A study of the current(2003-2005) prevalence of anti-HBs and immunologic memory of hepatitis B vaccine in children from the central area of Korea / 소아과

PURPOSE: This study was conducted to assess the current(2003-2005) prevalence of anti-HBs and immunologic memory for Hepatitis B vaccine in children from the central area of Korea. METHODS: Subjects were chosen from children and adolescents who received tests for hepatitis B surface antigen(HBsAg) and anti-HBs at Dankook University Hospital from March 2003 to May 2005. Among these, antibodies to hepatitis B core antigen(IgG anti-HBc) were checked. A single booster vaccination was performed on children whose anti-HBs titers were under 10 mIU/mL. One month after booster vaccination we rechecked the anti-HBs titer. RESULTS: A total of 3,277 subjects were tested for HBsAg/anti-HBs, and 1,913(58.4 percent) of them were positive for anti-HBs. Of these, 29 subjects(0.9 percent) were positive for HBsAg. Positive results for anti-HBs by age were 78.6 percent for 6-12 months of age, 62.7 percent for 1-3 years of age, 51.9 percent for 4-6 years of age, 49.5 percent for 7-12 years of age, 63.4 percent for 13-15 years of age and 72.2 percent for 16-18 years of age. The 80 subjects who were tested negative for HBsAg/anti-HBs received a single booster vaccine, 71 subjects were tested positive for antibodies. IgG anti-HBc titer was checked for 169 of the subjects, 5 subjects were positive. CONCLUSION: In our study, a significant anamnestic response was observed in 88.8 percent of children. This is believed to be a result of the relatively long immunologic memory effect of the hepatitis B vaccination in children from the central area of Korea.

A Case of Empyema Necessitatis in a Child / 소아알레르기및호흡기학회지

Empyema necessitatis, which is a rare complications of empyema especially in immunocompromised conditions, extends pus from the thoracic cavity into surrounding soft tissues. The causes of empyema necessitatis are fungal infection, pulmonary tuberculosis and various types of pneumonia. A 9-year-old boy presented with a 7 day history of anterior chest pain and a coin sized palpable mass. Physical examination revealed a papable egg sized erythematous mass above the areola of the left chest. Laboratory data revealed acute inflammation. CT scans of chest demonstrated acute inflammation from the left anterior chest to the mediastinum and pericardium. He underwent sono guided thoracentesis and percutaneous aspiration of the mass and no organisms grew in a culture of pleural fluid and percutaneous aspiration. Tuberculin skin test was negative. The child was treated with antibiotics. Then, pain and the size of the mass decreased, follow up results of CT were resolved and he was discharged with oral antibiotics. We experienced a rare case of empyema necessitatis in 9-year-old child who was immunocompetent.

A Case of CATCH22 Syndrome with First Attack of Hypocalcemic Seizure at 13 Years of Age / 소아과

The acronym 'CATCH22' is characterized by many clinical manifestations such as cardiac defects, abnormal face, thymic and parathyroid hypoplasia, cleft palate and hypocalcaemia. It is now known to arise from chromosome 22q11.2 microdeletion, and it is also called 22q11.2 deletion syndrome. Hypocalcemia occurs in more than 50% cases of this syndrome, most frequently in neonatal periods, with some exceptions. Our patient was not diagnosed until age 13, although he had a cleft palate and presented with nasal speech and learning disturbances. He had no clinical manifestations of hypocalcemia until age 13, when he developed generalized tonic-clonic convulsions several times in that year. Laboratory tests showed hypocalcemia, hyperphosphatemia, with normo-to-low parathyroid hormone levels in the serum. Chromosome analysis with FISH revealed a deletion on the proximal portion of the long arm of chromosome 22(22q11.2). The authors herein report a case of CATCH22 syndrome who showed hypocalcemic convulsions in late childhood with a review of the literature.