The author observed clinical study and response of -interferon treatment of 43 cases of chronic hepatitis who were admitted to Department of Pediatrics Pusan National University College of Medicine during the period of 4 year 6 months from Jenuary, 1988 to Jun, 1992. The results were as follows: 1) Of 43 patients with chronic hepatitis, CPH was 17 cases (39.5%) and CAH was 26 cases (60.5%). 2) Of 43 patients, chronic hepatitis caused by HBV was 37 cases (86.0%) 2 cases were by Wilson's disease, 1 case was by glycogen storage disease and in the 3 cases, the cause was undetermined and CPH by HBV and CAH were 14 cases (82.4%), 23 cases (88.5%) respectively. 3) A peak frequency (46.5%) of chronic hepatitis occurred between 6 to age and male predominated in a propotion of 3.5:1. 4) On the clinical manifestation, jaundice and hepatomegaly was higher frequency on CAH than on CPH. 5) On the laboratory findings, CAH had higher serum ALT and direct bilirubin level than CPH. 6) On effect of -interferon treatment for patients of CAH, serum ALT and AST levels normalized in 81.8% of patients, negative conversion of HBeAg was 38.5%, Anti-HBe serocoversion was 7.7%, negative conversion of HBsAg was 7.7% and the clearnce of HBV-DNA from seum showed 60.0%. 7) The HBeAg seroconversion (28.6%) on children of HBsAg(+) mother showed lower reponse than HBeAg seroconversion (50.0%) of HBsAg(-) mother after -interferon treatment for patients of CAH.
Bilirubin ; Busan ; Child* ; Glycogen Storage Disease ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Hepatolenticular Degeneration ; Hepatomegaly ; Humans ; Jaundice ; Male ; Mothers ; Pediatrics

BACKGROUND: Acute idiopathic thrombocytopenic purpura(ITP) in children has a low morbidity and mortality, and most of cases are self limited illness. But some of them are not responsive to treatment and finally progress to chronic disease. The purpose of this study is to evaluate the factors which influence the outcome in childhood idiopathic thrombocytopenic purpura. METHOD: From January 1990 to December 1995, patients with ITP who were admitted to the Pediatric department of Pusan National University Hospital were divided into acute and chronic form depending on whether the platelet count had returned to normal(150 x 10(9)/1) by six months after diagnosis. Between two groups, the clinical and laboratory characteristics, response to treatment were compared. RESULT: 1) Out of 55 patients with ITP, 36 cases(65.5%) were acute and 19 cases(34.5%) were chronic ITP. 2) Sex, previous viral infection history, clinical manifestations were not significantly different between two groups, but the chronic ITP was rare in less than 1 year of age. 3) The duration of symptoms over >2 weeks at presentation was strongly predictive of chronic ITP. 4) Most of chronic disease (87.5%) showed platelet counts below 150 x 10(9)/1 at 28 days after diagnosis as compared with acute disease(25.0%). 5) Among 19 cases of chronic disease, 6 cases responded completely to treatment, but 11 cases(57.9%) did not respond to any treatments, 2 cases improved spontaneously. CONCLUSION: A history of symptoms over 2 weeks at presentation and platelet counts below 150 x 10(9)/1 at 28 days after diagnosis were strong predictors of chronic ITP in children.
Busan ; Child ; Chronic Disease ; Diagnosis ; Humans ; Mortality ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic*

Primary hyperparathyroidism is a rare endocrine disease in children. It involves bone and joint, urinary tract, gastrointestinal tract and cardiovascular system. The main cause of these involvement is high level of PTH in serum, resulting in hypercalcemia.An 11 years old male patient who had complained of limping gait since last 18 months, showed typical laboratory and radiological findings of primary hyperparathyroidism. At the ultrasonography, computed tomography and radionuclide scanning, a well defined mass(10 X 15mm) was found on the posterior aspect of the right thyroid lobe. The mass was confirmed histologically as adenoma of parathyroid gland. The patient was successfully treated with subtotal parathyroidectomy and temporal administration of calcium and vitamin D.We report this case of primary hyperparathyroidism with brief review of the literatures.
Adenoma ; Calcium ; Cardiovascular System ; Child ; Endocrine System Diseases ; Gait ; Gastrointestinal Tract ; Humans ; Hyperparathyroidism, Primary ; Joints ; Male ; Parathyroid Glands ; Parathyroidectomy ; Thyroid Gland ; Ultrasonography ; Urinary Tract ; Vitamins

The authors studied anxiety-depression using New Anxiety-Depression Scale (NADS) in the subjects of 2,564 male and 1,252 female college freshmen of Yeungnam University. The authors collected the reports of NADS during the periods from January to February 1987, and applied ANOVA and t-test on anxiety depression scores in order to compare them between various psychosocial factors and sexes. The results are as follows: There was significant difference in the mean average of total scores between male and female students: male students scored 33.41±8.76 and female students scored 35.34±9.02 (P<0.001). The anxiety-depression scores relating to the items of sleep disturbance, apprehension, facial flushing and fatigue were relatively scored higher in both groups. One hundred and thirty nine male students (5.4%) showed seriously higher degree of anxiety-depression scores of 50 or more, while eighty eight female students (7.0%) showed the same scores. There was a strong tendency toward higher anxiety-depression scores in the students who were dissatisfied with their home atmosphere, colleges, departments, familiarity of parents and those who had pessimistic views of self image in the past, presents and future in both groups (P<0.001).
Anxiety ; Atmosphere ; Depression ; Fatigue ; Female ; Flushing ; Humans ; Male ; NAD ; Parents ; Psychology ; Recognition (Psychology)

Pheochromocytoma is one of the surgically curable hypertensive diseases and can arise wherever chromaffin cells are located. Herein, a case of extra-adrenal pheochromocytoma developed in a 51 year-old male is presented with brief review of literatures.
Chromaffin Cells ; Humans ; Male ; Middle Aged ; Pheochromocytoma*

A 43-year-old female patient with a congenital right coronary artery to right atrial fistula presented as congestive heart failure and aortic valve infective endocarditis. The diagnosis was made on the basis of echocardiography, especially TEE and confirmed by tight heart catheterization & aortography. She underwent aortic valve replacement due to severe aortic valve regurgitation with vegetations, fistulectomy and coronary aneurysmorrhaphy. The postoperative course was uneventful. She was treated with antibiotics because of infective endocarditis for 6 weeks. At present she remains well and visits out patient clinic regularly for oral anticoagulation without problem.
Adult ; Anti-Bacterial Agents ; Aortic Valve* ; Aortography ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Diagnosis ; Echocardiography ; Endocarditis* ; Estrogens, Conjugated (USP)* ; Female ; Fistula ; Heart Failure* ; Humans

PURPOSE: Endothelin-1 is the most potent vasoconstrictor. This study was investigated the correlation of plasma endothelin-1 and pulmonary hypertension associated with congenital heart defect. METHODS: We evaluated the concentration of ET-1 in 24 cases of congenital heart disease diagnosed at the Department of Pediatrics, Pusan National University, from December 1993 to September 1994. The patients were divided into 2 groups according to mean pulmonary arterial pressure: Pulmonary artery hypertension group(Group I) and normal pulmonary artery pressure group(Group II). Between 2 groups, there was no statistical significance in mean age, sex and oxygen saturation. GroupI included 9 patients of VSD and 1 patient of COA. Group II included 9 patients of VSD, 3 patients of TOF and 1 patient of PS, 1 patient of PS with DORV. RESULTS: The results were summarized as follows; 1) The mean pulmonary arterial pressure and pulmonary-to-systemic flow ratio (Qp/Qs), pulmonary vascular resistance in GroupIwere significantly higher than those in Group II. 2) The plasma concentrations of ET-1 in GroupI was significantly higher than those in Group II. 3) But there were no statistical significance between the concentrations of ET-1 and the mean pulmonary artery pressure, Qp/QS, pulmonary vascular resistnace. CONCLUSIONS: Based on these results, plasma ET-1 concentraions were elevated in patients with pulmonary hypertension associated with congenital heart defects.
Arterial Pressure ; Busan ; Endothelin-1* ; Heart Defects, Congenital* ; Humans ; Hypertension ; Hypertension, Pulmonary* ; Oxygen ; Pediatrics ; Plasma* ; Pulmonary Artery ; Vascular Resistance

INTRODUCTION: During an acute myocardial ischemia, maintenance of overall ventricular function may depend on remote nonischemic myocardium. Whereas fentanyl has minimal hemodynamic effects, volatile anesthetics, including halothane and isoflurane cause negative inotropic and lusitropic effects in normal myocardium. This investigation examined the effects of volatile anesthetics in comparision with fentanyl on compensatory responses to brief left anterior descending coronary artery (LAD) occlusion in remote normal myocardium (left circumflex coronary artery (LCX) supply) in an open-chest canine model. METHODS: Thirty-six mongrel dogs, acutely instrumented for measurement of pressure (left ventricle (LV) and aorta), flows (pulmonary trunk and LCX) and dimensions in ischemic and non-ischemic myocardium, were subjected to a 10-min LAD occlusion during fentanyl (n=10), halothane (n=13), or isoflurane (n=13) anesthesia. Regional contractile function was assessed using percent systolic shortening (%SS) and the preload recruitable stroke work slope (Mw). Diastolic function was evaluated using a regional time constant for intramyocardial pressure decline of LV (IMPtau), peak lengthening rate (dL/dtmax) and a regional chamber stiffness constant (Kp). RESULTS: Acute LAD occlusion caused immediate deterioration of anterior wall function similarly without changes in cardiac index, mean arterial pressure and dP/dtmax in all three groups. LV end-diastolic pressure (LVEDP), LVPtau, and heart rate increased and dP/dtmin decreased to the same extent with regional myocardial ischemia in all groups. During fentanyl anesthesia, acute myocardial ischemia was associated with an increase in %SS (26%) and Mw (48%) in LCX area without changes in IMPtau and dL/dtmax. With halothane or isoflurane anesthesia, %SS, Mw and IMPtau showed similar changes as those in fentanyl in response to LAD occlusion. However, dL/dtmax was increased (47 and 45% in the halothane and isoflurane groups, respectively) and Kp was increased (34 and 33% in the halothane and isoflurane groups, respectively) less compared to fentanyl (78%). Enhanced function in LCX zone was associated with a comparable increase (21~28% from baseline) in LCX flow in all groups. CONCLUSION: Enhanced regional contractility following acute coronary occlusion in nonischemic myocardium during fentanyl anesthesia is well-preserved with volatile anesthetics in an open-chest canine model. In addition, diastolic functions are also enhanced rather than depressed during anesthesia with volatile anesthetics. Halothane and isoflurane, however, do not differ in the compensatory responses to acute regional ischemia.
Anesthesia ; Anesthetics ; Animals ; Arterial Pressure ; Coronary Occlusion ; Coronary Vessels ; Dogs* ; Fentanyl ; Halothane ; Heart Rate ; Hemodynamics ; Ischemia ; Isoflurane ; Myocardial Ischemia* ; Myocardium* ; Stroke ; Ventricular Function

BACKGROUND/AIMS: In 1977, Teele and Smith reported their positive experience using an ultrasonographic in the evaluation of Congenital Hypertrophic Pyloric Stenosis (CHPS). Since that time, ultrasonography has been advocated by some as the diagnostic procedure of choice, although a number of false-negative cases have been encountered at any rate, in 1994, Becker reported that an endoscopy was far more accurate than an ultrasonography, the diagnosis being made in 97% and 81% of the cases. Therefore, we performed a prospective study to evaluate the diagnostic value of an upper gastrointestinal endoscopy in CHPS patients. METHODS: We reviewed the clinical records of 12 pediatric patients experiencing vomiting, who had visited Pusan National University Hospital from January 1993 to March 1997. We performed on upper gastrointestinal endoscopy and abdominal ultrasonography simultaneously in order to evaluate the diagnostic value of an upper gastrointestinal endoscopy in CHPS patients. RESULTS: The male to female ratio was 11: 1. In 7 of 12 patients, 58%, vomited within 4 weeks after birth. Diagnostic sensitivity by abdominal ultrasonography was about 75%, and by upper GI endoscopy, almost 100%. Associated lesions were discovered in 5 cases, 3 esophagitis and 2 gastritis in the upper GI endoscopy. CONCLUSIONS: The upper GI endoscopy was more accurate in the diagnosis of CHPS than the ultrasonography, and was more effective in the diagnosis of associated lesions.
Busan ; Diagnosis* ; Endoscopy ; Endoscopy, Gastrointestinal* ; Esophagitis ; Female ; Gastritis ; Humans ; Male ; Parturition ; Prospective Studies ; Pyloric Stenosis, Hypertrophic* ; Ultrasonography ; Vomiting

We experienced a case of G deletion syndrome II in a 8 year and 1 month old boy. He showed mental retardation, microcephaly, high arched palate, low set malformed ears, epicanthal fold, thoracic deformity, tracheomegaly and two lumens of esophagus. Chromosomal study showed the deletion of long arm of chromosome 22, kariotypically he was depicted as 46, XY, 22q-. A brief review of literature was also presented.
Arm ; Chromosomes, Human, Pair 22 ; Congenital Abnormalities ; Ear ; Esophagus ; Humans ; Infant, Newborn ; Intellectual Disability ; Male ; Microcephaly ; Palate