ABSTRACT
PURPOSE: Single umbilical artery (SUA), the most common malformation of the umbilical cord, has long been of interest because of its association with congenital malformations. This retrospective study was aimed to evaluate the incidence of SUA and its associated malformations. METHOD: The study population was inborn neonates of Kang-Nam Sacred Heart Hospital of Hallym University. We reviewed retrospectively the medical records of 15 infants with SUA, including 1 infant identified in prenatal ultrasonography. RESULTS: The incidence of SUA was 0.2% (15/9,351 cases). The mean birth weight was 2,658 gram (ranged from 1,060 to 3,700gram), and the mean gestational age was 38 weeks (ranged from 32 to 40 + 3weeks). Six cases (40%) of 15 cases with SUA were associated with congenital malformations : urogenital malformations in 4 cases, cardiovascular malformations in 3 cases, and musculoskeletal malformations in 3 cases. Only 1 case had abmormal karyotype, trisomy 18. CONCLUSION: Because SUA is highly associated with congenital malformations newborns with SUA should have a thorough and complete physical examination at birth and physicians should also be alert to the possibility of congenital malformations not evident at initial examination. Furthermore, prenatal detection of SUA has potential importance, since it may indicate that further work is necessary to rule out associated malformations and to help determine whether management should beltered.
Subject(s)
Humans , Infant , Infant, Newborn , Birth Weight , Gestational Age , Heart , Incidence , Karyotype , Medical Records , Parturition , Physical Examination , Retrospective Studies , Single Umbilical Artery , Trisomy , Ultrasonography, Prenatal , Umbilical CordABSTRACT
The "band heterotopia" or "double cortex" is a brain anomaly that is presumed to result from a premature arrest of neuronal migration. Generalized disorders of neuronal migration to the cerebral cortex have been recognized since the end of the 19th century. Recently, development of neuroimaging technique, such as MRI, have permitted easy diagnosis of generalized neuronal migration disorder. This syndrome is prevalent in females. Most patients present with generalized or multifocal epilepsy, some mental retardation, pyramidal signs and in some dysarthria. Full scales I.Q.s ranging from severely low to normal have been reported. EEG investigations usually demonstrate generalized spike-and-wave discharges or multifocal EEG abnormalities. Classic MRI findings demonstrate a band of subcortical gray matter heterotopia underlying the cortical mantle and separated from it by a thin rim of white mater. We report a 3 year old girl who present a single episode of generalized tonic clonic seizure with fever. Her MRI showed characteristic findings of band heterotopia. She has not been showed further seizure attack. She is being follow up at OPD without medication.
Subject(s)
Child, Preschool , Female , Humans , Brain , Cerebral Cortex , Diagnosis , Dysarthria , Electroencephalography , Epilepsy , Fever , Follow-Up Studies , Intellectual Disability , Magnetic Resonance Imaging , Neuroimaging , Malformations of Cortical Development, Group II , Neurons , Seizures , Weights and MeasuresABSTRACT
PURPOSE: The importance of trace elements in their effect on the physiology and pathology of the central nervous system is well recognized. Changes in the concentrations of these elements in the brain could take place in pathological states. Recently, a greater emphasis has been given to the role of trace elements in the function of the nervous system both in normal and pathological conditions. The past experiments from animal demonstrate that Na+-K+-ATPase inhibition, particularly in the hippocampus, is involved in epileptogenicity. Zinc is the most potent inhibitor of Na+-K+-ATPase followed closely by copper. Zinc modulates the activity of glutamic acid decarboxylase, the rate limiting enzyme in the synthesis of -aminobutyric acid (GABA), which is a major inhibitory neurotransmitter. There are few reports of zinc and copper concentrations in normal CSF and in CSF from patients with neurological diseases. The aim of this study was designed to determine the zinc and copper concentrations and their correlation with protein in CSF of pediatric patients with neurologic disorders. METHODS: The study population was 43 patients who had admitted to Kang Nam Sacred Heart Hospital of Hallym University from March to June, 1996 due to high fever, headache, vomiting, and seizure. All patients were examined CSF study, 32 patients (group I) were showed abnormal CSF and seizure disorders including febrile convulsion and 11 patients (group II) were showed normal CSF and clinical symptoms of febrile illness. Zinc and copper concentrations in CSF were determined with flame atomic absorption spectrophotometry. In addition, CSF zinc and copper concentrations in normal CSF proteingroup (group A) and in increased CSF protein group (group B) were determined to investigate probability that the damaged blood-brain-barrier permits the passage of zinc and copper into the subarachnoid space. RESULTS: 1) The CSF zinc concentrations in group I and II were 9.40+/-6.18 and 7.39+/-5.48microgram/dl, and the CSF copper concentrations in group I and II were 4.86+/-7.07 and 2.93+/-1.45microgram/dl, respectively. There was no statistically significant difference in the CSF zinc and copper concentrations between the two groups. 2) The CSF zinc concentrations in group A and B were 7.21+/-4.96 and 11.24+/-7.32microgram/ dl, and the copper concentrations in group A and B were 3.31+/-2.15 and 5.59+/-9.46microgram/dl, respectively. There was no statistically significant difference in the CSF zinc and copper concentrations between the two groups. 3) There was a significant positive correlation between the CSF zinc and copper concentrations as well as between the CSF zinc and protein concentrations. But there was no significant correlation between the CSF copper and protein concentrations. CONCLUSIONS: There was no statiscally significant defference in the CSF zinc and copper concentrations between neurologic disorders and febrile diseases. Increased CSF zinc and copper concentrations in increased CSF protein groups were not found. But there were some correlation between zinc, copper, protein levels in CSF. These results do not support assumption that damaged BBB permits the passage of the zinc, copper into the subarachnoid space.
Subject(s)
Animals , Child , Humans , Brain , Central Nervous System , Cerebrospinal Fluid , Copper , Epilepsy , Fever , Glutamate Decarboxylase , Headache , Heart , Hippocampus , Nervous System , Nervous System Diseases , Neurotransmitter Agents , Pathology , Physiology , Seizures , Seizures, Febrile , Spectrophotometry, Atomic , Subarachnoid Space , Trace Elements , Vomiting , ZincABSTRACT
PURPOSE: This is to analyze epidemic and clinical features of acute respiratory tract infections (ALRTI) by respiratory syncytial virus (RSV) and parainfluenza virus (PIV), which are considered to be the major respiratory pathogens in children. METHODS: Nasopharyngeal aspirates were collected from 515 patients with ALRTI hospitalized at Hangang Sacred Heart Hospital between Apr. '94 and Oct. '96. Nasopharyngeal aspirates were inoculated to HEp-2 cell, MDCK cell, and LLC-MK2 cell for the cultivation of viruses. The cultivated cells were observed for cytopathic effect on the 4th and 10th day. In case cytopathic effect was seen, indirect IF was done by using monoclonal antibodies for RSV and PIV 1, 2, 3 types. RESULTS: 1) The RSV and/or PIV have been identified in 150 out of 515 patients (29.1%), which break down into 86 patients (cultured only RSV), 46 patients (only PIV), 18 patients (both RSV and PIV). 2) ALRTI caused by RSV and PIV occurred mostly in the first two years of life (93%). The ratio of male to female patient was 2.1:1 and 74% of ALRTI was found in the patients with no history of underlying diseases. 3) RSV infection occurred mostly late autumn and winter, while PIV infection occurred all the year round, mostly in May. 4) RSV infection caused bronchiolitis in 67%, pneumonia in 28%, croup in 4%, while PIV infection caused bronchiolitis in 41%, croup in 37%, pneumonia in 20% clinically. And combined infection caused bronchiolitis in 67% and pneumonia in 28%. 5) The WBC count was normal in 49% of the RSV, 35% of the PIV, and 56% of the combined infection. The ESR was normal in 71% of the RSV, 59% of the PIV, and 79% of the combined infection. The CRP was normal in 83% of the RSV, 66% of the PIV, and 89% of the combined infection. 6) The following non-respiratory signs and symptoms were detected: diarrhea, increased AST/ALT, conjunctivitis, febrile seizure, exanthem, acute otitis media, enanthem. 7) The major radiologic features of RSV were normal in 54%, hyperaeration in 28%, peribronchial infiltration in 8%, and consolidation in 8%. PIV infection shows normal in 30%, hypopharyngeal dilatation in 33%, hyperaeration in 17%, and peribronchial infiltration in 4%. 8) The hospitalized period was 7.1 days on the average. None of them was died or mechanically ventilated due to ALRTI. CONCLUSIONS: RSV and PIV are considered to be the major causes of ALRTI. Diagnosis and treatment of RSV and PIV infections will be improved through further epidemiologic or clinical studies.
Subject(s)
Child , Female , Humans , Male , Antibodies, Monoclonal , Bronchiolitis , Conjunctivitis , Croup , Diagnosis , Diarrhea , Dilatation , Exanthema , Heart , Madin Darby Canine Kidney Cells , Otitis Media , Paramyxoviridae Infections , Pneumonia , Respiratory Syncytial Viruses , Respiratory System , Respiratory Tract Infections , Seizures, FebrileABSTRACT
PURPOSE: In the Summer 1996, there was an outbreak of aseptic meningitis without sequele. 116 cases who were admitted to our Department during a six month period from May to October, 1996. Therefore, we report epidemic of aseptic meningitis in 1996 and analyze and compare it with a epidemic of aseptic meningitis in 1993. METHODS: We studies about clinical manefestation and laboratory finding by retrospective study on 116 patients diagnosed as aseptic meningitis who had been admitted at Department of Pediatrics, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University. RESULTS: 1) Aseptic meningitis affected mostly children between the ages of 1 to 5 in 1996. Male-to-female ratio was 1.2 : 1 in aseptic meningitis in 1996. 2) The outbreak of aseptic meningitis was from middle to late August in 1996.3) Common chief complaints were fever, headache, vomiting, abdominal pain, upper respiratory tract infection, diarrhea, and irritibility in order. On physical examination, pharyngeal injection, neck stiffness, Kernig's sign were detected in decreasing frequency. 4) Values of WBC on peripheral blood were 5000-10,000/mm3 (60 cases, 51.7%) and values of ESR were more than 20mm/Hr (70 cases, 60.3%) and values of CRP positivity were 58 cases (50.0%) in 1996. In comparision with its in 1996, more than 10,000/mm3 in values of WBC and less than 20mm/hr in values of ESR and negativity in CRP values were detected mostly in 1993. 5) 176 cerebrospinal fluid studies were done. WBC count in cerebrospinal fluid were 6-75,000/mm3 (754+/-2351/mm3) and peaked on eighth days of onset of illness and decreased afterwards. Pleocytosis of cerebrospinal fluid were had of mean value 27.2% and peaked on first days of onset of aseptic meningitis. On virus culture, six cases were cultured in that one case of coxsakie virus, two cases of echo virus and six cases of nonspecific enterovirus and on enterovirus PCR, the positivity were 49 cases (41.0%). 6) 76 cases of who were diagnosed as aseptic meningitis were treated with antibiotics and 18 cases treated with mannitol for severe headache. None cases reported with seizure or decreased consciousness. The disease course mostly were three to seven days. CONCLUSIONS: We concluded that the causative agents of outbreak of aseptic meningitis in our hospital in 1996 were enterovirus and on virus culture, echo virus 9 and coxsackie virus A24 were cultured. Recently in our state, outbreak of aseptic meningitis epidemically in summer season and the causative viruses are cultured variably and various clinical symptoms and signs are manafested as well as.
Subject(s)
Child , Humans , Abdominal Pain , Anti-Bacterial Agents , Cerebrospinal Fluid , Consciousness , Diarrhea , Echovirus 9 , Enterovirus , Enterovirus B, Human , Fever , Headache , Heart , Leukocytosis , Mannitol , Meningitis, Aseptic , Neck , Pediatrics , Physical Examination , Polymerase Chain Reaction , Respiratory Tract Infections , Retrospective Studies , Seasons , Seizures , VomitingABSTRACT
We have experienced a case of dup (3q) syndrome in the neonate who had a multiple congenital anomalies of hypertrichosis, hypertelorism, upslanting palpaberal fissures, anteverted nostrils, long philtrum, micrognathia, downturned corners of the mouth, highly arched palate, short, webbed neck, clinodactyly, rocker-bottom feet, dermal sinus. Cytogenetic studies showed a duplication 3q21-->qter regions. Chromosome study of relatives is extremely important for counseling because only 25% of cases represented de novo duplications. We reported the case with the review of the associated literatures.
Subject(s)
Humans , Infant, Newborn , Counseling , Cytogenetics , Foot , Hypertelorism , Hypertrichosis , Lip , Mouth , Neck , Palate , Spina Bifida OccultaABSTRACT
Subacute necrotizing lymphadenitis is a benign form of lymphadenitis that was first described in Japan by Kikuchi in 1972. It mainly affects young women and usually manifests as fever and lymphadenopathy. Although it is a benign self-limited lymphadenitis, it has been misdiagnosed as malignant lymphoma. Histologically, involved lymph nodes contain a necrotizing process characterized by patch, well-circumscribed area with eosinophilic fibrinoid material. There is a striking degree of karyorrhexis and an absence of granulocyte with paucity of plasma cell. We expereinced a case of subacute necrotizing lymphadenitis in a 3 year old boy. There was spontaneous resolution of fever and lymphadenopathy, and now he keeps doing well.
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Eosinophils , Fever , Granulocytes , Histiocytic Necrotizing Lymphadenitis , Japan , Lymph Nodes , Lymphadenitis , Lymphatic Diseases , Lymphoma , Plasma Cells , Strikes, EmployeeABSTRACT
The incidence of congenital syphilis was decreased after penicillin was introduced in the treatment of the disease in 1943. However, occurrence of the disease is rapidly increasing in recent years. The authors observed 46 cases of congenital syphilis in the newborn and infants, in which 28 cases born at this hospital and 18 cases admitted from O.P.D., treated at Han-Gang Sung-Shim Hospital from January 1973 to 1978. The results were as follows : 1) The ratio of the cases delivered at this hospital was 0.35% and that of the cases admitted via O.P.D. was 0.23%. 2) The incidence of congenital syphilis in the newborn infants who were delivered at this hospital was 0.25% in fullterm babies and 0.10% in premature babies. 3) Birth weights of the cases born in this hospital were as follows : Fullterm babies, 71.5% : 2,000~2,300Gm, 14.3% : 1,501~2,000Gm, 14.3% : and no cases below 1,500Gm. 4) Cliniccl manifestations were developed at neonatal period in 77.8% and at infancy in 22.2%. 5) Common clinical manifestations were skin manifestation (73.9%), hepatomegaly (71.7%), splenomegaly (63.1%), and anemia (60.8%). 6) Peripheral blood findings of patients born at this hospital showed mild anemia (hemoglobin level below 15 Gm/dl) of 60.7%, and severe anemia (hemoglobin level below 10Gm/dl) of 25%. 7) VDRL titer of all cases were above 1 : 2. and those of mothers were above 1 : 2 except 1 case. 8) 83.3% of affected cases revealed periostitis and osteochondritis. Most common sites of involvement were tibia (75%) and ulnar (66.6%). 9) Three out of the 46 patients had complications during the treatment : one was nephrot ic syndrome, second was acute pyelonephritis, and third was pneumonia with sepsis.
Subject(s)
Humans , Infant , Infant, Newborn , Anemia , Birth Weight , Hepatomegaly , Incidence , Mothers , Osteochondritis , Penicillins , Periostitis , Pneumonia , Pyelonephritis , Sepsis , Skin Manifestations , Splenomegaly , Syphilis, Congenital , TibiaABSTRACT
This is the clinical studies of 171cases of acute poisoning in pediatric age which were visited at the emergency room of Han-gang Sacred Heart Hospital during the past 2 years and 5 months (Apr., 1974~Aug., 1976). The results were summerized as followings; 1. The incidence of acute poisoning among the emergency pediatric patients were 2.3%(171/7,310). 2. The sex ratio of male to female was 1.5:1. 3. The peak age group was 2 to 5 years of age (41.5%). 4. The peak incidence in a year was shown in August (17.5%) with prominence in summer season (47.3%). 5. The accidental poisoning was occured the most frequently from 4: 00 P.M. to 8:00P.M. during the day. 6. The motive of poisoning was mainly accidental causes (85.9%). 7. The most frequent causative substances were insecticides (29.8%) and then rodenticides (14%), D.D.S. (8.8%), reserpine (4.1%) were the next causes. 8. RH-787 poisoning were occured in 4 cases with the complication of diabetes mellitus 2 cases. 9. In poisonous plants, there were azalea (Rhododendron) poisoning (4 cases) and Gingko biloba Linne fruit poisoning (1 case).
Subject(s)
Child , Female , Humans , Male , Diabetes Mellitus , Emergencies , Emergency Service, Hospital , Fruit , Ginkgo biloba , Heart , Incidence , Insecticides , Plants, Toxic , Poisoning , Reserpine , Rodenticides , Seasons , Sex RatioABSTRACT
Clinical studies were performed on 32 cases of infectious cuoup prevailing in winter of 1975, admitted to department of pediatrics. The symptoms were critical and clinical course was more repidly progressed, so incidence of emergent tracheostomy was increased than previous years. Incidence of complicated Pulmonary disease was high, but prognosis was good relatively. According to these findings, specific prevalent viral infection was suspected, but identification of virus was not performed.
