Anaphylaxis to Curry Powder in Childhood / 소아알레르기및호흡기학회지

A 15-year old boy visited Samsung Medical Center complaining that when he ate curry and rice two months ago, he developed immediate palatal itching, generalized urticaria, headache and dyspnea. His chest radiographs were normal. He had no history of allergy, but a methacholine provocation challenge test revealed positive findings (PC20 3.62 mg/mL). Skin prick tests revealed positive findings to asparagus, house dust mites (Dp, Df), flower pollens (aster, chrysanthemum, golden rod), weed pollens (mugwort, ragweed, dandelion, short ragweed) and crude extract of curry powder. Specific IgE to Dp, Df and soy bean were positive (6.52, 31.2 and 1.91 kU/L) and total IgE was 1, 207 kU/L by the Pharmacia UniCAP- FEIA. After receiving parental consent, we performed an oral provocation test to confirm the relationship between his symptoms and curry powder. He ingested a small amount of curry powder with pure water, which was increased every 1 hour. We then measured his PEFR every 10 minutes after each subsequent curry powder ingestion. After he ate 20 gm of curry powder in one time, he exhibited profuse sweating, skin rash and dyspnea. When we treated him with epinephrine and bronchodilator, his symptoms improved. He developed the same symptoms 2 hours later, but these symptoms were brought under control by the same medication.

A Clinical Study on Relationship of Surgical Glove and Back Pain after Lumbar Puncture in Children / 소아과

PROPOSE: In this study, we evaluated whether powder on surgical gloves is a cause of postpuncture backpain in children. MOTHODS: In 164 children with meningitis between July and September 1997, we did not remove powder from surgical gloves. However, in 149 children with menigitis between May and October 2001 the powder was removed from the surgical gloves. RESULTS: Out of the 164 patients in 1997, 41 cases(25.00%) were found to have postdural puncture backpain. On the other hand, out of 149 patients in 2001, with whom we used gloves from which the powder was removed, we found only 8 patients(5.36%) with postdural puncture backpain. CONCLUSION: We conclude that the powder on surgical gloves is one of the main causes of postdural puncture backpain in children.

A Case of Resolution of Duodenal Obstruction Caused by Duodenal Ulcer after the Eradication of Helicobacter pylori Infection / 소아과

Duodenal ulcers are often complicated by obstruction, bleeding, or perforation. The eradication of Helicobacter pylori reduce ulcer recurrences and complications in patients with duodenal ulcer. However, there is controversy whether the eradication of H. pylori infection can resolve duodenal stenosis complicated by duodenal ulcers. After the eradication of H. pylori infection, duodenal stenosis complicated by duodenal ulcer was resolved in our case. Therefore, the evaluation and treatment for H. pylori infection are required in patients with duodenal stenosis complicated duodenal ulcers before endoscopic treatment or surgery.

Clinical Considerations about Mycoplasmal Pneumonia in Children in South Gyeongnam Area / 소아알레르기및호흡기학회지

PURPOSE: Mycoplasmal pneumonia is one of the most common respiratory diseases in childhood, and is increasing in frequency. We reviewed several aspects of Mycoplasmal pneumonia for applying treatment. METHODS: We reviewed clinical and radiological features of 79 cases of serologically proven Mycoplasmal pneumonia in admitted children between January and December 2003. RESULTS: The mean age was 4 years 2 months and the sex ratio was 1: 1.25 in the male to female ratio. The peak incidence of monthly distribution was September. On the chest x-ray examination, bronchopneumonia was the most common type and the right lower lobe (RLL) was the most common unilateral involvement in lobar consolidation. Leukocytosis, positive CRP and positive ESR were common findings in Mycoplasma pneumonia. CONCLUSION: In this study, peak incidence of monthly distribution did not conflict with previous reports but peak incidence of age in Mycoplasmal pneumonia was lower than in those reports. More studies are needed to prove changes of previous manifestations in Mycoplasmal pneumonia.

Lumbar Puncture in Patients Who Experienced First Seizure with Fever

PURPOSE: We aimed to ascertain whether lumbar punctures should be done to prove febrile seizure, and to study what conditions can delay or abolish lumbar puncture. METHODS: This retrospective study was done for four years, from January, 1996 to December, 1999. The subjects were the patients who visited Masan Samsung Hospital for the first convulsion with fever, and whose age ranged from 1-month to 5-years old. The total number of patients was 197. We investigated the rate of meningitis, which was classified by age, season, convulsion type, associated symptoms, and results of blood test. All data were tested chi-square. RESULTS: The diagnosis rate of meningitis among all 197 patients was 7.6%, and of these only one patient was proved to have bacterial meningitis. The rate was high in the young(below 6 month), in males and in summer and autumn. Although the general appearance was good after resolution of the fever, the rate of meningitis was 6.5%. Patients with nausea and vomiting totalled 11%; 9.1% of them were diagnosed with meningitis. The diagnosis rate of meningitis in cases in which additional seizures took place were 33.3%. CONCLUSION: The ultimate goal of lumbar punctures in seizure patients with accompanying fever is to rule out bacterial meningitis, which, has been demonstrated to be rare. So we think that lumbar puncture can be postponed by close observation of pediatrics specialists and skilled nurses.