Eosinophilic gastroenteritis (EGE) is a disorder characterized by eosinophilic infiltration of the bowel wall and various gastrointestinal (GI) manifestations. This study aimed to evaluate the characteristics of EGE in infants and children. A total of 22 patients were diagnosed with histologic EGE (hEGE) or possible EGE (pEGE). Serum specific IgE levels, peripheral eosinophil counts, and endoscopic biopsies were carried out. In the hEGE group (n = 13), initial symptoms included hematemesis, abdominal pain, and vomiting. Three of the subjects had normal endoscopic findings. Eight patients were categorized into the infant group and 5 into the child group. All patients in the infant group showed clinical improvement after switching from cow's milk feeding to special formula or breast feeding. The infant group showed a higher eosinophil count in the gastric mucosal biopsy than the child group. In the pEGE group (n = 9) initial symptoms included hematemesis, abdominal pain, and vomiting. Seven patients in this group showed a good response to treatment with restriction of the suspected foods and/or the administration of ketotifen. Both hEGE and pEGE groups showed clinical improvement after restriction of suspected foods in the majority of cases and also showed a similar clinical course. EGE should be considered in the differential diagnosis of patients with chronic abdominal pain, vomiting, and hematemesis of unknown cause. The infant group may have a better prognosis than the child group if treated properly.
Child ; Child, Preschool ; Diagnosis, Differential ; Disease Progression ; Endoscopy, Gastrointestinal/*methods ; Enteritis/*pathology/*therapy ; Eosinophilia/*pathology/*therapy ; Female ; Gastritis/*pathology/*therapy ; Humans ; Infant ; Infant, Newborn ; Intestinal Mucosa/*pathology ; Male ; Republic of Korea ; Treatment Outcome

PURPOSE: Bacterial meningitis in neonates and young infants is one of the most serious conditions that can lead to severe neurological sequelae despite the appropriate treatment. This study aimed at evaluating the clinical manifestations and treatment outcomes in patients under the age of three months, who had been diagnosed with bacterial meningitis. METHODS: A total of twelve patients with bacterial meningitis under the age of three months from January 1997 to June 2010 were retrospectively evaluated through a review of their medical records. Patients who showed positive culture results were included in the study. RESULTS: A total of 12 patients (6 males and 6 females, mean age 44.2+/-30.0 days) were enrolled in the study. All patients had fever upon admission. But most of them were unremarkable upon physical examination (75%). Streptococcus agalactiae was the most common organism cultured from CSF (7cases; 58.3%). Six cases showed positive results on CSF culture as well as on blood culture. Cefotaxime and ampicilin/sulbactam or cefotaxime and ampicilin were given as initial treatment with a mean treatment duration of 15.1+/-6.0 days. Neurological complications and sequelae included subdural effusion and hearing disturbance in two cases (16.7%). Nine cases (75%) showed excellent outcomes without neurological deficits, and none were left with a severe degree of sequelae. CONCLUSION: The study showed that neonates or young infants with bacterial meningitis almost always present with fever and that S. agalactiae was the most common causative organism. In addition, the final outcome for these patients may be improved with early and appropriate treatment.
Cefotaxime ; Female ; Fever ; Hearing ; Humans ; Infant ; Infant, Newborn ; Male ; Medical Records ; Meningitis, Bacterial ; Physical Examination ; Retrospective Studies ; Streptococcus agalactiae ; Subdural Effusion ; Treatment Outcome

PURPOSE: It is now well established that infection and inflammation play an important role in the pathogenesis of ischemic brain damage. The loss of neutrophils from systemic circulation is an associated finding in injury mediated by granulocyte. Periventricular leukomalacia(PVL) caused by ischemia is the principal form of brain injury in premature infants. This study was conducted to evaluate whether the low neutrophil count is associated with periventricular leukomalacia(PVL) in premature infants. METHODS: Retrospective review of medical records was undertaken. Subjects were premature infants with a birth weight of less than 1,500 gm, admitted to the Neonatal Intensive Care Unit of Kyungpook University Hospital. A complete blood count of peripheral blood was done within the 1st hour of life. Neutropenia was defined as absolute neutrophil count <1,500/mm3, PVL as increased periven tricular echodensities followed by cyst formation on ultrasonography or corresponding signs on brain MRI. RESULTS: Thirteen infants out of a total population of 37 revealed neutropenia. Respiratory distress syndrome and requirement for respiratory support were not different between infants with neutropenia(neutropenia group) and infants without neutropenia(control group). Intraventricular hemorrhage (IVH) and grade 3 and 4 IVH were more frequent in neutropenia group(P<0.05). There was no statistically significant increase of PVL in neutropenia group. The neutrophil count was 18,760.0+/-10,266.1/mm3, 7,272.0+/-7,435.0/mm3 infants with PVL and 11,131.7+/-3,386.5/mm3, 2,407.5+/-1,933.1/mm3 in infants without PVL, respectively. The frequency of mechanical ventilation and artificial surfactant therapy was higher in infants with PVL compared with infants without PVL, but statistical analysis was not performed due to small number of subjects. CONCLUSION: A low number of neutrophils in the systemic circulation was not associated with an increased risk of PVL in premature infants.
Birth Weight ; Blood Cell Count ; Brain ; Brain Injuries ; Granulocytes ; Gyeongsangbuk-do ; Hemorrhage ; Humans ; Infant ; Infant, Newborn* ; Infant, Premature ; Inflammation ; Intensive Care, Neonatal ; Ischemia ; Leukomalacia, Periventricular* ; Magnetic Resonance Imaging ; Medical Records ; Neutropenia ; Neutrophils* ; Respiration, Artificial ; Retrospective Studies ; Ultrasonography

A 56 year-old man complaining of dry cough, dyspnea, chest pain, fever, and chills was admitted to the emergency room. The patient had a history of esophagectomy and esophagogastrostomy and subsequent radiotherapy because of an esophageal cancer. After the emergency echocardiography revealed a small amount of pericardial effusion and pneumopericardium. Upper GI contrast study showed a fistulous tract between the stomach and the pericardium, and an emergency operation was done under the diagnosis of gastropericardial fistula. The patient expired postoperative seven days later. Gastropericardial fistula caused by a peptic ulcer perforation after the esophagectomy and esophagogastrostomy operation is a very rare complication and brings forth a disastrous result. Early detection using the chest radiography, electrocardiogram, upper GI study, echocardiography and a review of physical examination, and an immediate treatment are therefore mandatory.
Chest Pain ; Chills ; Cough ; Diagnosis ; Dyspnea ; Echocardiography ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Esophageal Neoplasms ; Esophagectomy* ; Fever ; Fistula* ; Gastric Fistula ; Humans ; Middle Aged ; Peptic Ulcer ; Peptic Ulcer Perforation ; Pericardial Effusion ; Pericardium ; Physical Examination ; Pneumopericardium ; Radiography ; Radiotherapy ; Stomach ; Thorax

Langerhans' Cell Histiocytosis(LCH) is a disease of unknown origin, characterized by abnormal proliferation of Langerhans' cells. Previously, it has been called histiocytosis X, which included eosinophilic granuloma, Hand-Sch ller-Christian's disease, and Letterer-Siwe disease. Any organs or tissues such as skin, lymph nodes, bone and bone marrow can be involved. However, LCH of chest wall is rarely reported in our country. We experienced a 18 month old male child, who had osteolytic lesion involving the rib with axillary lymph node metastasis. The tumor was confirmed as LCH after surgery.
Bone Marrow ; Child ; Eosinophilic Granuloma ; Histiocytosis* ; Histiocytosis, Langerhans-Cell ; Humans ; Infant ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Ribs ; Skin ; Thoracic Wall* ; Thorax*

PURPOSE: This study was undertaken to determine whether any features of apoptosis would occur in the established model of cerebral hypoxia-ischemia in neonatal rats. It was also undertaken to evaluate the effect of post-insult hyperoxia on hypoxic ischemic cerebral injury. METHODS: Seven-day-old neonatal rats underwent unilateral carotid artery dissection followed by 2 hours of hypoxia. To this end rat pups, allocated into 2 groups, were resuscitated with high concentration O2(>FiO2 95%) or room air for a 1-hour period. All of them were killed at 3 days after the above procedures. Their brains were perfusion fixed and removed to examine tissue damage by light microscope and apoptosis by terminal deoxynucleotidyl transferase mediated dUTP- biotin nick end labeling(TUNEL) reactivity. RESULTS: The result demonstrates that hypoxia-ischemia model induces tissue damage and TUNEL. Post-insult exposure to high reactivity concentration O2 does not aggravate hypoxic-ischemic cerebral injury 3 days after the insult but increases TUNEL reactivity in injured tissue. CONCLUSIONS: These findings suggest that many cells die by apoptosis following hypoxia-ischemia in neonatal brain and resuscitation with high concentration O2 seems to provide an adverse effect over a brain injury by induction of apoptosis.
Animals ; Anoxia ; Apoptosis ; Biotin ; Brain Injuries* ; Brain* ; Carotid Arteries ; DNA Nucleotidylexotransferase ; Hyperoxia ; Hypoxia-Ischemia, Brain ; In Situ Nick-End Labeling ; Ischemia ; Models, Animal* ; Oxygen* ; Perfusion ; Rats* ; Resuscitation*

Chronic pulmonary artery thromboembolism is a relatively rare phenomenon causing hypoxia and pulmonary hypertension that eventually leads to respiratory failure and right heart failure. Patients with acute pulmonary artery thromboembolism are generally treated with antithrombotics and thrombolytics. However, in cases with chronic pulmonary artery thromboembolism the fibrinized thrombus is so strongly adhered to the pulmonary artery wall that medical treatment becomes ineffective and surgical treatment must then be considered. We report a 47year old patient, with a history of repeated admission due to unresolved chronic obstructive pulmonary disease and chronic pulmonary artery thromboembolism at a local hospital, who underwent a successful endarterectomy of pulmonary artery thromboemboli using intermittent total circulatory arrest.
Anoxia ; Endarterectomy* ; Fibrin ; Heart Failure ; Humans ; Hypertension, Pulmonary ; Pulmonary Artery ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Embolism* ; Respiratory Insufficiency ; Thromboembolism ; Thrombosis

The incidence of pulmonary leiomyosarcoma as primary lung tumor is very rare. Most of the primary leiomyosarcomas originate in the hilar region in relation to the main bronchus or pulmonary vessels and only a few originate more peripherally. This rare tumor can mimic bronchial carcinoma and present with local or systemic symptoms, or it may be discovered as an incidental finding on a routine chest X-ray. We report with review of literature, a case of incidental primary pulmonary leiomyosarcoma which originated peripherally. Huge mass was found on the left lung of a 61-year-old man on the chest X-ray peripherally. He underwent the surgical resection of the left pneumonectomy and the postoperative course was uneventful.
Bronchi ; Carcinoma, Bronchogenic ; Humans ; Incidence ; Incidental Findings ; Leiomyosarcoma* ; Lung ; Middle Aged ; Pneumonectomy ; Thorax

Synovial sarcoma is a malignant soft tissue tumor originated from the primitive mesencymal cell. It occurs primarily in the extremities, especially in the lower extremities. Primary pulmonary synovial sarcoma has been rarely reported in literatures. We experienced a case of intrapulmonary synovial sarcoma with brain metastasis which originated from the lung.
Brain* ; Extremities ; Lower Extremity ; Lung ; Neoplasm Metastasis* ; Sarcoma ; Sarcoma, Synovial*

The Dowling-Meara type of epidermolysis bullosa simplex is a rare genodermatosis transmitted by autosomal dominant pattern. It starts during the first 3 months of life and is characterized by generalized bullae in a herpetiform pattern. We report two cases of Dowling-Meara type of epidermolysis bullosa simplex. The first case is an 18-year-old male patient who showed bullae in a herpetiform arrangement on the dorsa of both hands, forearms, and trunk, hyperkeratosis on the palms and soles, postinflammatory hypo- and hyperpigmentations, and dystrophy of finger and toe nails. The second case is a 1-month-old boy who showed multiple bullae in a herpetiform and confluent arrangement scattered on the whole body, particularly on the dorsa of both feet and hands. Microscopically and electro-microscopically, two cases all showed intraepidermal blisters formed within the basal keratinocyte in association with clumping of the tonofilaments and cytolysis of the basal cells.
Adolescent ; Blister ; Epidermolysis Bullosa Simplex* ; Epidermolysis Bullosa* ; Fingers ; Foot ; Forearm ; Hand ; Humans ; Infant, Newborn ; Intermediate Filaments ; Keratinocytes ; Male ; Toes