No abstract available.
Ankylosis* ; Radiotherapy* ; Temporomandibular Joint*

A study on prevalence of hepatitis B surface antigen(HBsAg) in 1,292 grade-school children(548 of rural area, 744 of urban area) by Counterimmunoelectrophoretic method: various liver fuction tests and liver biopsy were performed, and the results obtained are as follows: 1) Fifty four of 1,292 children who were selected randomly were positive for HBsAg(4.2%) and incidence of HBsAg was higher in rural area(4.6%) than in urban area(3.9%). 2) The incidence of HBsAg was higher in male children(4.5%) than female Children(3.7%). 3) Age distribution revealed highest incidence at 10(5.9%), years old lowest incidence at 9(2.9%), but any significant interrelationship wasn't found between ages. 4) The order of liver function tests which showed abnormal values by numver are as follows: GGT(26.2%), SGOT(23.6%), Total protein(7.1%), SGPT(4.8%), TTT(4.8%), BSP retention test(2.4%), PT(0%). The values of GGT and SGOT were thought to be most useful in HBsAg positive children. 5) All tests showed normal values in 22 children(52.4%), one test and more than 2 tests showed abnormal values each in 18 children(42.8%) and in 2 children(4.8%). 6) On liver biopsy performed in nine HBsAg positive children, one showed normal liver tissue, two showed mild hepatocellular degenerative change, five showed chronic persistent hepatitis and showed chronic active hepatitis. On orcein staining, three showed intracytoplasmic inclusion bodies thought to be HBsAg.
Age Distribution ; Aspartate Aminotransferases ; Biopsy ; Child* ; Female ; Hepatitis B ; Hepatitis B Surface Antigens* ; Hepatitis, Chronic ; Humans ; Incidence ; Inclusion Bodies ; Liver ; Liver Function Tests ; Male ; Prevalence ; Reference Values

We experienced two cases of Hand, Foot and Mouth Disease with vesicular lesions in the oral cavity and maculopapular rash on hands and feet. The diagnosis was confirmed by clinical features and biopsy findings. Also we made a brief review of literatures.
Biopsy ; Diagnosis ; Exanthema ; Foot* ; Hand* ; Hand, Foot and Mouth Disease ; Mouth

Native valve endocarditis (NVE) without preexisting structural valve or congenital cardiac malformation especially in pediatric group is rare. A case of isolated tricuspid valve endocarditis in a 7-year-old child without any cardiac malformation is described. This child had suffered from fever and productive cough for 3 weeks. Blood culture grew Staphylococcus aureus. Fever was not controlled even with proper antibiotic treatment. Transthoracic echocardiogram and lung perfusion scan revealed a large vegetation on the tricuspid valve with multiple embolism Surgical procedures included vegetectomy partial cusps resection and pericardial patch valvuloplasty. Th patient was in NYHA class I during follow up.
Child ; Cough ; Embolism ; Endocarditis* ; Endocarditis, Bacterial ; Fever ; Follow-Up Studies ; Humans ; Lung ; Perfusion ; Staphylococcus aureus ; Tricuspid Valve*

A 4-day-old patient with Down syndrome (DS) visited out patient department (OPD) because of jaundice and VSD. Peripheral blood smear showed 21% of myeloblast. After 4 weeks of observation, WBC count was 55,100/mm3 (blast 90%). BM aspirate showed AML (M7) and treatment was started with low dose Ara-C (20 mg/m2 for 21 days). After remission, maintenance therapy was done with low dose Ara-C (16 mg/m2 for 21 days), 6-TG (40 mg/m2 for 21 days) and low dose IL-2 (0.5 106U/m2 for 21 days) alternatively for 2 years. The patient remained in complete remission and VSD was corrected at 9 months of age. This case shows that remission can be achieved with low dose Ara-C and it can be maintained thereafter with low dose Ara-C, 6-TG and IL-2. Low dose IL-2 has the advantage of selectively activating immune cells with high affinity receptors, low treatment related morbidity, good compliance which can be injected at OPD. As the patients with DS have defect in IL-2 secretion, IL-2 may have an beneficial effects on treating AML in DS.
Compliance ; Cytarabine ; Down Syndrome* ; Drug Therapy* ; Granulocyte Precursor Cells ; Humans ; Interleukin-2* ; Jaundice ; Leukemia, Myeloid, Acute*

Castleman's disease was first described in 1956 in a group of patients with localized mediastinal lymph node enlargement characterized by hyperplasia of lymphoid follicles and marked capillary proliferation with endothelial hyperplasia. They have been divided into 2 histologic types: the hyaline-vascular type, which was more common and usually asymptomatic, was characterized by small hyaline-vascular follicles and interfollicular capillary proliferation; the plasma-cell type was characterized by large follicles with intervening sheets of plasma cells. Systemic manifestations, such as fever, anemia and hyperglobulinemia, were frequently associated with the plasma cell type. Localized lesions have behaved in a benign fashion, and complete surgical excision has been curative. But recent years, reports have described a multicentric variety with severe systemic manifestations, exorable clinical course and poor outcome. Although Castleman's disease has been described at all ages, the disease is rare in childhood. This paper describes a case of plasma cell type Castleman's disease in a 12-year-old boy and review of the literature. We conclude that the Castleman's disease must be considered in childhood lymphadenopathy and the clinicians should be mindful of the malignant potential of the disease and their possible multicentricity. Appropriate treatment plan, close follow-up and periodic surveillance are necessary.
Anemia ; Capillaries ; Child ; Fever ; Follow-Up Studies ; Giant Lymph Node Hyperplasia* ; Humans ; Hyperplasia ; Lymph Nodes ; Lymphatic Diseases ; Male ; Plasma Cells* ; Plasma*

Henoch-Schonlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and C3 deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.
Abdominal Pain ; Acute Kidney Injury ; Adult ; Arthralgia ; Azotemia ; Biopsy ; Exanthema ; Fluorescent Antibody Technique ; Gastrointestinal Hemorrhage ; Glomerulonephritis ; Humans ; Immunoglobulin A ; Joints ; Kidney ; Lower Extremity ; Oliguria ; Purpura ; Purpura, Schoenlein-Henoch ; Renal Dialysis ; Skin ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous ; Wrist

PURPOSE: Serum vitamin D (25-hydroxyvitamin D, 25[OH] D) and interleukin-31 (IL-31) are related to atopic dermatitis, but their relationship with allergic rhinitis is unclear. The purpose of this study was to compare the levels of serum IL-31 and 25 (OH) D between the allergic rhinitis (AR), nonallergic rhinitis (NAR), and control groups and to investigate the relationship between IL-31 and 25 (OH) D. METHODS: We recruited 59 children with only rhinitis and 33 controls without any allergic diseases. Serum IL-31 and 25(OH) D levels were assayed using an enzyme-linked immunosorbent assay and high-performance liquid chromatography, respectively. The patients were considered to have atopic sensitization if the levels of serum specific IgE to inhalant allergens as assessed using immunoCAP were ≥0.35 IU/mL or if they tested positive for one or more allergens by the skin prick test. RESULTS: Of children with rhinitis, 25 had nonatopy (NAR), and 34 children had atopy (AR). Serum 25(OH) D levels were significantly lower in the rhinitis group than in the control group, while there was no significant difference serum 25(OH) D levels between the AR and NAR groups. Children with rhinitis demonstrated higher serum IL-31 levels than controls; however, there was no difference in serum IL-31 levels between the AR and NAR groups. Serum 25(OH) D levels were inversely correlated with serum IL-31 levels and blood eosinophil counts. On the other hand, serum 25(OH) D levels were not correlated with total serum IgE levels. CONCLUSION: Serum 25(OH) D and IL-31 may play a role in the pathogenesis of rhinitis via mechanisms other than IgE-related pathway.
Allergens ; Child ; Chromatography, Liquid ; Dermatitis, Atopic ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Hand ; Humans ; Immunoglobulin E ; Rhinitis ; Rhinitis, Allergic ; Skin ; Vitamin D ; Vitamins

PURPOSE: Macrolide-resistant Mycoplasma pneumoniae pneumonia (MPP) is characterized by prolonged fever and radiological progression despite macrolide treatment. Few studies have examined serum procalcitonin (PCT) level in children with MPP. We aimed to investigate the association of acute inflammation markers including PCT with clinical parameters in children with MPP. METHODS: A total of 147 children were recruited. The diagnosis of MPP relied on serial measurement of IgM antibody against mycoplasma and/or polymerase chain reaction. We evaluated the relationships between C-reactive protein (CRP), PCT, and lactate dehydrogenase (LDH) levels and white blood cell (WBC) counts, and clinical severity of the disease. We used multivariate logistic regression analysis to estimate the odds ratio for prolonged fever (>3 days after admission) and hospital stay (> 6 days), comparing quintiles 2–5 of the PCT levels with the lowest quintile. RESULTS: The serum PCT and CRP levels were higher in children with fever and hospital stay than in those with fever lasting ≤ 3 days after admission and hospital stay ≤ 6 days. CRP level was higher in segmental/lobar pneumonia than in bronchopneumonia. The LDH level and WBC counts were higher in children with fever lasting for >3 days before compared to those with fever lasting for ≤ 3 days. The highest quintile of PCT levels was associated with a significantly higher risk of prolonged fever and/or hospital stay than the lowest quintile. CONCLUSION: Serum PCT and CRP levels on admission day were associated with persistent fever and longer hospitalization in children with MPP.
Bronchopneumonia ; C-Reactive Protein ; Child* ; Diagnosis ; Drug Resistance ; Fever* ; Hospitalization ; Humans ; Immunoglobulin M ; Inflammation ; L-Lactate Dehydrogenase ; Length of Stay ; Leukocytes ; Logistic Models ; Mycoplasma pneumoniae ; Mycoplasma* ; Odds Ratio ; Pneumonia ; Pneumonia, Mycoplasma* ; Polymerase Chain Reaction ; Risk Factors*

BACKGROUND: Continuous femoral nerve block (CFNB) improves postoperative analgesia after total knee arthroplasty (TKA). The aim of this study was to investigate the clinical efficacy and complications of our in-plane three-step needle insertion technique that was devised to reduce the risk of direct femoral nerve injury during CFNB in anesthetized patients. METHODS: This retrospective study included 488 patients who had undergone TKA. Ultrasound (US)-guided CFNB was performed under general or spinal anesthesia using an in-plane, three-step needle insertion technique. The success rate and difficulties of catheter placement, clinical efficacy of analgesia, and complications were recorded. RESULTS: Femoral catheters were placed with a 100% success rate. In 488 patients, real-time US imaging revealed easy separation of the fascia iliaca and the femoral nerve following injection of local anesthetic through a Tuohy needle. Verbal numerical rating scale pain scores (0–10) were 2.0 ± 1.2, 3.5 ± 1.9, 3.2 ± 1.7, 2.9 ± 1.3, and 2.5 ± 1.1 at 1, 6, 12, 24 and 48 h postoperatively. No femoral hematoma, femoral abscess, or neurologic complications, including paresthesia or neurologic deficits, were observed during the 8-week follow-up period. CONCLUSIONS: This retrospective study suggests that an in-plane three-step needle insertion technique for CFNB may reduce the risk of femoral nerve injury in anesthetized patients.
Abscess ; Analgesia ; Anesthesia, Spinal ; Arthroplasty ; Arthroplasty, Replacement, Knee* ; Catheters ; Fascia ; Femoral Nerve* ; Follow-Up Studies ; Hematoma ; Humans ; Knee ; Needles* ; Neurologic Manifestations ; Paresthesia ; Retrospective Studies* ; Treatment Outcome ; Ultrasonography