Clinical Study of Neonatal Pelvicectasia

OBJECTIVE: This study was conducted to investigate the different cause of pelvicectasia and its clinical outcome. The most important management of pelvicectasia consist of the early diagnosis and evaluation of the pathologic abnormalities of congenital pelvicectasia. This will help to offer the guideline on management of neonatal pelvicectasia. METHODS: We examined one hundred and seventy-one live neonates who were hospitalized and diagnosed with pelvicectasia at Soonchunhyang University Cheonan Hospital from January 2008 to December 2008. A retrospective study was carried out in these patients for last three years. Renal ultrasonography was repeated at 1 month after birth and then 3 months interval. Diuretic renal scan with (99m)Tc-labeled diethylenetriamine pentaacetic acid augmented with furosemide and voiding cystourethrogram was done after 4 to 6 weeks of first renal ultrasonography. Patients were followed-up for 1 to 30 months (average, 7.2 months). RESULTS: Pelvicectasia was postnatally detected in 171 cases (33.7%) among 507 neonates. Males were twice than females. Additional imaging studies revealed that normal kidney structure was the most common postnatal diagnosis (97.1%), followed by ureteropelvic obstruction, vesicoureteral reflux, multicystic kidney, ureteric duplication. Spontaneous regression of pelvicectasia was revealed in 165 renal units (67.6%). CONCLUSION: There are many cause of spontaneous regression in mild to moderate pelvicectasia. Urinary tract infection occurs in many neonates with pelvicectasia. Mild to moderate neonatal pelvicectasia without vesicoureteral reflux is clinically much less significant. Accordingly, close observation with serial renal ultrasonography may be sufficient.

Isolation of Enterovirus Type 71 in a 3-year-old Boy Suffering from Toxic Epidermal Necrolysis / 소아알레르기및호흡기학회지

Toxic epidermal necrolysis (TEN) is an exfoliative disease of skin and characterized by flaccid bullae and spreading erythema so that the skin has the appearance of being scalded. It results primarily from a toxic reaction to various drugs, but occasionally occurs as a result of infection, neoplastic conditions, or other exposure. Enterovirus 71 (EV 71), the most recently described serotype of the genus Enterovirus (family Picornaviridae), causes a variety of diseases, including aseptic meningitis, encephalitis, poliomyelitis-like paralysis, hand-foot-mouth disease, gastroenteritis, fever and rash. A 3-year-old boy presented at the Department of Pediatrics, Soonchunhyang University Cheonan Hospital due to TEN. There were no definite causes such as drug toxicity, Graft-Versus-Host disease (GVHD) and infection. However, we could have isolated EV 71 from the patient's stool. Until now, there have been no reports showing the relationship between EV 71 and TEN, we report here in a case of TEN-associated with EV 71. Further evaluation is needed to study the relationship of TEN with EV 71.