005). CONCLUSIONS: Nutritional benefit of breast milk was proven by significantly high serum levels of arachidonic acid and DHA in breast milk fed group. Essential fatty acids and DHA should be addded to infant formula. Excessive amount of whole cow's milk feeding to infants is not good in nutritional aspects. Education and guidance about feeding method of infants are also needed.

A Case of Unusual (1q;21q) Translocation Down Syndrome Inherited from a t (1q;21q) Balanced Carrier Mother

Down syndrome is the most common autosomal syndrome in man. The incidence of trisomy 21 due to translocation is about 3.5-5%. Translocations are usually centric fusions between a 21 and a D group (54.2%) or a G group (40.9%) chromosome. Since the short arm of 21 carries no phenotypically active genes, even if the short arm of 21 is lost, usually there is no imbalance with clinical significance. Rare translocations in Down syndrome may also occur between a 21 and other chromosomes (4.9%). We experienced a case of unusual (1q;21q) translocation Down syndrome inherited from a t (1q;21q) balanced carrier mother. The segmental trisomy was confirmed by FISH analysis. This is the first case of a familial Down syndrome with t (1q;21q) in Korea.

A Case of Treatment of Acute Renal Failure due to Bilateral Ureter Injuries after Bilateral Inguinal Herniorrhaphy / 대한신장학회잡지

Inguinal herniorrhaphy is the most frequent general surgical operation performed by pediatric surgeons, but some complications can usually be attributed to inappropriate approach and traumatic dissection. We experienced a case of acute renal failure due to bilateral ureter injuries after bilateral inguinal hernia repairs. The patient was a 3 month old male infant who presented as anuria and generalized edema after bilateral herniorrhaphy and was treated with peritoneal dialysis for 2 weeks. After 4 days of peritoneal dialysis, general conditions and symptoms were improved, but anuria persisted for 2 weeks. We performed IVP and abdominal CT. Both studies showed abnormal dye accumulation in peritoneal cavity. Ureteroneocystostomy on right and segmental resection of ureter and end to end anastomosis of left ureter were done without any complications. He has been doing well and has had normal kidney function. Therefore we report a case of acute renal failure due to bilateral ureter injuries after both inguinal herniorrhaphy with a brief review of literatures.

Conversion Rates of Tuberculin Test according to BCG Vaccination Methods

PURPOSE: Tuberculosis, a major public health problem, is an important cause of childhood morbidity and mortality in developing countries. To decline the tuberculosis morbidity rate, active BCG vaccination is performed worldwide. Recently percutaneous multiple puncture technique of BCG vaccination was introduced and used because of side effects of intradermal BCG vaccination such as scar, local ulceration, regional suppurative lymphadenitis. We studied the difference of positive conversion rates and side effect after intradermal BCG vaccination and percutaneous multiple puncture technique BCG vaccination. METHODS: Three hundred seventy one infants, who were vaccinated at well baby clinic of Soonchunhyang University Hospital and performed tuberculin skin test using 5TU PPD (NIH, Korea) at 4month, were divided two groups; group I of 257 infants immunized percutaneous multiple puncture technique BCG (Japan BCG Laboratory, Japan) and group II of 174 infants immunized intradermal BCG (Institute Meri ux, France). RESULTS: 1) Sixtysix point five percent of male infants and 72.4% of female infants were vaccinated percutaneous multiple puncture technique BCG (Group I) 2) The positive conversion rate was 97.7% in group I and 76.3% in group II (p<0.05). 3) The positive conversion rate vaccinated within 2 weeks after birth were 97.9%, 2-4weeks 97.8%, 5-6weeks 95.2% in group I, and within 2 weeks 73.5%, 2-4weeks 75.8%, 5-6weeks 83.3% in group II. 4) The mean induration of positive conversions were 10.6+/-2.8mm in group I and 9.3+/-2.7mm in group II, that of Group I was significantly higher than that of groupII (p<0.05). 5) The complications of BCG vaccination were fever, generalized rash, and local ulceration in group I, fever, severe irritability in groupII. But there was no significant difference in two groups. CONCLUSIONS: The infants of vaccinated with percutaneous multiple puncture technique showed larger size of mean induration and higher positive conversion rate after PPD and less scar after vaccination compared with intradermal method. Further studies is necessary to find out the optimum time for BCG vaccination by percutaneous multiple puncture technique to provide the better immunity.

Time of First Defecation and Voiding in the Term and Premature Infants

PURPOSE: Almost of the term infants pass the first stool and urine within 48 hours after birth and delay of first defecation and voiding is considered as an initial sign of congenital intestinal obstruction or gastrointertinal motility disorder. In the premature infants, although they do not have congenital intestinal obstruction, the time of first defecation or voiding is delayed beacause of developmental prematurity of the gastrointestinal motility. To know factors which affect the time of first defecation and voiding, we studied. METHODS: From February 1993 to May 1995, Newborns (24 term, 77 premature, total 101) who were delivered in Soonchunhyang University Hospital without congenital intestinal obstruction were reviewed retrospectively about the relationship between the factors such as birth weight, gestational age, delivery type or the first feeding time and the first defecation or voiding time. RESULTS: 1) All of the term infants passed the first stool within 24 hours after birth. 2) Among the infants who passed the first stool after 24 hours since birth, 27.6% were 32-36 weeks and 40.5% were 27-31 weeks of gestational age. 3) Among the infants who passed the first stool after 24 hours since birth, 14.3% were 2,000-2,499gm, 35.7% were 1,500-1,999gm and 55% were 1,000-1,499gm of birth weight. 4) There was no statistically significant correlation between the first defecation time and sex, type of delivery or time of first feeding time. 5) Most of the term and premature infants passed the first urine within 24 hours after birth. There was no difference according to gestational age, birth weight, type of delivery or first feeding time. CONCLUSIONS: In larger parts of the premature and preterm infants, the first defecation wa delayed for 24 hours after birth. So, we should wait the first defecation more than 24 hours after birth in prematurity.

Time of First Defecation and Voiding in the Term and Premature Infants

PURPOSE: Almost of the term infants pass the first stool and urine within 48 hours after birth and delay of first defecation and voiding is considered as an initial sign of congenital intestinal obstruction or gastrointertinal motility disorder. In the premature infants, although they do not have congenital intestinal obstruction, the time of first defecation or voiding is delayed beacause of developmental prematurity of the gastrointestinal motility. To know factors which affect the time of first defecation and voiding, we studied. METHODS: From February 1993 to May 1995, Newborns (24 term, 77 premature, total 101) who were delivered in Soonchunhyang University Hospital without congenital intestinal obstruction were reviewed retrospectively about the relationship between the factors such as birth weight, gestational age, delivery type or the first feeding time and the first defecation or voiding time. RESULTS: 1) All of the term infants passed the first stool within 24 hours after birth. 2) Among the infants who passed the first stool after 24 hours since birth, 27.6% were 32-36 weeks and 40.5% were 27-31 weeks of gestational age. 3) Among the infants who passed the first stool after 24 hours since birth, 14.3% were 2,000-2,499gm, 35.7% were 1,500-1,999gm and 55% were 1,000-1,499gm of birth weight. 4) There was no statistically significant correlation between the first defecation time and sex, type of delivery or time of first feeding time. 5) Most of the term and premature infants passed the first urine within 24 hours after birth. There was no difference according to gestational age, birth weight, type of delivery or first feeding time. CONCLUSIONS: In larger parts of the premature and preterm infants, the first defecation wa delayed for 24 hours after birth. So, we should wait the first defecation more than 24 hours after birth in prematurity.

A Survey about the Usage of Whole Cow's Milk and Commercial Baby Food in Children

PURPOSE: The appropriate age and amount that whole cow's milk and commercial baby food can be introduced safely into the infant diet are unknown and remains an area of controversy. Early feeding of excessive amount of whole cow's milk has been associated with iron deficiency anemia and nutritional deficiency. We studied the present status and problems on the feedig of whole cow's milk and commercial baby food in children. METHODS: This survey was done through questionnaire to the 541 out patients who visited Seoul, Chun An and Eum Sung Soon Chun Hyang University Hospitals during the period from Jun. 1994 to Fab. 1995. RESULTS: 1) Feeding patterns according to age of children: Infants were fed prepared milk(63.6%), human milk(16.2%), whole cow's milk(8.1%), commercial baby food(7.1%) and rice(5.0%) in the order of frequency. Children between 1 and 2 years of age were fed rice(37.1%), whole cow's milk (34.3%), prepared milk(17.1%), commercial baby food(7.4%) and human milk(4.0%) in the order of frequency. 2) Whole cow's milk feeding was started at 3 to 6 months of age in 11.5%, at 7 to 12 months of age in 59.6% and after 12months of age in 28.9%. 3) The daily feeding amounts of whole cow's milk was less than 500 ml in 48.2%, 500 to 999 ml in 36.2%, and more than 1000 ml in 15.6%. Suprisingly 49.7% of them were fed more than 500 ml a day. 4) About iron content in whole cow's milk, only 25.9% of mothers gave the correct answer. 5) 62.5% of mothers considered that whole cow's milk was the best food in infant period. 6) Only 19.1% of subjects used commercial baby food properly in method and amount. CONCLUSIONS: Whole cow's milk was introduced during early months of life and fed in excessive amount. There was a lack of maternal knowledge about iron content in whole cow's milk. The improper use of commercial baby food produced the numerous nutritional problems. Thus, we need education about whole cow's milk and commercial baby food to mothers.

Serum Vitamin A Level and Immunization Status in Serologically Confirmed Measles Patients

PURPOSE: To know the relationship between serum vitamin A level and clinical symptoms in measles patients and to re-evaluate the measles vaccination schedule, we performed this study. METHODS: From Jan. to Jun. 1994, we checked serum vitamin A levels and compared with clinical symptoms, laboratory findings, complications and vaccination status in 153 patients with positive measles IgM by ELISA. RESULTS: The results were as follows 1) The measles was most prevalent in the group of 7-9 months(26.1%) and 5-9 years(27.5%) of age. 2) Mean serum vitamin A level was 215.9+/-79.6ng/ml but it was lower than normal value(410-1200ng/ml). 3) Serum vitamin A level was significantly lower in the group of over 2 years of age (194.3+/-78.4ng/ml) than the group of under 2 years of age (230.2+/-77.8ng/ml). 4) There was no relationship between serum vitamin A level and clinical symptoms. 5) About half of the patients with measles IgM antibodies had a Measles vaccination before. The kinds of vaccination were measles vaccine only in 5.2%, MMR in 25.5% and measles and MMR both in 19.6% of 77 cases with the history of documented measles vaccination. CONCLUSIONS: Serum vitamin A level was lower than normal range in our study subjects and there was no relationship between serum vitamin A level and clinical manifestations of mealses. About half of the patients with measles in our study subjects had measles vaccination before. Therefore it is necessary to reestablish the measles vaccination schedule in children.

A Case of Abdominal Wall Abscess

We experienced a case of abdominal wall abscess originated from abdominal wall hematoma in 3 year old girl, who complained of abdominal pain, fever and lethargy. On admission, abdominal ultrasonography, abdominal computed tomography, and diagnostic needle aspiration were performed. Incision was made over the abscess so necrotic tissue and pus were evacuated. A nelaton catheter drain was placed into abscess cavity and, irrigation was done daily with normal saline mixed with antibiotics. Postoperative course was uncomplicated and the patient was discharged on 17th hospital day.

Report of Nationwide Epidemiology of Aseptic Meningitis Outbreak in 1993 in Korea

PURPOSE: There has been no nationwide report pertaining to the epidemiology of aseptic meningitis, although a great numer of patients have been diagnosed of the illness. Therefore, we report an explosive outbreak of aseptic meningitis occured in a nationwide scale in 1993. METHODS: Aseptic meningitis epidemiology surveillence was performed retrospectively on the patients diagnosed of aseptic meinigitis from January 1993 to December 1993 at 60 hospitals (the third graded medical centers and comparable training hospitals) located in 9 districts. The data pertaining to the patients were obtained through the questionnaire answered by the pediatricians or pediatric houseofficers. Monthly and geographical distributions, age and sex distributions, clinical manifestations, laboratory data, complications, and the causative virus of aseptic meningitis were described. RESULTS: 1) The total number of cases reported in 1993 aseptic meningitis epidemiology surveillence was 5,090. Geographically the greatest number of patients was reported from Seoul (2,693), followed by Kyungnam (851), Chunbook (497), Kyungi (492), Chungnam (189), Kangwon (133), Kyungbook (127), Chunnam (82), and Cheju (26). 2) Monthly distribution revealed that the number of patients was increased from April to August and 95.4% (4,858 cases) of the totoal were diagnosed from May to July. The median dates for the diagnosis of aseptic meningitis in various districts were May 8 in Cheju, followed by Chunbook, Kyungnam, Chunnam, Kyungbook, Chungnam, Kyungi, Seoul in June and July 3 in Kangwon. 3) Average age of the study population was 4.7+/-2.9 years and male to female ratio 2.1:1. 4) Subjective symptoms consisted of headache, abdominal pain, poor appetite, irritability, etc, and physical findings fever, local neurological signs, etc in order of frequency. Duration of temperature elevation was 6.1+/-3.7 days in average and 22 cases had no temperature elevation at all. 5) Initial CSF findings revealed pressure of 132 66 mmH2O, leukocytes 594+/-890/mm3 with PMNL 25.6+/-24.7% and lymphocytes 72.3+/-26.1%, protein 47.0+/-37.6 mg/dl, and glucose 60.3+/-14.9 mg/dl. In 35.7% of the patients, CSF leukocytes were more than 500/mm3 and in 19.9% were greater than 1000/mm3. Thirty five patients did not have pleocytosis in the initial CSF examination. 6) The associated illnesses were pharyngotonsillitis (1,285 cases, 31.3%), pneumonia (104 cases, 2.7%), sinusitis (74 cases, 1.9%), etc. 7) While almost all the patients (99.0%) were reported to be improved without complications, 48 cases had complications with 7 encephalitis, 2 neurogenic bladder, 2 Guillian-Barr syndrome, 5 paralysis, and 32 unspecified. Six cases were reported to be deceased. 8) Virus was isolated from 25 out of 55 cases from Seoul and Kyungnam areas on whom virus isolation was tried, and all were echovirus 9. CONCLUSIONS: Aseptic meningitis outbreak in 1993 was nationwide, geographically begun in the southern part of the peninsula spreading rapidly northward, and seasonally occurred from April to August with the peak in June. The average age was 4.7+/-.9 years and male to female ratio 2.1:1. Clinical manifestations and laboratory findings of the study patients were comparable to the reported previoulsy. The causative virus for the nationwide aseptic meningitis outbreak in 1993 was echovirus 9.

Immunologic Considerations in the Pathogenesis of Chronic and Recurrent Sinusitis in Children

PURPOSE: Although the chronic sinusitis is one of the most common and troublesome respiratory diseases in children, the pathogenesis still remains unclear. It is suggested that many of the immunologic factors including allergic conditions may contribute the nasal inflammatory changes. This study was designed to evaluate and demonstrate the possible role of various immunologic factors on the pathogenesis of chronic sinusitis in children. METHODS: During the 6 months study period from March to August, 1995, 33 children with chronic and recurrent clinical symptoms of sinusitis were evaluated. History taking, physical examinatin, paranasal radiologic examination, total IgE, allergen-specific IgE antibodies, serum IgA, IgG subclasses and T cell subsets were analysed in most of the children. RESULTS: The results were as follows; 1) The value of total serum IgE was increased in 19 cases(63.3% of the total). 2) All children in this study shows normal serum IgA levels. 3) In ten of 31 children(74.1%) with chronic sinusitis, serum concentrations of IgG2 were lower than geometric mean value. There was a decreased concentration of IgG1 in 3 cases(21.4%), IgG3 in 4 cases(28.6%), and IgG4 in 2 cases(14.3%). 4) The ratio of T4 to T8 was less than 2 in 23 cases(82.1%) out of 28 cases and reversed in 1 case. 5) Decreased serum concentration of IgG2 was more prevalent in cases with normal serum IgE levels rather than the cases with high serum IgE levels. 6) There was no correlation between the toral serum IgE levels and the ratio of T4 to T8 7) In the case with reversed T4 to T8 ratio, all the IgG subclasses are decreased except IgG3. 8) Chronic cough was the most common clinical manifestations in this study and postnasal drip, purulent nasal discharge, nasal stuffiness, fever and allergic shiner were noted in order. 9) Many of the children in this study have an allergic diseases, such as allergic rhinitis(48.5%), asthma(45.5%), and atopic dermatitis(33.3%). 10) PNS radiographs show diffuse opacification or mucosal thickening in all of the patients. CONCLUSIONS: In this study, we suggested that complex immunologic reactions including IgE-mediated allergic reaction, IgG subclasses deficiencies and cellular immunity are involved in the pathogenesis of chronic and recurrent sinusitis.

Intracraial Hemorrhage in Premature and Low Birth Weight Infants by Craniosonography

No abstract available.

Intracranial hemorrhage in full-term neonates by ultrasonography

Intracranial hemorrhage is the most common neuropathologic finding in premature infants. But in full-term infants, it is less common and rarely causes death. We found out intracranial hemorrhages in 21 full-term neonates by real-time neurosonography and concluded as followings. 1) Among 21 neonates, 17 infants were male and 4 infants were female. 2) In 11 (52.3%) infants the hemorrhage was detected within 7 days after birth. 3) The intracranial hemorrhage was not related with delivery type nor Apgar score. 4) In 13 cases (61.9%) the hemorrhage was in the subependymal germinal matrix and the degree was Grade I. 5) Precipitating or associated factors were asphyxia, pneumonia, ventilator care, RDS and congenital heart disease. 6) Symptoms and signs were seizure, apnea, lethargy, cyanosis, jaundice, anemia or bulging fontanel.

A clinical study of histiocytosis syndrome

We made a clinical study on 10 cases of histiocytosis syndrome who had been admitted to the pediatric department of Soon Chun Hyang University Hospital from Jan. 1982 to Dec. 1991. The results were obtained as follows 1) The sex incidence revealed male predominance with the ratio 4:1. 2) Among 10 cases, 4 cases were classified as eosinophilic granuloma, 1 case as Letterer-Siwe disease, 1 case as linfection associated hemophagocytic syndrome and 4 cases as malignant histiocytosis. 3) The mean age of symptom onset was 4 and 7/12 years in all disease group. 4) The common clinical symptoms and signs at dignosis were dyspnea, mass, pain on lower extremities and fever. 5) The most common organ involved among 9 organ systems was liver-spleen and the number of organ systems involved were 1 in 3 2 ases(30%), 3 in 2 cases(20%), 8 in 2 cases (20%) and 6, 7 and 10 organs in each 1 case. 6) The abnormal hematologic findings (Hb; 10g/dl and/or WBC; 4,000/mm3 and/or PLT; 100,000/mm3) were found in 6 cases. 7) Low serum albumin was found in 2 cases. Results of blood culture were Pseudomonas aeruginosae and Salmonella typhi in each 1 case. 8) The common findings on tissue biopsy were histiocytic proliferation and infiltration. 9) 4 patients of MH who recieved chemotherapy, a combination of adriamycin, vincristine, cyclophosphamide and prednisone were given in a total of four courses every 2 weeks ad induction therapy. When complete response was attained, a combination of adriamycin, vincristine, prednisone (AOP) and cyclophosphamide, vincristine, prednisone(COP) was administered alternately every 4 weeks as maintenance therapy for 6-64 months. 10) Among 4 patiens of MH who recieved chemotherapy, 1 patient was lost during induction chemotherapy, for 1 day.2 patients expired during induction chemotherapy, for 1 month, 1 patient expired during maintenance chemotherapty, for 8months, Eosinophilic granuloma cases (3) were recieved currettage and no recurrence. IAHS case due to typhoid fever was improved spontaneously.