A Clinical Study of the Congenital Hypertrophic Pyloric Stenosis

A Clinical study was carried out on 39 cases with congenital hypertrophic pyloric stenosis who were admitted to the department of Pediatrics, Catholic Medical College, during the 7 years 8 months from January 1971 to August 1978. The following results were obrained. 1. The age incidence was highest in the 2-4 weeks of age and 82.0% were under the 8 weeks. Af age Male to female ratio was 12:1. 2. The age at onset was within 3 weeks of age in the majority cases(69.2%). 3. In distribution of birth weight, the majority cases(75%) were 3.0~4.0kg. and 18 cases(46%) were first born bady. 4. In the body weight percentile on admission, the jahority cases(75.4%) were under the 25 percentile. 5. The kinds of feeding in order of frequency were breast(41.0%), bottle(30.8%) and mixed feeding(28.2%). 6. The average duration of symptoms prior to operation was 17 days. 7. On the physical examination, gastric peristaltic wave was observed in 30 cases(77%) and the pyloric tumor mass was palpated in 26 cases(67%). And Projectile vomitiong and dehydration were observed in all cases. 8. Barium meal X-ray study showed the string sign in 33 cases(88.9%).

A Case of Takayasu's Arteritis with Congestive Heart Failure

A 38 month old girl was admitted with the episode of anorexia, coughing and dyspnea to St. Mary's hospital on Nov. 9, 1977. She had treated as hepatitis at private clinic for one month before admission, however these symptoms were aggrevated with coughing and progressed dyspnea since a week ago. On physical examination, body temperature 36.8C, body weight 11.7kg, heart rate 150/min, BP 130/110mmHg at right arm, 160/90mmHg at left arm and 100/90mmHg at both legs were noted. The right radial pulse was palpated weakly compare to the left radial and both femoral pulses, which were also weak and bruit were heard on the both right carotid artery and abdominal aorta. On cardiac ausculation, no significant murmur was heard except gallop rhythm. The ECG and chest X-ray revealed the left ventricular enlargement and grade I K-W hypertensive retinopathy was found by fundoscopy. On selective left angiographic study mitral regurgitation(grade IV) was proved, and localized obliteration of the right subclavian artery and left carotid artery and diffuse constrictive narrowing of the thoracic and abdominal aorta at the level from D7 to suprarenal(type III) were seen by sequential ascending and abdominal aortorgaphy. The infrarenal abdominal aorta was also hypoplastic. Tuberculin skin test was strongly positive, and VDRL and LE preparation were negative.