We made a clinical study on 10 cases of histiocytosis syndrome who had been admitted to the pediatric department of Soon Chun Hyang University Hospital from Jan. 1982 to Dec. 1991. The results were obtained as follows 1) The sex incidence revealed male predominance with the ratio 4:1. 2) Among 10 cases, 4 cases were classified as eosinophilic granuloma, 1 case as Letterer-Siwe disease, 1 case as linfection associated hemophagocytic syndrome and 4 cases as malignant histiocytosis. 3) The mean age of symptom onset was 4 and 7/12 years in all disease group. 4) The common clinical symptoms and signs at dignosis were dyspnea, mass, pain on lower extremities and fever. 5) The most common organ involved among 9 organ systems was liver-spleen and the number of organ systems involved were 1 in 3 2 ases(30%), 3 in 2 cases(20%), 8 in 2 cases (20%) and 6, 7 and 10 organs in each 1 case. 6) The abnormal hematologic findings (Hb; 10g/dl and/or WBC; 4,000/mm3 and/or PLT; 100,000/mm3) were found in 6 cases. 7) Low serum albumin was found in 2 cases. Results of blood culture were Pseudomonas aeruginosae and Salmonella typhi in each 1 case. 8) The common findings on tissue biopsy were histiocytic proliferation and infiltration. 9) 4 patients of MH who recieved chemotherapy, a combination of adriamycin, vincristine, cyclophosphamide and prednisone were given in a total of four courses every 2 weeks ad induction therapy. When complete response was attained, a combination of adriamycin, vincristine, prednisone (AOP) and cyclophosphamide, vincristine, prednisone(COP) was administered alternately every 4 weeks as maintenance therapy for 6-64 months. 10) Among 4 patiens of MH who recieved chemotherapy, 1 patient was lost during induction chemotherapy, for 1 day.2 patients expired during induction chemotherapy, for 1 month, 1 patient expired during maintenance chemotherapty, for 8months, Eosinophilic granuloma cases (3) were recieved currettage and no recurrence. IAHS case due to typhoid fever was improved spontaneously.
Biopsy ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Dyspnea ; Eosinophilic Granuloma ; Fever ; Histiocytic Sarcoma ; Histiocytosis* ; Histiocytosis, Langerhans-Cell ; Humans ; Incidence ; Induction Chemotherapy ; Lower Extremity ; Lymphohistiocytosis, Hemophagocytic ; Male ; Prednisone ; Pseudomonas aeruginosa ; Recurrence ; Salmonella typhi ; Serum Albumin ; Typhoid Fever ; Vincristine

No abstract available.
Hemorrhage* ; Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn

PURPOSE: Almost of the term infants pass the first stool and urine within 48 hours after birth and delay of first defecation and voiding is considered as an initial sign of congenital intestinal obstruction or gastrointertinal motility disorder. In the premature infants, although they do not have congenital intestinal obstruction, the time of first defecation or voiding is delayed beacause of developmental prematurity of the gastrointestinal motility. To know factors which affect the time of first defecation and voiding, we studied. METHODS: From February 1993 to May 1995, Newborns (24 term, 77 premature, total 101) who were delivered in Soonchunhyang University Hospital without congenital intestinal obstruction were reviewed retrospectively about the relationship between the factors such as birth weight, gestational age, delivery type or the first feeding time and the first defecation or voiding time. RESULTS: 1) All of the term infants passed the first stool within 24 hours after birth. 2) Among the infants who passed the first stool after 24 hours since birth, 27.6% were 32-36 weeks and 40.5% were 27-31 weeks of gestational age. 3) Among the infants who passed the first stool after 24 hours since birth, 14.3% were 2,000-2,499gm, 35.7% were 1,500-1,999gm and 55% were 1,000-1,499gm of birth weight. 4) There was no statistically significant correlation between the first defecation time and sex, type of delivery or time of first feeding time. 5) Most of the term and premature infants passed the first urine within 24 hours after birth. There was no difference according to gestational age, birth weight, type of delivery or first feeding time. CONCLUSIONS: In larger parts of the premature and preterm infants, the first defecation wa delayed for 24 hours after birth. So, we should wait the first defecation more than 24 hours after birth in prematurity.
Birth Weight ; Defecation* ; Gastrointestinal Motility ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Intestinal Obstruction ; Parturition ; Retrospective Studies

PURPOSE: Almost of the term infants pass the first stool and urine within 48 hours after birth and delay of first defecation and voiding is considered as an initial sign of congenital intestinal obstruction or gastrointertinal motility disorder. In the premature infants, although they do not have congenital intestinal obstruction, the time of first defecation or voiding is delayed beacause of developmental prematurity of the gastrointestinal motility. To know factors which affect the time of first defecation and voiding, we studied. METHODS: From February 1993 to May 1995, Newborns (24 term, 77 premature, total 101) who were delivered in Soonchunhyang University Hospital without congenital intestinal obstruction were reviewed retrospectively about the relationship between the factors such as birth weight, gestational age, delivery type or the first feeding time and the first defecation or voiding time. RESULTS: 1) All of the term infants passed the first stool within 24 hours after birth. 2) Among the infants who passed the first stool after 24 hours since birth, 27.6% were 32-36 weeks and 40.5% were 27-31 weeks of gestational age. 3) Among the infants who passed the first stool after 24 hours since birth, 14.3% were 2,000-2,499gm, 35.7% were 1,500-1,999gm and 55% were 1,000-1,499gm of birth weight. 4) There was no statistically significant correlation between the first defecation time and sex, type of delivery or time of first feeding time. 5) Most of the term and premature infants passed the first urine within 24 hours after birth. There was no difference according to gestational age, birth weight, type of delivery or first feeding time. CONCLUSIONS: In larger parts of the premature and preterm infants, the first defecation wa delayed for 24 hours after birth. So, we should wait the first defecation more than 24 hours after birth in prematurity.
Birth Weight ; Defecation* ; Gastrointestinal Motility ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Intestinal Obstruction ; Parturition ; Retrospective Studies

Intracranial hemorrhage is the most common neuropathologic finding in premature infants. But in full-term infants, it is less common and rarely causes death. We found out intracranial hemorrhages in 21 full-term neonates by real-time neurosonography and concluded as followings. 1) Among 21 neonates, 17 infants were male and 4 infants were female. 2) In 11 (52.3%) infants the hemorrhage was detected within 7 days after birth. 3) The intracranial hemorrhage was not related with delivery type nor Apgar score. 4) In 13 cases (61.9%) the hemorrhage was in the subependymal germinal matrix and the degree was Grade I. 5) Precipitating or associated factors were asphyxia, pneumonia, ventilator care, RDS and congenital heart disease. 6) Symptoms and signs were seizure, apnea, lethargy, cyanosis, jaundice, anemia or bulging fontanel.
Anemia ; Apgar Score ; Apnea ; Asphyxia ; Cyanosis ; Female ; Heart Defects, Congenital ; Hemorrhage ; Humans ; Infant ; Infant, Newborn* ; Infant, Premature ; Intracranial Hemorrhages* ; Jaundice ; Lethargy ; Male ; Parturition ; Pneumonia ; Seizures ; Ultrasonography* ; Ventilators, Mechanical

Acrodermatitis enteropethica (AE) is a rare autosomal recessive disorder of zinc absorption leading to chronic diarrhea and characteristic skin lesion. The term is also applied to any acquired zinc deficiency state resulting in the same clinical pictures. We experienced one case of AE in 1 month old male infant who had bacterial enterocolitis. The skin around mouth, anus, eyes, ears, hands and legs became reddish, vesicular and eczematoid. Serum zinc level was decreased to 51.4 microgram/dL (N=70~150). Endoscopic finding revealed pale gastric mucosa and villous atrophy of small intestine. Biopsy finding of small intestine showed no villi due to mucosal atrophy. On 13 day of admission jaundice with DIC were noted and AST & ALT were elevated to 110 & 36.8 IU/L, respectively. Diarrhea was improved but jaundice and liver function were not recovered until discharge from hospital. After discharge when the patient was 4 months of age serum bilirubin and AST/ALT had not been normalized. CMV shell vial culture of urine and CMV Ig G antibody were positive. So intravenous ganciclovir injection of 7.5 mg/kg, two times a day for 2 weeks and then 10 mg/kg/day for 3 months was done from 4 to 6 months of age. No virus was found in the urine and AST & ALT were normalized at 2 months after stopping ganciclovir treatment.
Absorption ; Acrodermatitis* ; Anal Canal ; Atrophy ; Bilirubin ; Biopsy ; Dacarbazine ; Diarrhea ; Ear ; Enterocolitis ; Ganciclovir ; Gastric Mucosa ; Hand ; Hepatitis* ; Humans ; Infant ; Infant, Newborn ; Intestine, Small ; Jaundice ; Leg ; Liver ; Male ; Mouth ; Skin ; Zinc

PURPOSE: Lipids and fatty acids are very important for brain and nervous system in growing children. This study was carried out to compare the composition of serum lipids and fatty acids according to the type of feeding in children. METHODS: One hundred and twenty two children aged from 5 month to 24 month who visited Soonchunhyang University Hospital from Mar. 1995 to Jan. 1996 with no gastrointestinal or nutritional problems were selected to compare the composition of serum lipids and fatty acids according to the type of feeding. They were divided into 3 groups according to type of feeding. Thirty three cases were breast milk fed group (BF), 48 cases were formula fed group and 41 cases were whole cow's milk fed group. Serum lipids were analysed by Folch method. Fatty acid methyl ester was made with BF3-methanol solution. Fatty acid contents (area%) were calculated by automatic analyser. RESULTS: 1) The mean serum cholesterol level was 144.14mg/dl and it was significantly higher in breast milk fed group (BF). 2) The mean serum low density lipoprotein (LDL) level was 88.82mg/dl and it was significantly higher in breast milk fed group (BF) (p<0.05). 3) Serum polyunsaturated fatty acid (PUFA) level was 39.13% and it was significantly higher in BF. 5) Mean serum omega6 fatty acid level was 35.43% and there was no significant difference between three groups. 6) Mean serum omega3 fatty acid level was 3.70% and it was significantly higher in BF (p<0.05). 7) Mean serum arachidonic acid (AA) level was 5.28% and it was significantly higher in BF (p<0.005). 8) Mean serum eicosapentaenoic acid (EPA) level was 0.51% and there was no significant difference between three groups. 9) Mean serum docosahexaenoic acid (DHA) level was 2.00% and it was significantly higher in BF (p<0.005). CONCLUSIONS: Nutritional benefit of breast milk was proven by significantly high serum levels of arachidonic acid and DHA in breast milk fed group. Essential fatty acids and DHA should be addded to infant formula. Excessive amount of whole cow's milk feeding to infants is not good in nutritional aspects. Education and guidance about feeding method of infants are also needed.
Arachidonic Acid ; Brain ; Child* ; Cholesterol ; Education ; Eicosapentaenoic Acid ; Fatty Acids* ; Fatty Acids, Essential ; Feeding Methods ; Humans ; Infant ; Infant Formula ; Lipoproteins ; Milk ; Milk, Human ; Nervous System

PURPOSE: Tuberculosis, a major public health problem, is an important cause of childhood morbidity and mortality in developing countries. To decline the tuberculosis morbidity rate, active BCG vaccination is performed worldwide. Recently percutaneous multiple puncture technique of BCG vaccination was introduced and used because of side effects of intradermal BCG vaccination such as scar, local ulceration, regional suppurative lymphadenitis. We studied the difference of positive conversion rates and side effect after intradermal BCG vaccination and percutaneous multiple puncture technique BCG vaccination. METHODS: Three hundred seventy one infants, who were vaccinated at well baby clinic of Soonchunhyang University Hospital and performed tuberculin skin test using 5TU PPD (NIH, Korea) at 4month, were divided two groups; group I of 257 infants immunized percutaneous multiple puncture technique BCG (Japan BCG Laboratory, Japan) and group II of 174 infants immunized intradermal BCG (Institute Meri ux, France). RESULTS: 1) Sixtysix point five percent of male infants and 72.4% of female infants were vaccinated percutaneous multiple puncture technique BCG (Group I) 2) The positive conversion rate was 97.7% in group I and 76.3% in group II (p<0.05). 3) The positive conversion rate vaccinated within 2 weeks after birth were 97.9%, 2-4weeks 97.8%, 5-6weeks 95.2% in group I, and within 2 weeks 73.5%, 2-4weeks 75.8%, 5-6weeks 83.3% in group II. 4) The mean induration of positive conversions were 10.6+/-2.8mm in group I and 9.3+/-2.7mm in group II, that of Group I was significantly higher than that of groupII (p<0.05). 5) The complications of BCG vaccination were fever, generalized rash, and local ulceration in group I, fever, severe irritability in groupII. But there was no significant difference in two groups. CONCLUSIONS: The infants of vaccinated with percutaneous multiple puncture technique showed larger size of mean induration and higher positive conversion rate after PPD and less scar after vaccination compared with intradermal method. Further studies is necessary to find out the optimum time for BCG vaccination by percutaneous multiple puncture technique to provide the better immunity.
Cicatrix ; Developing Countries ; Exanthema ; Female ; Fever ; Humans ; Infant ; Lymphadenitis ; Male ; Mortality ; Mycobacterium bovis* ; Parturition ; Public Health ; Punctures ; Skin Tests ; Tuberculin Test* ; Tuberculin* ; Tuberculosis ; Ulcer ; Vaccination*

Secondary peptic ulceration and gastritis have been known to be associated with stress, exogenous agents, drugs or infection. Salicylate (aspirin) ingestion has been known to be associated with increased incidence of gastric ulcer and more frequently as the cause of hemorrhagic gastric erosions and gastritis. Some medications such as tetracyclines and iron preparations have been associated with ulceration of the gastrointestinal tract. Chemotherapeutic agents including cytoxan and methotrexate also have been implicated in the development of mucosal and gastrointestinal ulcers. We have experienced two cases of hemorrhagic gastric ulcers due to creosote ingestion in a 13 month and a 45 year old boys. Creosote is a main component of one of the popular digestives, Jungrohwan in Japan and Korea.
Creosote* ; Cyclophosphamide ; Eating ; Gastritis ; Gastrointestinal Tract ; Humans ; Incidence ; Iron ; Japan ; Korea ; Methotrexate ; Middle Aged ; Peptic Ulcer ; Stomach Ulcer* ; Tetracyclines ; Ulcer

Duodenal web is an uncommon lesion that infrequently cause partial or complete intestinal obstruction. If the duonenal web is incomplete and only partially obstructs the duodenal lumen, the onset of symptoms may be delayed for years, and obstructive symptoms will be only minimal and intermittent. Congenital duodenal obstruction is occasionally associated with intestinal malrotation. We experienced a case of duodenal web associated with intestinal malrotation in a 9-year-old girl who had been suffered from intermittent projectile vomiting since birth without failure to thrive. The diagnosis was made by UGI series & abdominal CT. Patient remained asymptomatic after operation.
Child ; Diagnosis ; Duodenal Obstruction ; Failure to Thrive ; Female ; Humans ; Intestinal Obstruction ; Parturition ; Tomography, X-Ray Computed ; Vomiting