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

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.
Female* ; Humans ; Kidney* ; Ureter* ; Ureterocele*

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

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

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

In a group of 59 children with nephrotic syndrome who had been admitted to Severance Ho-spital, during the period of 2 years from July of 1978 till June of 1980, the histological picture seen on renal biopsy, the selective protein index, and the response to the steroid therapy were studied. The degree of selective protein index is not related to the total daily amount of urinary protein excretion and selective protein index remains relatively constant over months in the minimal lesion nephrotic syndrom. Those patients with primary renal disease and the nephrotic syndrome who displayed high selectivity types of proteinuria usually responds initially to steroid therapy within 8 weeks. Studies of selective protein index allow the pediatrician to avoid renal biopsy with safety in nephrotic children aged 1 to 5 years, but distinguish any given renal disease with certainty. The mesangial proliferative glomerulonephritis with immune deposits has relatively poor selectivity of proteinuria and without immune deposits, it has high or moder-ate selectivity of proteinuria. Response to treatment of steroid in the Henoch-Sch?lein Purpura was poor and not related with selective protein index.
Biopsy ; Child ; Glomerulonephritis ; Humans ; Nephrotic Syndrome* ; Proteinuria ; Purpura

Measurements of serum C3 levels by the single radial immunodiffusion method using Helena plates were done in 41 patients with acute poststreptococcal glomerulonephritis and in 25 healthy children. In 28 patients the sequential determination were done until returning the level above normal range. The mean value of serum C3 concentration in this group as a who1e was lower than in the control group and the difference was statistically significant (p < 0.001). The initial reduction of serum C3 concentration did not correlate with the severity of the acute phase of the disease. In those children with acute poststreptococcal glomerulonephritis, serum C3 concentration returned to normal within six weeks.
Adolescent ; Child ; Child, Preschool ; Complement 3/analysis* ; Complement 3/deficiency ; Female ; Glomerulonephritis/etiology ; Glomerulonephritis/immunology* ; Human ; Male ; Streptococcal Infections/complications ; Streptococcal Infections/immunology*

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