We analysed 58 patients who were admitted to the Department of Pediatrics, Yonsei University College of Medicine due to infectious mononucleosis from January 1986 to August 1992. Of 58 patients who had responses to IgM to EBV viral capsid antigen and/or heterophil antibody, 35 patients had hapatitis. Of 35 hepatitis patients, group I consisted of 22 patients who had only EBV infection and group II consisted of 13 patients who had hepatitis B markers or cytomegaloviral markers. The results were as follows: 1) Sex distribution revealed males to females to be 1.1:1. In the age distribution, the proportion of patients with 1 to 3 years of age occupied 40.9% for group I and 30.8% for group II. In non-hepatitis group, 73.9% of patients were in 2 months to 3 years of age. 2) The common presenting symptoms and signs of hepatitis group included hepatomegaly in 24 cases (68.6%), fever in 19 (54.3%), anorexia in 17 (48.6%), throat injection in 16 (45.7%), splenomegaly in 5 (42.9%), and cervical lymphadenopathy in 10 cases (28.6%) etc. 3) In group I, complications or combined diseases included pneumonia in 4 case, disseminated intravascular coagulation in 2 and 1 case in acute pancreatitis. Group II included 1 case of iron deficiency anemia, acute renal failure, peritonitis and pulmonary hemorrhage respectively. 4) Anemia (Hb: <10g/dl) was found in 3 cases (13.6%) for group I, and in 2 cases (15.4%) for group II. Leukocytosis above 10,000/mm3 was demonstrated in 15 cases (68.2%)for group I and in 3 cases (23.1%)for group II. The higher percentage (>15%)of atypical lymphocytes were found in 3 cases (13.6%)for group I and in 1 case(7.7%) for group II. Thrombocytopenia (platelet: <100,000/mm3) was detected in 1 case (4.5%) for group I and in 3 cases (23.1%)for group II. Total bilirubin above 1.0mg/dl was found in 6 cases (27.3%)for group I and in 5 cases(58.1%)for group II. 5) AST level of 100~500IU/L was found in 10 cases(45.4%)for group I, and in 5 cases (38.5%) for group II. AST level above 500IU/L was demonstrated in 1 case (4.5%) and in 3 cases (23.1%) respectively. The mean values of AST level were 253.4 455.3IU/L and 316.7 102.4 IU/L, respectively. 6) Elevated ALT level of 100~500 IU/L was found in 9 cases (40.9%)for group I and in 9 cases(69.2%)for group II. ALT level above 500IU/L was detected in 5 cases (22.7%)for group I and in 3 cases (15.4%)for group II. The mean values of ALT level were 356.9 561.2IU/L and 308.3 259.1IU/L, respectively. 7) Elevated ALT levels returned to normal values within 3 weeks in 14 cases (82.4%) for group I and in 6 cases (66.7%)for group II. The mean duration of normalization of ALT level were 17.3 14.1 days for group I and 19.9 14.8 days for group II. Our results suggest that it AST/ALT levels are elevated and hepatitis A, B, C markers are negative, or if sudden elevated AST/ALT levels are noted in hepatitis B carriers or a patient with cytomegaloviral hepatitis, Epstein-Barr virus infection should be suspected.
Acute Kidney Injury ; Age Distribution ; Anemia ; Anemia, Iron-Deficiency ; Anorexia ; Bilirubin ; Capsid ; Disseminated Intravascular Coagulation ; Epstein-Barr Virus Infections ; Female ; Fever ; Hemorrhage ; Hepatitis A ; Hepatitis B ; Hepatitis* ; Hepatomegaly ; Herpesvirus 4, Human ; Humans ; Immunoglobulin M ; Infectious Mononucleosis ; Leukocytosis ; Lymphatic Diseases ; Lymphocytes ; Male ; Pancreatitis ; Pediatrics ; Peritonitis ; Pharynx ; Pneumonia ; Reference Values ; Sex Distribution ; Splenomegaly ; Thrombocytopenia

Together, neonatal hepatitis and biliary atresia make up approximately 70 to 80% of the causes of neonatal cholestasis. Biliary atresia must be differentiated from neonatal hepatitis as soon as possible in order to institute early surgical intervention. We performed this study to examine whether the measurement of the serum alpha-fetoprotein (AFP) and thyroxine-binding globulin(TBG) was useful for differentiating these two conditions. Serum AFP levels were measured using enzyme immunoassay in 76 infants with cholestasis and serum TBG levels were measured using radio immunoassay in 30 infants with cholestasis and 23 infants without cholestasis. Serum AFP and TBG concentrations in patients were compared with the normal ranges in infants and were expressed as standard deviation (SD) scores. 52.7% of the patients with neonatal hepatitis showed SD scores of AFP higher than 4.0. By contrast, 14.3% of the patients with biliary atresia showed SD scores of AFP highter than 4.0(p<0.005). The patients with either neonatal hepatitis or biliary atresia had TBG concentrations above the normal ranges, but there was no difference between neonatal hepatitis and biliary atresia. The patients with neonatal hepatitis who recovered from jaundice after 6 months of age or progressed to chronic liver disease of died of the liver disease showed hight serum levels of AFP and TBG than the patients who recovered from jaundice before 6 months of age. In conclusion. SD scores of AFP could be used to differentiate between neonatal heptatis and biliary atresia, and SD scores of AFP and TBG might be used as an indicator of prognosis of neonatal hepatitis.
alpha-Fetoproteins* ; Biliary Atresia* ; Cholestasis ; Hepatitis A ; Hepatitis* ; Humans ; Immunoassay ; Immunoenzyme Techniques ; Infant ; Jaundice ; Liver Diseases ; Prognosis ; Reference Values ; Thyroxine-Binding Globulin*

Intraspinal tumors in children are of especially interest to orthopaedic surgeons for two reasons; First, musculoskeletal abnormalities, are often treated for long periods before the correct diagnosls is suspected; Second, important orthopaedic problems are encountered in almost everychild treated for intraspinal tumor, not only during the immediate postoperative management but all through subsequent growth. We report a case presentation of the intraspinai tumor, dermoid cyst, successfully treated with operation.
Child ; Dermoid Cyst ; Humans ; Musculoskeletal Abnormalities ; Surgeons

PURPOSE: To evaluate the clinical characteristics, treatments and outcome of patients with hemorrhagic shock and encephalopathy(HSE) syndrome. METHODS: We performed a clinical study on 14 patients who were diagnosed as hemorrhagic shock and having encephalopathy syndrome in the Department of Pediatrics, from 1984 to 1998. Age, sex, clinical symptoms and physical findings at admission, the most deranged laboratory findings, radiologic findings, treatments and outcome were analyzed. RESULTS: The age of onset was 1.0+/-0.9 years and the male to female ratio was 1: 1.8. At admission, clinical findings included dehydration in 85.7%, shock in 85.7%, fever in 71.4%, vomiting in 71.4%, diarrhea in 64.3%, GI bleeding in 50%, convulsion in 42.9%, and edema in 35.7%. Altered mental state was found in 100%, hepatomegaly in 64.3%, and splenomegaly in 21.4%. Laboratory findings revealed D-dimer positive in 92.9%, the mean hemoglobin level 8.2+/-2.1g/dL, BUN 35.7+/-24.0mg/dL, creatinine 1.9+/-1.5mg/dL, AST 561.0+/-1,412.1IU/L, ALT 858.9+/-1,649.8IU/L, blood glucose 229.5+/-197.4mg/dL, ammonia 195.4+/-129.7pg/dL, and total bilirubin 4.9+/-8.2mg/dL. On serologic tests, rotavirus and Epstein-Barr virus was found in 1 patient(7.1%), respectively. The mortality rate was 78.6%. CONCLUSION: We found that shock and disseminated intravascular coagulation(DIC) played important roles in the pathogensis of HSE syndrome, and encephalopathy, hepatic and renal insufficiency, and respiratory failure were secondary complications resulting from shock and DIC. Despite vigorous treatment, the prognosis was very poor. We feel more efforts should be focused on investigating the etiology and pathophysiology of HSE to prevent as well as develop a specific therapy. (J Korean Pediatr Soc 2000;43:814-819)
Age of Onset ; Ammonia ; Bilirubin ; Blood Glucose ; Creatinine ; Dacarbazine ; Death, Sudden* ; Dehydration ; Diarrhea ; Edema ; Female ; Fever ; Hemorrhage ; Hepatic Encephalopathy ; Hepatomegaly ; Herpesvirus 4, Human ; Humans ; Infant* ; Male ; Mortality ; Pediatrics ; Prognosis ; Renal Insufficiency ; Respiratory Insufficiency ; Rotavirus ; Seizures ; Serologic Tests ; Shock ; Shock, Hemorrhagic* ; Splenomegaly ; Vomiting

No abstract available.
Hepatitis* ; Humans ; Immunoglobulins* ; Prospective Studies*

Adenoid cystic carcinoma occurs most commonly in the salivary glands, and also has been recognized in numerous other locations. However, it is rarely found in the prostate. We report a case of adenoid cystic c arcinoma of the prostate in a 77-year-old man whose chief complaint was urinary retention. Digital rectal examination transrectal ultrasonography revealed a markedly enlarged prostated and PSA was 4.6ng/ml. The transurethral prostatectomy was performed and the histopathological diagnosis was the adenoid cystic carcinoma. We review the clinical and pathologic feature of this disease.
Adenoids* ; Aged ; Carcinoma, Adenoid Cystic* ; Diagnosis ; Digital Rectal Examination ; Humans ; Prostate ; Salivary Glands ; Transurethral Resection of Prostate ; Ultrasonography ; Urinary Retention

No abstract available.
Temporomandibular Joint Disorders*

No abstract available.
Hepatolenticular Degeneration*

No abstract available.
Adhesives*

PURPOSE: H. pylori infection was recently reported to be associated with unexplained iron-deficiency anemia(IDA) in children and adolescents. H. pylori-related IDA was thought to occur due to GI blood loss, scavenging of iron by H. pylori and iron malabsorption. The aim of this study was to examine how the status of H. pylori infection and age of children affected RBC indices, serum iron level and TIBC. METHODS: We performed esophagogastroduodenoscopy, and examined RBC indices, serum iron and TIBC on 178 pediatric patients with recurrent abdominal pain. H. pylori infection was assessed by CLO test and silver stain of gastric biopsy specimen. RESULTS: H. pylori infection was found in 42 of 178 patients(23.6%). In children with H. pylori infection, the prevalence of iron deficiency(ID) and IDA(39.0% and 10.3%, respectively) was higher than in children without H. pylori infection(29.6% and 4.1%, respectively), but there was no statistically significant difference. Serum iron level was lower(69.5+/-32.7 vs 77.3+/-34.1g/dL; P= 0.08) and TIBC was higher(380.8+/-50.4 vs 366.9+/-47.0g/dL; P=0.09) in children with H. pylori infection than in children without H. pylori infection. All RBC indices and iron saturation were lower in children with H. pylori infection than in children without H. pylori infection, but there was no significant difference between the two groups. In correlation analysis, serum iron, Hgb, Hct, MCV and MCH were significantly increased by age in children without H. pylori infection (P<0.05), but MCH and MCHC were decreased significantly(P<0.05) by age in children with H. pylori infection. In multiple regression analysis, the change of serum iron, MCH and MCHC by age was significantly influenced by the status of H. pylori infection(P<0.05). CONCLUSION: H. pylori infection decreases RBC indices and serum iron and increases TIBC in children. These changes become prominent as age increases. This age effect rnay be related to the duration of H. pylori infection. (J Korean Pediatr Soc 2000;43:755-762)
Abdominal Pain ; Adolescent ; Anemia, Iron-Deficiency ; Biopsy ; Child* ; Endoscopy, Digestive System ; Erythrocytes* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Iron* ; Prevalence ; Silver