No abstract available.
Asthma* ; Child* ; Humans ; Sinusitis*

Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
Bacterial Infections ; Cardiovascular Diseases ; Developed Countries ; Humans ; Immunoglobulins ; Infant* ; Male ; Mucocutaneous Lymph Node Syndrome* ; Opportunistic Infections ; Sepsis* ; Tumor Necrosis Factor-alpha ; Infliximab

PURPOSE: Cytokines are known to play a major role in mediating many of the immunological and pathological findings of allergic disease. Many studies on allergen-specific T cell clones isolated from atopic individuals have shown that these cells produce cytokines of the Th2 phenotype. The purpose of the present study was to investigate cytokine patterns of T lymphocyte induced by Dermatophagoides pteronyssinus in atopic asthma. METHODS: Freshly isolated peripheral blood mononuclear cells of Dp(+) asthmatic children, Dp(-) asthmatic children, nonasthmatic children, and normal adults were stimulated with Dp antigen and examined for the induction of IFN-gamma, IL-2, IL-4, and IL-5 mRNA using RT-PCR. RESULTS: The lymphoproliferative response to crude Dp antigen was maximized at Dp concentration of 2.5 microgram/mL. The lymphoproliferative response was low in children including Dp(+) asthmatics, Dp(-) asthmatics and nonasthmatics, but that of normal adults was high. The expression of IFN-gamma was not so different in each group, but the expression of IL-4 was least in adults, and that of IL-5 was most prominent in Dp(+) asthmatic children. In adult healthy group, IFN-gamma expression without IL-4 and IFN-gamma without IL-5 was significantly higher than those in children. IL-5 expression with or without IFN-gamma was the highest in Dp(+) asthmatic children. IL-4 and IL-5 or IL-5 without IL-4 expression were observed more frequently in Dp(+) asthmatic children than in any other groups. Th2 response was most prominent in Dp(+) asthmatics, and Th1 response was most prominent in normal adult group. CONCLUSION: In conclusion, we observed significantly prominent Th2 response in Dp(+) asthmatic children, especially that of IL-5.
Adult ; Asthma ; Child ; Clone Cells ; Cytokines* ; Dermatophagoides pteronyssinus* ; Gene Expression* ; Humans ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Lymphocytes ; Negotiating ; Phenotype ; Pyroglyphidae* ; RNA, Messenger

Apert syndrome is an uncommon congenital disorder characterized by malformation of the skull, most often acrocephaly or oxycephaly, in association with symmetrical syndactyly of both hands and feet. It is due to a disturbance in the growth of bone and soft tissue, affecting principally the head, hands, and feet. Recently we experienced a typical Apert syndrome expressed only in one neonate of dizygotic twin.
Acrocephalosyndactylia* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Craniosynostoses ; Foot ; Hand ; Head ; Humans ; Infant, Newborn* ; Skull ; Syndactyly ; Twins, Dizygotic*

Guillain-Barr syndrome is rarely complicated by hypertension, which has been ascribed to sympathetic nervous system hyperactivity. We report a 11 years old female with Guillain-Barr syndrome complicated by persistent hypertension associated with elevated renin-angiotensin. So we report this case with brief review of related literatures.
Child ; Female ; Humans ; Hypertension* ; Sympathetic Nervous System

Neonatal ascites is an uncommon problem with many etiologies. The common causes include hematologic diseases, bowel perforation, obstructive uropathy, cardiovascular diseases, chylous ascites, intrauterine infection, and meconium peritonitis. Recently, the wide application of sonography has greatly narrowed the list of differential diagnosis of neonatal ascites. Meconium peritonitis is readily diagnosed if calcification in the abdomen or scrotum can be seen radiologically or sonographically in a neonate with abdominal distension at birth. We report a case of generalized meconium peritonitis without intraabdominal calcification by radiologic and sonographic study and notable meconium hydrocele at birth.
Abdomen ; Ascites ; Cardiovascular Diseases ; Chylous Ascites ; Diagnosis, Differential ; Hematologic Diseases ; Humans ; Infant, Newborn ; Meconium* ; Parturition ; Peritonitis* ; Scrotum ; Ultrasonography

PURPOSE: The clinical findings of early neonatal hypocalcemia are variable and it is difficult to find relationship between the symptoms and hypocalcemia due to complex causes. The purpose of this study is to establish the relationship between early neonatal hypocalcemia and clinical manifestations and to propose a guideline for appropriate treatment of early neonatal hypocalcemia, especially in asymptomatic cases. METHODS: Study subjects were all sick babies admitted to nursery and NICU and randornly selected 43 healthy babies at Sun General Hospital from January 1996 to December 1996. We examined serum calcium level within 72 hours after birth. Then we evaluated prospectively clinical findings according to each disease category in hypocalcemic cases and analysed the relationship of time course of clinical findings with hypocalcemia and compared serum calcium concentration followed by each therapy after 3 days. RESULTS: The results were as follows. 1) The incidence of early neonatal hypocalcernia was high in premature infants, low birth weight infants, infants with neonatal asphyxia, hyaline membrane disease and transient tachypnea. 2) Tremor, seizure, apnea, dyspnea, abdominal distension, cyanosis, and vomiting were frequently presented symptoms in early neonatal hypocalcemia. 3) In the cases of early hypocalcemia with symptoms, these symptoms persisted continuously after norrnalization of serum calcium concentration. 4) Among asymptomatic hypocalcernic group, mean serum calcium levels changed from 6.7 mg/dL to 8.7 mg/dL in 23 cases of no treatment, from 5.4 mg/dL to 10.3 mg/dL in 4 cases of calcium gluconate infusion, and from 6.3 mg/dL to 8.7 mg/dL in 7 cases of feeding low phosphorus containing milk. None persisted in hypocalcemic state irrespective of treatment methods. CONCLUSION: It is difficult to regard these symptoms as a rule to treatment because these symptoms were present after normalizaton of serum calcium concentration. In addition, asymptomatic hypocalcemia was improved shortly without any treatment without any problem. We conclude that for asymptomatic hypocalcemia, withholding dangerous calcium gluconate infusion would be perrnissible.
Apnea ; Asphyxia ; Calcium ; Calcium Gluconate ; Cyanosis ; Dyspnea ; Hospitals, General ; Humans ; Hyaline Membrane Disease ; Hypocalcemia* ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Milk ; Nurseries ; Parturition ; Phosphorus ; Prospective Studies ; Seizures ; Solar System ; Tachypnea ; Tremor ; Vomiting

PURPOSE: It was noted some changes of clinical manifestations of mycoplasma pneumonia. we reviewed and compared these changes and saught any clues causes for proper dignosis and treatment. METHODS: We divided patients with mycoplasma pneumonia into two groups, Group 1 (from Jan. to Dec. 1996) and Group 2 (from Jan. to Dec. 1994), and analyzed clinical, radiologic, and serologic differences. RESULTS: Mean age of onset lowered markedly from was 8.34 +/- 2.56 years to 6.91 +/- 3.28 years (P<0.05). In clinical symptoms, high fever lasted longer and gastrointestinal symptoms were more frequent noted group 1. Serologically, high titers of mycoplasma-specific antibody (>1 : 1280) were more frequently observed in group 1 and correlated with severity of clinical manifestations. In radiologic findings, alveolar consolidation were significantly prominent findings in Group (P<0.05). The mean period of response to Roxithromycin was not difference between two groups but longer lasting fever (> or = 3 days) in spite of medication were more prevalent in Group 1 (P<0.05), suggesting increased cases of diminished responsiveness to treatment. CONCLUSIONS: Recently, there was some clinical changes of mycoplasma pneumonia, lowering of onset age, severe clinical symptoms, and more decreased responsiveness to antibiotic treatment. We suggest that it is to neccessary to make some efforts to prevent antibiotics abuse and to decrease the occurrence of resistant strains by introducing of new method for early diagnosis, selective identification of micro-organism and minute sensitivity test for antibiotics.
Age of Onset ; Anti-Bacterial Agents ; Early Diagnosis ; Fever ; Humans ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Roxithromycin

PURPOSE: The purpose of this trial was to determine whether salbtamol and budesonide combined inhalation therapy is more efficacious than conservative treatment for admitted infants with bronchiolitis in early phase. METHODS: The study subjects were 72 infants admitted to Sun Hospital in Taejeon from July 1994 to June 1995, whose age from 1 month to 12 months with clinical diagnosis of bronchiolitis. Infants were randomly assigned to different three treatment groups as follw: Group C: 21 infants who received conservative treatment with oxygen (4liter/min); Group A: 23 infants who received salbutamol (0.1mg/kg) inhalation therapy using ultrasonic nebulizer at 6 hours interval add to conservative therapy; Group B: 28 infants who received budesonide (0.1mg/kg) inhalation therapy with above mentioned treatment at 12 hours interval. Then, infants were analyzed by comparison of clinical score, repiratory rate at time order of entry, 12 hours, 24 hours, 48 hours, 72 hours, and 5 days after treatment. We also compared ABGA of admission time to 24 hours after treatment of all groups and appreciate total hospital days of three groups. On follow up, same analyzing methods of comparison were used on 42 non-recurrent wheezing infants. RESULTS: The mean values of clinical score and respiratory rate were significantly improved in salbutamol and budesonide inhalation treatment group at 24 hours from medium of 6.1 60.7/min to 2.4, 42.3/min respectly. This effect was sustained thereafter. On the while, salbutamol inhalation group was significantly improved the clinical score and respiratory reate at 12 hours after therapy, but thereafter there was no obvious difference to conservative treatment. After then we exclude the recurrent infants and analyzed above mentioned items retrospectively. The improvement of clinical score and respiratory rate of salbutamol and budesonide inhalation therapy group was significant. Oxygenation was improved after 24hours of salbutamol and budesonide inhalation therapy. Total hospital stay was significantly reduced in salbutamol and budesonide inhalation group, and slightly reduced inthe salbutamol inhalation group. CONCLUSION: Infants with bronchiolitis treated with salbutamol and budesonide inhalation achieved better results in clinical score, repiratory rate PO2, and hospital days than no inhalation therapy. No reapiratory failure was occurred. So, this trial as treatment of bronchiolitis may be useful and effective therapy in those infants.
Albuterol* ; Bronchiolitis* ; Budesonide* ; Daejeon ; Diagnosis ; Follow-Up Studies ; Humans ; Infant* ; Inhalation* ; Length of Stay ; Nebulizers and Vaporizers ; Oxygen ; Respiratory Rate ; Respiratory Sounds ; Respiratory Therapy* ; Retrospective Studies ; Solar System ; Ultrasonics

PURPOSE: The purpose of this trial was to determine whether salbtamol and budesonide combined inhalation therapy is more efficacious than conservative treatment for admitted infants with bronchiolitis in early phase. METHODS: The study subjects were 72 infants admitted to Sun Hospital in Taejeon from July 1994 to June 1995, whose age from 1 month to 12 months with clinical diagnosis of bronchiolitis. Infants were randomly assigned to different three treatment groups as follw: Group C: 21 infants who received conservative treatment with oxygen (4liter/min); Group A: 23 infants who received salbutamol (0.1mg/kg) inhalation therapy using ultrasonic nebulizer at 6 hours interval add to conservative therapy; Group B: 28 infants who received budesonide (0.1mg/kg) inhalation therapy with above mentioned treatment at 12 hours interval. Then, infants were analyzed by comparison of clinical score, repiratory rate at time order of entry, 12 hours, 24 hours, 48 hours, 72 hours, and 5 days after treatment. We also compared ABGA of admission time to 24 hours after treatment of all groups and appreciate total hospital days of three groups. On follow up, same analyzing methods of comparison were used on 42 non-recurrent wheezing infants. RESULTS: The mean values of clinical score and respiratory rate were significantly improved in salbutamol and budesonide inhalation treatment group at 24 hours from medium of 6.1 60.7/min to 2.4, 42.3/min respectly. This effect was sustained thereafter. On the while, salbutamol inhalation group was significantly improved the clinical score and respiratory reate at 12 hours after therapy, but thereafter there was no obvious difference to conservative treatment. After then we exclude the recurrent infants and analyzed above mentioned items retrospectively. The improvement of clinical score and respiratory rate of salbutamol and budesonide inhalation therapy group was significant. Oxygenation was improved after 24hours of salbutamol and budesonide inhalation therapy. Total hospital stay was significantly reduced in salbutamol and budesonide inhalation group, and slightly reduced inthe salbutamol inhalation group. CONCLUSION: Infants with bronchiolitis treated with salbutamol and budesonide inhalation achieved better results in clinical score, repiratory rate PO2, and hospital days than no inhalation therapy. No reapiratory failure was occurred. So, this trial as treatment of bronchiolitis may be useful and effective therapy in those infants.
Albuterol* ; Bronchiolitis* ; Budesonide* ; Daejeon ; Diagnosis ; Follow-Up Studies ; Humans ; Infant* ; Inhalation* ; Length of Stay ; Nebulizers and Vaporizers ; Oxygen ; Respiratory Rate ; Respiratory Sounds ; Respiratory Therapy* ; Retrospective Studies ; Solar System ; Ultrasonics