Association of HLA antigens with certain diseases provide insights into genetically determined susceptibility to disease. Although nephrotic syndrome is one of the commonest diseases, it is poorly understood. A group of 57 patients suffering from a minimal lesion nephrotic syndrome (33 patients) and mesangioproliferative glomerulonephritis (24 patients) was studied for immunologic markers. The incidence of HLA-A w 24 is significantly greater in the minimal lesion nephrotic syndrome patients than in controls (18.7% in patients, 0% in controls, p < 0.01). This report fails to show a high incidence of specific HLA antigen in mesangioproliferative glomerulonephritis patients. We believe that the high incidence of HLA-Aw 24 in minimal lesion nephrotic syndrome is indicative of a congenital predisposition to nephrotic syndrome.
Glomerulonephritis/immunology ; HLA Antigens/analysis* ; Human ; Nephrosis, Lipoid/immunology*

No abstract available.
Anti-Bacterial Agents* ; Dysentery, Bacillary*

Intussusception is an interesting condition and is one of the most common causes of intestinal obstruction in the infant. We experienced a case of neonatal intussusception in a two-day-old male. The patient developed bloody stool, without a history of vomiting-after passing meconium, on the second day of life. Diagnosis of ileo-cecal type intussusception, which was induced by congenital polyp, was confirmed by exploratory laparatomy performed on the 4th day of life. The polyp was found at the proximal portion of the ileum, 45 cm from the ileo-cecal valve. In Korea a 40 day old patient was the youngest previously reported. We have presented this case with a review of the literature.
Human ; Ileum* ; Infant, Newborn ; Infant, Newborn, Diseases/etiology* ; Intestinal Polyps/complications ; Intestinal Polyps/congenital* ; Intussusception/etiology* ; Male

Cushing's syndrome is very rare in infancy, especially in Korea. We observed a case of Cushing's syndrome in a one year and 2 month old female baby with the complaints of a 3 months history of obesty and hirsutism and 2 months history of polyphagia. There were retarded bone age, hypertension, increased urinary excretion of 17-hydroxycorticosteroid and 17-ketosteroid and eosinopenia but no thymic shadow in the chest X-ray. There was no response to the dexamethasone test (2mg divided in 4 doses orally for 2 days), which suggested an adrenal tumor. Intravenous pyelography showed that the left kidney was displaced downward as compared to the right kidney and there was a henegg sized radio-opaque shadow at the upper pole of the left kidney suggesting a left adrenal tumor. The tumor, reported as a benign adenoma pathologically, was removed successfully by anterior abdominal approach. Hypertension, eosinopenia and hypokalemia were raturned to normal from 3 days after surgery but 17-hydroxycorticosteroid and 17-ketosteroid were returned to normal from 2 weeks after surgery. We have presented this case and have reviewed the literature.
Adenoma/*pathology ; Adrenal Gland Neoplasms/*pathology ; *Adrenalectomy ; Cushing Syndrome/etiology/*surgery ; Female ; Human ; Infant

Tuberculosis is still one of the most serious infectious diseases in Korea. Tuberculosis in childhood is a serious prablem to Korean pediatricians. Miliary tuberculosis, a form of extrapulmonary tubercubsis, has been frequently observed in outpatient dispensaries or in-patient wards in Korea. Only one clinical review by Mm et al (1969) was reported. We have summarized another eighty four psdiatric patients who were observed during a nine years and three months period from Jan. 1960 to March of 1969, at Wonju Union Christian Hospital, Wonju, Kang Won Do, a branch hospital of our Saverance. The following results were obtained; 1). During nine years and three months from Jan. 1960 to March of 1969, eighty four cases of miliary tuberculosis were observed which was 1.7 per cent of the total admission of pediatric patients (4,991) during the above period. 2). The youngest one was a five month old female infant and the oldest was a thirteen year old boy. The age group of three to six years included 40.5 per cent while 10.7 per cent were under one year. 3). Only eighteen per cent of the patients had a definite contact history with tuberculosis in the family. 4). Their chief complaints on admission were fever, cough, vomiting, loss of appetite, abdominal pain, fatigue, in order. All eight convulsive patients had complication of meningitis. 5). Negative tuberculin responses were found in more than fifty per cent of patients. 6). Tuberculous meningitis was the most frequent complication (28.5 per cent)in miliary tuberculosis. Tuberculous complications were found in fifty per cent of all patients. 7). Death rate was twelve per cent. Six out of ten deaths occurred within three days after admission. Eight out of ten deaths were complicated cases of tuberculous meningitis. Seven out of ten deaths were male patients. 8). In improved cases, improvement on X-ray and by clinical symptoms appeared after two weeks or several months. 9). The Patients were treated by triple chemotherapy and addition of corticosteroid, but we did not find a remarkable effect of steroid. 10). The prevention must precede treatment and doctor's and patient's attention to miliary tuberculosis must be emphasized.
Adolescent ; Child ; Child, Preschool ; Human ; Infant ; Prednisolone/therapeutic use ; Tuberculosis, Miliary/drug therapy/*epidemiology

A 13 year old boy was diagnosed as primary nephrotic diabetesinsipidus, whose symptom has been devloped from 3 years of age, subsequetly he developed bilateral hydronephrosis and neurogenic bladder. His pedigree could be explored 5 generations and represented inheritace as X-linked recesslive transmission, He was treated with indomethacin 2mg/Kg/day plus chlorothiazid 500mg/dau and this new method shows markedly decreased urine outpur and increased urine osmolarity.
Adolescent ; Diabetes Insipidus, Nephrogenic* ; Family Characteristics ; Humans ; Hydronephrosis ; Indomethacin ; Male ; Osmolar Concentration ; Pedigree ; Urinary Bladder, Neurogenic

Anaphylactoid nephritis is a disease complicated by anaphylactoid purpura manifested by a non-thrombocytopenic purpura, abdominal pain. And joint pain The manifestation of nephritis may vary from microscopic hematuria to acute rapidly progressive nephritic and nephrotic syndrome. This paper reports on anaphylactoid nephritis in children. These cases were collected fromthe Department of Pediatrics, Yonsei university Medical College from January 1,1974 to may 31, 1979. The results are as follows; 1. Among 75 cases of anaphylactoid purpura, 25 cases developed nephritis(33%), 16 cases were male and 9female. The age distribution was from 3years 5months to 15years. The peak incidence occured between 5 and 7years ofage with 11 cases. 2. The evidence of renal invovement in 18 cases among 25 were detected within 4 weeks after onset of skin manifestation. 3. The clinical manifestations were skin rashes, abdominal pain, joint pain, pitting edema, gross hematuria, and melena in orders. 4. The clinical classification of renal involvement were transient hematuria 4 cases, acute nephritis, 7 cases recurrent hematuria 1 case, nephrotic syndrome 5 cases, and undetermined 8 cases. 5. In additionto the usual signs of renal involvement, serum levels of IgA were checked. The elevation of IgA was 4 cases among the tested 6 cases. 6. According to the pathologic findings and immunofluorescent technique, 8 cases out of 9 cases by kidney biopsy were focal proliferative glomerulonephritis and 1 case diffuse proliferative flomerulonephritis. The deposit of glomeruli by immunofluorescent technique was IgA, IgG, IgM, and fibrin 7. All the cases were treated with prednisone and only 4 cases were combined with immunosuppressant, azathioprine without benfit.
Abdominal Pain ; Age Distribution ; Arthralgia ; Azathioprine ; Biopsy ; Child* ; Classification ; Edema ; Exanthema ; Fibrin ; Glomerulonephritis ; Hematuria ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Kidney ; Male ; Melena ; Nephritis ; Nephrotic Syndrome ; Pediatrics ; Prednisone ; Purpura ; Purpura, Schoenlein-Henoch ; Skin Manifestations

A 13-year-old boy was diagnosed as having primary nephrogenic diabetes insipidus, and symptoms developed at 3 years of age. Subsequently he developed bilateral hydronephrosis and a neurogenic bladder. His pedigree could be explored back 5 generations and represented an inheritance as an X-linked recessive transmission factor. He was treated with indomethacin 2 mg/kg/day plus chlorothiazide 500 mg/day and this new treatment showed a markedly decreased urine output and increased urine osmolarity. (Nephrogenic diabetes insipidus, Hydronephrosis, Indomethacin)
Adolescent ; Bladder, Neurogenic/etiology ; Chlorothiazide/therapeutic use ; Diabetes Insipidus/complications ; Diabetes Insipidus/congenital* ; Diabetes Insipidus/drug therapy ; Diabetes Insipidus/genetics ; Drug Therapy, Combination ; Human ; Hydronephrosis/etiology* ; Indomethacin/therapeutic use* ; Male

We have clinically observed 39 patients with abdominal tumors who were admitted in Severance Hospital during the past 10 years from April 1960 to March 1970. Unfortunately follow-up study couldn't be made. The following results were obtained. 1) Of the total number observed, 25 patients were male and 14 patients female. 2) The majority of the patients, 34 (87%) were under 6 years of age and 20 (51%) were between 1 to 3 years of age. The youngest patient was a 3-month-old female with Wilms' tumor. 3) In our series, Wilms' tumor (15 cases, 38.5%) was the most common and neuroblastoma (8 cases) was next most common tumor in the abdominal cavity. In addition we found another 4 cases of neuroblastoma in other sites. We observed hepatoma (8cases), ovarian tumor (3cases), lymphosarcoma (2cases), mesenteric cyst (one case) and adenoma of the left adrenal gland (one case) in that order of frequency. 4) In 15patients with Wilms' tumor, hypertension was observed in 8 patients and hematuria in 4 patients. Compared with Wilms' tumor, no hematuria was noted in the cases with neuroblastoma and hypertension occurred in 3 of these. 5) On abdominal X-ray, calcification was present in 4 cases with neuroblastoma (50%) and was present in only one of 15 patients with Wilms' tumor. 6) Comparing the sites of metastasis between Wilms' tumor and neuroblastoma, 4 of 15 patients with Wilms' tumor had lung metastasis and 4 of 8 patients of neuroblastoma had bony metastasis. Liver metastasis was found at autopsy in one case of neuroblastoma. 7) Three cases of hepatoblastoma were under 2 years of age and three cases of hepatocarcinoma were over 12 years of age. 8) Three cases of ovarian tumor were benign cystic teratoma. Tortion of the ovarian pedicle occurred in one of 3 patients with severe low abdominal pain. All patients were discharged in good condition after salphingo-oophorectomy. 9) One case of lymphosarcoma of the ileum was associated with intussusception. 10) A one year o1d female with adenoma of the left adrenal gland had typical Cushing's syndrome.
Abdominal Neoplasms/epidemiology* ; Adolescent ; Carcinoma, Hepatocellular/epidemiology ; Child ; Child, Preschool ; Female ; Human ; Infant ; Korea ; Liver Neoplasms ; Lymphoma, Non-Hodgkin/epidemiology ; Male ; Mesenteric Cyst/epidemiology ; Nephroblastoma/epidemiology ; Neuroblastoma/epidemiology ; Ovarian Neoplasms/epidemiology

Twenty one infants and children were entered into the study protocol when bacteriologic diagnosis of shigellosis was made by stool culture indenification. Fifteen patients were treated at Inje Hospital in Kangwon Do and six patients were treated at Severance Hospital in Seoul. Susceptibility studies were revealed that ampicillin was resistant in all cases. Gentamicin and Panimycin which are aminoglycosides were quite effective. But their use was limited because of their nephrotoxicity and those antibiotics should be used only by parenteral route. A daily dose of 20microgram per kilogram of body weight of rifampin was given by mouth divided every 6 hrs for 7 days routinely except 2 cases. After that follow up stool culture were performed on 13 patient. The results were negative except one case. There was no untoward reaction of rifampin during therapy except for the red coloring of urine and stool. To prevent developing the resistance of shigella to rifampin, it is necessary to confirm that negative conversion of stool cultures has been achieved. Our experience should encourge the use of rifampin in the treatment of shigellosis.
Aminoglycosides ; Ampicillin ; Anti-Bacterial Agents ; Body Weight ; Child ; Diagnosis ; Dysentery, Bacillary* ; Follow-Up Studies ; Gangwon-do ; Gentamicins ; Humans ; Infant ; Mouth ; Rifampin* ; Seoul ; Shigella