Clinical studies were made on 50 cases of chronic cough infants who were admitted to the department of Pediatrics of Kangnam St. Mary' s hospital from January, 1990 to July, 1991. The results were as follows; 1) The age distribution was from 3 months to 24 months old, and the most prevalent age group was 13~18months old. The male to female was 2.1:1. 2) The etiologic classification of the 50 cases were infantile asthma in 23 cases(46%), viral lower respiratory infection in 13 cases(26%), and infantile asthma associated with sinusitis in 5 cases(10%). 3) Cough was the most common clinical manifestation in all cases and followed by rhinorrhea, dyspnea, fever, and nasal stuffiness. Among physical findings, wheezing rales, and chest retraction were noted. 4) The duration of cough was 5 to 8 weeks in 26 cases(52%), 2 to weeks in 19 cases(38%), and above 9 weeks in 5 cases(10%). 5) 13 of 50 cases had a past allergic history and 8 of 50 cases had a family history of allergy. 6) In 50 cases, formula feeding was done in 28 cases(56%), breast feeing in 13 cases(26%), and mixed feeding in 9 cases(18%). 7) Eosinophilia was noted in 39.3% of infantile asthma and total IgE level above 100IUm/ml was noted in 60.7% of infantile asthma and in 18.2% of other diseases. 8) RAST results of infantile asthma showed that the positivity was 21.4% in house dust, 32.1% in Dermatophagoides pteronyssinus, 28.6% in Dermatophagoides farinae, 28.6% in egg white, 35.7% in milk. The ratio of positive RAST results were higher in infantile asthma than in other diseases. 9) Abnormal findings, including overinflation, infiltration, increased bronchovascular marking, and atelectasis, were noted in 42 cases(84%) on chest X-ray. In 7 cases, total opacification was noted on Waters' and Caldwell's view. In conclusion, chronic cough in infancy is best managed by determining the precise cause of the cough, then specificially treating the underlying disorder.
Age Distribution ; Asthma ; Breast ; Child, Preschool ; Classification ; Cough* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust ; Dyspnea ; Egg White ; Eosinophilia ; Fees and Charges ; Female ; Fever ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Male ; Milk ; Pediatrics ; Pulmonary Atelectasis ; Respiratory Sounds ; Sinusitis ; Thorax

Segmental dilatation of small intestine or colon can induce signs of intestinal obstruction, such as abdominal distension, vomiting and constipation. There are no anatomical gross obstructive lesions, and moreover, ganglion cells are observed in both dilated and undilated distal segments of the intestine. It often accompanied by other congenital anomalies. We reported two cases of segmental dilatation of the intestine in the newborn infants, one in small intestine and the other in colon, with brief review of the related literatures.
Colon ; Constipation ; Dilatation* ; Ganglion Cysts ; Humans ; Infant, Newborn* ; Intestinal Obstruction ; Intestine, Small ; Intestines* ; Vomiting

No abstract available.

No abstract available.
Pelger-Huet Anomaly*

Peptic ulcer disease in children presents an interesting and sometimes difficult problem to the clinicians. Since the incidence is quite small in children, only small collected series have been reported in the literature. With the improvement of diagnostic aids (particularly radiologic equipments and greater attention paid by clinicians, peptic ulcers have been detected with increasing frequency. However, there is a paucity of information available concerning this disease in infancy and childhood in Korea. The symptoms and signs of peptic ulcer disease in childhood are obscure and have many differences from those of tihe adult, which too often go unrecogntzed until complications set in. The authors made on clinical observation on 14 patients with peptic ulcer under the age of 15 years, who had been admitted to the department of pediatrics of National Medical Center from Aug, 1972 to July 1978. The age, sex and seasonal incidences, type and location of ulcer, symptom curation, clinical and laboratory findings, complications and prognosis were analyzed and the data are summerized as follows. 1) The incidence of peptic ulcer in childhood was 0.33% of a total 4221 admissions, and the average number of patients of peptic ulcer per year was 2.3. 2) Among 14 patients, 9 cases (68%) were between 12 and 15 years of age, 4 patients (28%) between 7 and 11, and the majority (93%) were between the ages of 7 and 15. The youngest patients wea 4 year old male. 3) Sex incidence showed that males predominated in a proportion of 13:1. 4) Seasonal incidence was relatively high (inspring) (28.6%) and autumn (42.9%). 5) Three cases (21.5%) had gastric ulcer and 11 cases (78.5%) had duodenal (ulcer, 12 cases were diagnosed as primary type and 2 cases were) thought to be secondary type due to steroid therapy. 6) Duration of symptoms were variable, with the range between 1 week and 3 years. 7) The majority have abdominal pain (100%), vomiting (85.6%) and epigstric tenderness (71.4%), Other symptoms and signs were anemia (42.9%), indigestion (38.5%), melena (38.5%), epigastric pain (28.6%), general weakness (21.5%), weight loss (14.3%) and abdominal rigidity (14.3%). 8) Gastric analysis was performed in 5 patients, 2 of these patients had slight hyperchlorhydria, but 3 cases showed normal results. 9) Complications were found in 4 patients (28.6%). These were perforation (2 cases, 14.3%) and obstruction (2 cases 14.3%). Postoperative condition during hospitalization was excellent. 10) Among the chronic primary ulcer patients (12 cases), ulcer symptoms disappeared in 10 cases with medical treatment such as antacids, tranquilizers and other conservative treatments and within one month after treatments were discharged with improvement.
Abdominal Pain ; Adult ; Anemia ; Antacids ; Child ; Child, Preschool ; Dyspepsia ; Hospitalization ; Humans ; Incidence ; Korea ; Male ; Melena ; Only Child ; Pediatrics ; Peptic Ulcer* ; Prognosis ; Seasons ; Stomach Ulcer ; Ulcer ; Vomiting ; Weight Loss

PURPOSE: During the childhood, Mantoux test is very popular for detecting tuberculous infection and also useful for evaluating the immunity against tuberculosis after BCG vaccination. But the response and conversion rate is affected by the age of vaccination, the quality of vaccine, the duration after vaccination and the frequency of the test. This study was performed to investigate the difference of the response and conversion rate, according to duration after vaccination, gestational age, sex and feeding type. METHODS: The subject was included 85 of infants (71 of full term infants, 14 of preterm infants) and was followed up 3 months, 9 months, 15 months after vaccination, from July, 1992 to June, 1994 in Kangnam St. Mary's Hospital. We injected intradermally the BCG vaccine (0.05ml) which was produced by National Institute of Health and PPD (5TU) was used as a testing material of Mantoux test. Injecting BCG and interpreting the result of the Mantoux test was done by the same person. RESULTS: 1) The positive conversion rates of Mantoux test which was done 3 month, 9 month and 15 month after vaccination were 26.8%, 53.5% and 60.6% in the full-term infant group, and 14.3%, 28.6%, and 50% in the preterm infant group. The conversion rate was significantly lower in preterm infant group as compared with that of the full-term infant group 3 months after vaccination. 2) The sizes of induration in Mantoux test, which was done 3 month, 9 month and 15 month after vaccination, are 7.2mm, 8.5mm, 9.4mm in the full-term infant group and 5.0mm, 6.6mm, 8.2mm in the preterm infant group. The size of induration was significantly lower in the preterm infant group as compared with that of the full-term infant group. 3) There is no difference in conversion rate of Mantoux test according to the sex, feeding type in both groups. 4) Complication rate for BCG vaccine is 9.9%, which is leaded by lymphadenitis, persistent ulcer, and febrile abscess as the order, in the full-term infant group and there are no complications in the preterm infant group. CONCLUSIONS: In those results, the size of induration and conversion rate is increased as the duration after vaccination, then lower conversion rate in the preterm infant group 3 months after vaccination may be due to immunological immaturity of preterm infant.
Abscess ; BCG Vaccine ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Lymphadenitis ; Mycobacterium bovis* ; Tuberculosis ; Ulcer ; Vaccination*

PURPOSE: The aim of this study was to evaluate the utility of contrast-enhanced MRI with first-pass and delayed images in prediction of myocardial viability after acute myocardial infarction. MATERIALS AND METHODS: Ten patients (M:F=:4, mean age =6 5 years) with acute myocardial infarction underwent first-pass image after bolus injection of gadolinium (one image/sec for 120sec)and delayed image (7 2 minutes later). According to 60 segments on midventricular level, the assessment of MRI were concerned about location of lesion, depth of lesion, enhancement on first-pass image and enhancement pattern on delayed image. MRI findings were compared with wall motion on resting echocardiography and stress or follow-up echocardiography. RESULTS: 1) MRI findings were classified into 4 types: normal enhancement on first-pass and delayed images (type 1), normal enhancement on first-pass image and nontransmural hyperenhancement on delayed image (type 2), non-transmural enhancing defect on first-pass image and transmural enhancement with endocardial non-enhancing defect on delayed image (type 3), and transmural enhancing defect on first-pass image and transmural hyperenhancement on delayed image (type 4).2) Type 2 suggested viable myocardium and type 3 had high porbability of viability. Type was compatible with non-viable myocardium. CONCLUSION: Enhancing defect on first-pass image and involving thickness on both the first-pass image and delayed image in contrast enhanced MRI may predict myocardial viability.
Echocardiography ; Follow-Up Studies ; Gadolinium ; Humans ; Magnetic Resonance Imaging* ; Myocardial Infarction* ; Myocardium

This report describes two cases of complete heart block associated with acute myocarditis. Both cases developed Adams-Stokes attack. One patients was considered to be due to viral infection as judged by clinical course and the other patient was confirmed as Korean hemorrhagic fever by indirect immunofluorescent antibody test. Both cases improved during about 4 weeks admission without sequelae with general supportive treatment only.
Heart Block* ; Heart* ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Myocarditis*

OBJECTIVE: The purpose of this study is to review retrospectively 28 patients with re-operation due to complications related to instrumentation from thoracic and lumbar spinal fusion surgery. METHODS: A total of 285 patients underwent spinal fusion surgery with instrumentation between 1996 and 2000. Of these, 11 men and 17 women(mean age 46 years, range 21 to 69 years) presented with complications related to instrumentation. Previous surgery was preformed for vertebral column instability secondary to fracture(4), spondylolisthesis(12), failed back surgery syndrome(7), osteomyelitis(1), herniated nuclus pulposus(4). All patients underwent repeated spinal surgery including removal of instrument, new instrument fixation, or I & D. The mean follow-up period after second operation was 19 months. RESULTS: The complications related instrumentation system include six interbody fusion system retropulsion, eight screw loosenings, five screw fractures, three screw malpositions, three osteomyelitis, and one donor site infection. After repeated surgery, eight became asymptomatic and did not require further treatment, but eleven showed persistent low back pain without neurological deficits and the remaining nine continued to have nerve root deficits. CONCLUSION: In conclusion, spinal fusion surgery with instrumentation offers an immediate postoperative stability of the thoracic and lumbar spine and enhances early fusion. However, it may be associated with few, but significant, complications which may permanantly. The proper selection of patients and meticulous surgical technique for surgery are probably the most important factors associated good outcomes and prevention of complications.
Follow-Up Studies ; Humans ; Low Back Pain ; Male ; Osteomyelitis ; Retrospective Studies ; Spinal Fusion* ; Spine ; Spondylolisthesis ; Tissue Donors

Major neurological features of achondroplasia are attributed to premature synostoses of the pedicles of the vertebrae and of the base of the skull producing obstruction of the ventricular fluid circulation or compression of the medulla and spinal cord. Significant hydrocephalus is due to the obstruction of the cerebrosspinal fluid pathways at the level of the foramen magnum or the disturbance of CSF absorption caused by increased superior sagittal sinus pressure. In generally, the hydrocephalus in achondroplasia is of the communicating type in the pattern, so the CSF diversionary shunt may not be indicate. But, shunting procedures may be needed in patients who showed signs of severe IICP such as bulging fontanels and enlarged lateral ventricle. In this case, we experienced that the hydrocephalus in achondroplasia is prosorption following the stenosis of the foramen magnum and increased superior sagittal sinus pressure.
Absorption ; Achondroplasia* ; Constriction, Pathologic ; Foramen Magnum ; Humans ; Hydrocephalus* ; Lateral Ventricles ; Skull ; Spinal Cord ; Spine ; Superior Sagittal Sinus ; Synostosis