No abstract available.
Child* ; Humans ; Scrub Typhus*

PURPOSE: To establish the incidence of deep vein thrombosis among Koreans after primary total hip arthroplasty and the usefulness of color doppler ultrasonography for routine noninvasive screening for deep vein thrombosis. MATERIALS AND METHODS: We performed prospective, randomized routine venography and color doppler ultrasonography before and after operation in a consecutive series of 89 primary total hip arthroplasty in which no form of prophylaxis was used. RESULTS: Of the 89 cases, eleven (12.4%) were found to have deep vein thrombosis (three proximal veins and eight distal veins) by bilateral venography. Most of the thromboses except two were asymptomatic. No patient had a symptomatic pulmonary embolism. Statistical analysis of risk factors, age, gender, weight, height, fixation method, and duration of operation time, were performed and there was no statistical difference (P>0.05). The reliability of color doppler ultrasonography for detection of deep vein thrombosis was demonstrated. CONCLUSIONS: We found insufficient evidence to recommend routine thromboprophylaxis in primary total hip arthroplasty among Koreans. The authors recommend that routine bilateral color doppler ultrasonography screening be considered after primary total hip arthroplasty for detection of deep vein thrombosis
Arthroplasty, Replacement, Hip* ; Humans ; Incidence ; Mass Screening ; Phlebography ; Prevalence* ; Prospective Studies ; Pulmonary Embolism ; Risk Factors ; Thrombosis ; Ultrasonography, Doppler, Color ; Veins ; Venous Thrombosis*

No abstract available.
Dyskeratosis Congenita*

PURPOSE: High dose intravenous immunoglobulin (IVIG) therapy is effective in reducing the incidence of coronary artery aneurysm in Kawasaki disease (KD) patients, however, the precise mechanisms by which IVIG reverses the immune activation is unknown. METHODS: The sera and peripheral mononuclear cells (PBMCs) were obtained from 10 KD patients in the acute stage (24 hrs before) and 24 hrs after one dose of IVIG (2g/kg) treatment. We measured serum interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) and compared them to the messenger RNA expression of the PBMCs by reverse transcription polymerase chain reaction. We also investigated the cytokines' or immunoglobulins' production of PBMCs which were stimulated with phytohemagglutinin-P (PHA-P) or pokeweed mitogen (PWM, without in vitro IVIG treatment) by enzyme-linked immunosorbent assay. RESULTS: The serum levels of IL-6 and TNF-alpha decreased significantly after IVIG treatment. However, the gene expression of IL-6 and TNF-alpha showed no significant difference after IVIG treatment. IL-6 and TNF-alpha productions of PBMCs stimulated with PHA-P decreased significantly after IVIG treatment, however, IL-4 and IFN-gamma production showed no significant differences. IL-6 production of PBMCs stimulated with PWM also decreased significantly after IVIG treatment, but TNF-alpha did not change significantly. The synthesis of IgG, IgM, IgA and IgG1 after IVIG treatment showed a significant decrease, and that of IgG2 showed a slight decrease, but was not statistically significant. CONCLUSION: The results demonstrate that the administration of IVIG in the acute stage of KD resulted in the alterations of activated immunologic abnormalities, especially in monocytes and B cells.
Aneurysm ; B-Lymphocytes ; Coronary Vessels ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Incidence ; Interleukin-4 ; Interleukin-6 ; Monocytes ; Mucocutaneous Lymph Node Syndrome* ; Phytolacca americana ; Polymerase Chain Reaction ; Reverse Transcription ; RNA, Messenger ; Tumor Necrosis Factor-alpha

PURPOSE: The pertussis vaccines are divided into whole-cell vaccine and acellular vaccine. Purified component acellular pertussis vaccine, originally developed in Japan, has been used for primary immunization series in Korea since 1984. We performed this study to evaluate the prevalence of pertussis antibodies following vaccination with acellular pertussis vaccine. METHODS: We randomized 80 children who were immunized according to vaccine schedules including less than 2 month-old infants at Department of Pediatrics, Catholic University Medical College from February 1995 to October 1995. We measured agglutination titers of children by bacterial agglutination test. RESULTS: 1) The age distribution ranged from 5 days to 7 years old, the mean age was 14.5+/- 12.8 months and male to female ratio was 1:1. 2) Only 23 cases (28.8%) of the 80 cases were positive results. 3) Among 7 infants who were less than 2 months-old and were not immunized, 5 infants (71.4%) were seropositive. 4) There was no significant difference in positive rates among age groups which include 2 to 6 months age group, 7 to 18 months age group, and older than 18 months age group. CONCLUSIONS: The prevalence of pertussis positive rates is only 28.8% and there was no difference among age groups.
Age Distribution ; Agglutination ; Agglutination Tests ; Antibodies* ; Appointments and Schedules ; Child* ; Female ; Humans ; Immunization ; Infant ; Japan ; Korea ; Male ; Pediatrics ; Pertussis Vaccine ; Prevalence ; Vaccination* ; Vaccines ; Whooping Cough*

Abnomalities in the production and transport of airway secretions play an important role in the pathophysiology of asthma. Segmental atelectasis as a complication of asthma, is relatively common in children. On the other hand, massive atelectasis such as the collapse of one lung is a very rare occurence. We report a seven-year-old male asthmatic patient with right lung collapse caused by mucoid impaction. Fourteen months before admission, the patient experiened bronchopneumonia with left unilateral lung collapse due to mucus plugging and recovered by bronchoscopic removal. The clinical findings, chest X-ray and chest CT suggested the collapse of the right lung was caused by mucus plugging. Fiberoptic bronchoscopy revealed the obstruction of the right main bronchus due to thick mucoid impaction. The histologic finding of mucoid material removed by brochoscopy showed only eosinophil clusters. In addition to fibroptic broncoscopic removal of mucoid secretions, hydration, chest physiotherapy, brochodilators and steroids, the patient received tracheostomy because of difficulty in sputum expectoration, poor improvement of clinical symptoms and chest X-ray findings, with rapid improvements. This case showed that early aspiration of bronchial mucoid secretions by bronchoscopy and tracheostomy was very critical, without waiting for a further deterioration of respiratory function.
Asthma ; Bronchi ; Bronchopneumonia ; Bronchoscopy ; Child* ; Eosinophils ; Hand ; Humans ; Lung* ; Male ; Mucus ; Pulmonary Atelectasis* ; Sputum ; Steroids ; Thorax ; Tomography, X-Ray Computed ; Tracheostomy

The major manifestations of aplastic anemia are characterized by persistent bone marrow aplasia and peripheral pancytopenia due to defective stem cells in which differentiation is not curtailed or preferential elimination of stem cells with self-renewal capacity, which results in serious complications such as bleeding and infection. Recent advances in the therapeutic modalities, such as bone marrow transplantation and immunosuppressive therapy, and in supportive measures as component transfusion and infection control with better quality of antibiotics resulted in an improved survival and subsequently increased possibility of complications which need surgical intervention. Considering the fact that surgery may not only control complications, but offers the opportunity to give effective therapy for aplastic anemia and therefore improves chances for survival, it is strongly suggested that active surgical intervention should be performed. We report a case of patient with aplastic anemia who had been performed surgical intervention of partial maxillectomy for the squamous cell carcinoma on maxilla without serious complications during perioperative and postoperative period.
Anemia, Aplastic* ; Anti-Bacterial Agents ; Bone Marrow ; Bone Marrow Transplantation ; Carcinoma, Squamous Cell* ; Hemorrhage ; Humans ; Infection Control ; Maxilla ; Pancytopenia ; Postoperative Period ; Stem Cells

PURPOSE: To evaluate the efficacy of steroid therapy on prevention of development and progression of coronary artery aneurysm in intravenous immune globulin (IVIG)-resistant Kawasaki disease, we treated three children with high dose of intravenous methylprednisolone followed by low dose oral prednisolone. METHODS: We selected three children with Kawasaki disease who did not repond or who initially responded but soon developed recrudescent fever after retreatment of IVIG (total 4gm/kg). These three patients were treated with high dose methylprednisolone (10mg/kg) intravenously and followed by low dose prednisolone (1mg/kg) orally for 7 days. Echocardiographic evalutions were performed within 8 days of admission (before steroid therapy), at discharge and 1 month after discharge. RESULTS: All three patients showed rapid normalization of clinical symptoms and did not developed significant coronry artery abnormalities. No adverse reaction was observed. CONCLUSIONS: Steroid therapy (mini pulse methylprednisolone and prednisolone therapy) is valuable for patients with Kawasaki disease resistant to intravenous immune globulin therapy.
Adrenal Cortex Hormones* ; Aneurysm ; Arteries ; Child ; Coronary Vessels ; Echocardiography ; Fever ; Humans ; Immunoglobulins, Intravenous ; Methylprednisolone ; Mucocutaneous Lymph Node Syndrome* ; Prednisolone ; Retreatment

Diffuse myalgia is common in transient systemic viral infections but overt myositis, with weakness and signs of muscle inflammation, rarely accompanies viral infection in chidren. We describe a 8-year-old boy with severe myalgia and tenderness in both lower extremities, whose unusual skeletal muscle uptake on Technetium-methylene diphosphate bone scan helped to diagnosis of myositis. Clinical course, muscle-derived enzyme studies(AST, ALT, LD, CK), electromyogram findings, histopathologic findings obtained from left gastrocnemius muscle biopsy and serologic studies for enteroviral antibodies (enterovirus type 71 and Coxsackie B4 neutralization antibody titer 1:128 respectively) were all compatible with acute viral myositis.
Antibodies ; Biopsy ; Child ; Diagnosis ; Humans ; Inflammation ; Lower Extremity ; Male ; Muscle, Skeletal ; Myalgia ; Myositis*

No abstract available.
Adipose Tissue* ; Workplace*