Prediction of Intravenous Immunoglobulin Non-responders in Patients with Kawasaki Disease / 소아과

PURPOSE: We evaluated the effects of intravenous immunoglobulin(IVIG) on the levels of laboratory indices examined serially according to the responsiveness to IVIG therapy in children with Kawasaki disease(KD). METHODS: Children with KD(n=63) who had been treated with IVIG at a dosage of 2.0 g/kg were classified into two groups: the IVIG-resistant(consistent fever over 48 hours after initiation of IVIG infusion, n=9) and the IVIG-responsive(defervescence within 48 hours, n=54). The levels of various laboratory indices were determined three times during admission: before, 24 hours after and seven days after IVIG administration. RESULTS: Among the nine children in the IVIG-resistant group, four(44.4% vs 9.3% in IVIG-responsive group, P=0.019) had coronary artery lesions(CAL). On comparing the two groups, the following statistically significant differences(P16 mg/dL) before IVIG treatment and persistently elevated levels of CRP(>11 mg/ dL), WBC(>12,000/mm3) and neutrophil counts(>6,500/mm3) 24 hours after IVIG administration.

A Case of G-6-PD Guadalajara / 소아과

Glucose-6-phosphate dehydrogenase(G-6-PD) deficiency is a disease that shows hemolytic anemia and jaundice caused by injury of erythrocytes. The gene of G-6-PD has 13 exons and locates in Xq28, and over 150 mutations of this gene have been reported. We experienced a G-6-PD deficienct male patient who was suffering hemolytic anemia and jaundice confirmed by measuring low G-6-PD activity in the erythrocytes. We found point mutation at 1159th nucleotide in 10th exon, cytosine was changed to thymidine, and was confirmed as G-6-PD Guadalajara.

Dorsal Dislocation of the Metacarpophalangeal Joint of the Index Finger: A Case Report / 대한정형외과학회잡지

The dislocation of metacarpophalangeal joint of the index is apparently rare injury and produeed by striking of the volar surface of the outstretched index against a resistent object. This injury presents certain characteristics which make it distinctly different from dislocation of the thumb or little finger. The proximal phalanx is displaced over the dorsum of the corresponding metacarpal, the hand is deformed, and the index is inclined toward the middle finger. In 1957 Kaplan reported his study about the pathological anatomy and proper treatment technique in the dislocation of the metacarpophalangeal joint of the index finger. In this type of dislocation, closed reduction, even if performed immediately after the injury, is unsuccessful, and open reduction is mandatory. The authors have experienced a case of dorsal dislocation of the metacarpophalangeal joint of the index finger developed 3 weeks prior to admission on 20 th, May, 1985.