Clinical Observation of Mesenteric Lymphadenitis in Children / 소아과

PURPOSE: Mesenteric lymphadenitis is classified into acute and chronic, specific and nonspecific types according to clinical aspect and causative disease. We under took this study to find out clinical aspects, associated diseases and hospital course of mesenteric lymphadenitis in children. METHODS: We examined 98 children aged from 18 months to 14 years who visited Dongsan Medical Center for abdominal pain between March 1998 and May 2002. Ultrasonography was performed and medical records were analysed. The specific group had a causative disease, and the chronic group had persistent clinical symptom over three months. RESULTS: Symptoms were chronic in 4% of the patients and acute in 96%. Most of the patients were in oen to five years of age. In the acute group, abdominal pain, vomiting, fever and diarrhea were shown commonly in order, and average WBC count was normal. Gastroduodenitis, tonsillitis, pneumonia and enterocolitis were accompanied in the acute specific group. Ultrasonograms of abdomens showed lymph node enlargement. In the acute group, symptoms were improved within one week. Lymph node enlargement was noted on follow up ultrasonograms in the chronic group. Gastrocolonoscopy of chronic group showed one case of H. pylori positive duodenitis, one case of ulcerative colitis, and two cases of Crohn's disease. CONCLUSION: There was no statistical significance in clinical aspect, laboratory findings and hospital course between the patients with specific etiology and nonspecific etiology. Symptoms improved within one week in patients in the acute group. If abdominal pain persists, additional examinations such as endoscopic biopsy, stool cultures, or small bowel studies should be performed to determine the underlying cause.

Four Cases of Staphylococcal Scalded Skin Syndrome / 소아과

Staphylococcal scalded skin syndrome is a systemic disease with a clinical spectrum ranging from subcorneal pustules, patterned exfoliation to extensive erosion and peeling of skin by the exfoliative toxin of group II Staphylococcus aureus. This disease occurs mainly in infancy and children below five years and it isn't easy to differentiate from other vesicular diseases clinically, but skin biopsy shows an epidermal split at the granular layer. The form and severity of staphylococcal scalded skin syndrome will vary according to defense system and toxic factors. Treatment is effective antibiotics, and the mortality rate increases to 5% in children. In our four cases, symptoms were erythema and fever, followed by formation of large bullae and denuded skin. On laboratory findings, leukocytosis was noted in three cases, and S. aureus was confirmed by culture of eye discharge in all cases. Our cases improved with antibiotic therapy. We experienced four cases of staphylococcal scalded skin syndrome which were presented with vesicle and exfoliative skin lesion and treated successfully.

Endoscopic Findings of Children with Henoch-Schonlein Purpura

PURPOSE: This study was performed to analyze the endoscopic findings in Henoch-Schonlein purpura patients, and to compare the differences in endoscopic findings according to age and gastrointestinal symptoms. METHODS: We examined children with Henoch-Schonlein purpura aged 3 to 15 years between September 1996 and October 2002. The total number studied was 65, consisting of 41 boys and 24 girls. Endoscopy was performed and the results were analysed. RESULTS: Among 65 cases, 12 cases of duodenitis, nine cases of gastritis and duodenitis, six cases of duodenal erosion, five cases of gastritis, five cases of duodenal ulcer, two cases of gastric ulcer and one case of colonic erosion were noted. Endoscopic abnormality was found in 38 of 53 who had gastrointestinal symptoms, and in two of 12 who didn't have gastrointestinal symptoms. CONCLUSION: Most of the gastrointestinal symptoms in Henoch-Schonlein purpura patients were relieved without complication. But in some cases severe symptoms such as hematemesis, melena, and abdominal pain localized to epigastric area were developed when diagnosis was delayed. Prompt endoscopy will be helpful for diagnosis and therapy of Henoch-Schonlein purpura with gastrointestinal involvement.

A Case of Goltz Syndrome

Goltz syndrome(focal dermal hypoplasia) is a rare disorder characterized by ectodermal and mesodermal dysplasia described in 1962 by Goltz. In Korea, one case of Goltz syndrome was reported in 1994. The inheritance mode is mostly X-linked dominant. Skin abnormality is the most common manifestation including hypoplasia of the dermis. Skeletal involvement such as syndactyly, polydactyly, scoliosis, kyphosis and spina bifida occulta may be present, also ocular and dental abnormalities are reported. Radiologic findings are the osteopathy and striation of the long bone. We experienced a case of Goltz syndrome in a 9-year old female who was presented with right side hypotrophy, focal dermal hypoplasia, ocular(anidria, microcornea), dental(oligodontia, amelogenesis) and skeletal(syndactyly) abnormalities. Skin biopsy was performed and showed decreased expression of type I collagen gene with Northern blotting.

A Case of Right Intrathoracic Kidney with Complex Cardiac Anomalies / 대한주산의학회잡지

Intrathoracic kidneys are rare developmental anomalies and represent less than 5% of all congenital kidney ectopia. Ectopic intrathoracic kidneys are usually asymptomatic and have normal renal function. This disease occurs more frequently in males and on the left side. We report a case of right intrathoracic kidney with congenital complex cardiac anomalies such as single atrium, patent ductus arteriosus and tricuspid regurgitation.