Clincal Observation on Infants of Diabetic Mother

Chlinnical observation was conducted on 10 cases of infants of diabetic mother at II Sin Woman's Hopital and the Busan National University Hospital during 19 months from Jan. 1977 to Jul. 1978. The results were summarized as follows : 1. Frequency of diabetic mothers was 0.094% and most of them were in 3rd decade of age. 5 mothers treated, two of them treated irregularly, and five not treated during pregnacy had the mean duration of 3 years from onset of diabetic symptoms to delivery. 2. Diabetic mother whose mean gravidity was 3.6 had histories of toxemia(50%), natural abortions or stillbirths(19%), and I case of polyhydramniosis and pyelonephritis respectively. 3. Among 10 cases of infants of diabetic mothers (5 full terms and 5 preterms), four large for gestational age, three appropriate for gestational age, and three small for gestational age, seven of them were delivered with vaginal and three with C-S deliveries. 4. Among 10 cases of infants of diabetic mothers, two of three infants with hypoglycemia had Apgar score below 6 at 1 minute and died soon after birth, and I case showed hypoglycemic symptoms such as tremor, sweating and so on. Hyperbilirubinemia ranging from 10 to 18 mg/dl in 3 cases, RDS 2 cases, and congenital anomaly 3 cases were also observed.

Comparison of Tuberculin Tests between Mono and Mantoux

To compare Mono-Test withstandard Mantoux tuberculin test, 221 primary school children aged 6 to 7, were randomly subjected. Each subject was simultaneously ted intradermally with three kinds of tuberculin reagents, 1TU PPD and 5TU PPD at one side of forearm and Mono-Test(Institut Merieux) at other side. Approximately 72 hours later, all sites of tested were measured by author. The criteria for positive Mantoux test was given when the tran sverse diameter of indr ation was 10mm or more. If 2mm or more induration was considreed as positive Mono-test, the sensitivity and specificity of Mono-Test to 1TU PPD Mantiux test were 94.44% and 75.14% respectively, ant those to 5TU PPD Mantoux test were 90.20% and 80.59% respectively. On the other hand, when 5mm or more induration was considered as positive Mono-Test, the sensitivity and specificity to 1TU PPD Mantoux test were 80.56% and 97.30% respectively and those to 5TU PPD Mantoux test were 66.67% and 98.24% respectively. Considering of false negativity and false positivity rates, Mono-Test be used only for screening of tuberculosis instead of Mantoux test and in that case it 4 will be better to using 2mm or more induration as a positive criteria of Mono-Test. Any doubtful or positive Mono-Test case sholud be retested with standard Mantoux test because of its relatively high falsespositive rates.

Clinical Observation of Diphtheria

We have observed clinically 57 cases of diphtheria, admitted to Dept. of Pediatrics and E. N. T. of College of Medicine, Busan National University during a period of past 4 years from Jan. 1973 to Dec. 1976. The following results were obtained from this observation: 1. The yearly prevalence rate seemed not to be reduced throughout 4 years. 2. The seasonal incidence was highest from Oct. to next Feb when 77.5% of cases was de-veloped. Most of cases (82.5%) was below the age 8 years with the sex ratio of male to female, 1.5:1. 3. About one half of cases gad been resided in the rural area. 4. Concerning the degree of the immunization status of diphtheria, 48.3% of cases was never taken, 17.5% unknown, 33.4% inadequate, and 5.3% was adequate. 5. The sites of occurence of dephtheria were pharynx (33.3%) larynx (47.4%) and both (19.3%) 6. 77.2% of cases was found diphtheria organism, which was detected on smear (63.2%) and culture (52.6%) individually. 7. The chief clinical symptoms and signs on admission were dyspnea (77.2%) pseudomemb-rane (77.2%) prostration (75.4%) fever (72.0%) hoarseness (54.4%) cough (50.9%) and the like in order of frequency. 8. Anemia was found in 77.2% leukocytosis in 84.2% of cases. 9. 54.5% of cases had complications, of which myocarditis (22.4%) pneumonia (21.0%)bull neck (14.0%) nephritis (12.2%) and nerve palsy (10.5%) were developed. 10. The onest of myocarditis was the 3th-8th day of depheheria and the most common abnormal ECG finding was the changes of S-T segment and T wave. 11. The morality rate was 12.3% of the total cases (45.5% of mixed type the and 7.4% of laryngeal type were expired). The causes of death were myocarditis (its mortality rate, 46. 1%) and paralysis of diapgragm.