PURPOSE: Mental retardation, which can be defined as subnormal cognitive ability with markedly decreased ability to adapt to one's environment, is a common developmental disorder. But the diagnosis of mental retardation in young children is frequently missed in pediatric clinics. The purpose of this study is to increase the rate of early diagnosis and intervention by providing clinical information about mental retardation in early childhood. METHODS: Clinical observations of 72 mental retarded children diagnosed in the Pediatric Developmental Clinic of St. Mary's Hospital of Catholic University Medical College were made. Mental retardation was defined as Mental Developmental Index of Bayley Scales of Infant Development-II or IQ of Wechsler Intelligence Preschool Primary Scale of Intelligence-Revised below 70. Children of IQs below 50 were classified as serious mental retardation and IQs between 50-70 as mild mental retardation. RESULTS: The mean age of diagnosis of mental retardation was 23+/-11 months; median was 19 months old. Children with serious mental retardation consisted of 47.2% of the total. 50.0% of patients visited the developmental clinic via private pediatric clinics. The etiology of mental retardation was not identified in 45.8% of cases; postnatal, perinatal and prenatal causes were found in 27.8%, 20.8% and 5.6%, respectively. The most frequent chief complaints were motor developmental disorder and speech and language disorders. Delay in gross motor milestone was observed in 63.9% of patients. 55.0% of patients received brain CTs or MRI revealed abnormal findings. The most common associated impairment was speech and language disorder with a prevalence rate of 62.5%. A variety of therapeutic procedures were provided for the mental retarded children, including early intervention, physical therapy, special education, nutritional support, speech therapy and behavioral management. CONCLUSION: As a primary heath provider, pediatricians could make earlier diagnosis of mental retardation in young children by understanding the variety of clinical findings of this common pediatric disorder.
Brain ; Child ; Child, Preschool* ; Diagnosis ; Early Diagnosis ; Early Intervention (Education) ; Education, Special ; Humans ; Infant ; Intellectual Disability* ; Intelligence ; Language Disorders ; Magnetic Resonance Imaging ; Nutritional Support ; Prevalence ; Speech Therapy ; Weights and Measures

Congenital nasolacrimal duct obstruction is a major cause of epiphora in infants and the incidence is known to be 1.75% to 12.5%. Debates continues about optimal management for patient`s age. Both early intervention and late intervention have advantages and disadvantages. This study was designed to evaluate the effect of probing for congenital nasolacrimal duet obstruction in association with the patient` s age to decide the optimal timing for probing. From January 1993 to November 1996, 85 eyes of 68 patients were diagnosed as congenital nasolacrimal duct obstruction and had probing under topical anesthesia. The success of probing was defined as improvement of symptoms for at least 4 weeks of period after probing. The probing was successful in 73 out of 85 eyes and the success rate was 85.8%. The success rate of infants between 3 to 9 months of age was 92.6%. The success rate of infants older than 10 months of age was 74.2%. The difference between two groups was statistically significant(P<0.05). The success rate of probing for congenital nasolacrimal duct obstruction was highly associated with the age and it began to decrease when the age of the patient was over 10 months. Therefore it is recommendable to probe for congenital nasolacrimal duct obstruction before the age of the patient reaches 10 months.
Anesthesia ; Early Intervention (Education) ; Humans ; Incidence ; Infant ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct*

Multiple agents can cause anaphylaxis in a perioperative setting. Identifying the agent responsible is essential for avoiding future adverse reactions as well as to attenuate the progression of anaphylaxis. Being able to distinguish an anaphylactic reaction from an anaphylactoid reaction would help clarify the therapeutic and medicolegal issues. Anaphylaxis generally occurs after reexposure to a specific antigen and requires the release of proinflammatory mediators from mast cells and basophils. An increased concentration of mast cell tryptase is a highly sensitive indicator of anaphylactic reactions during anesthesia. Botropase(R) is a procoagulant hemocoagulase purified from venom of Bothrops jararaca, a Brazilian viper and in wide use in patients with high risk of bleeding. We report a case of suspected anaphylaxis to Botropase(R) in a 67 years old female patient undergoing segmental resection of the liver with elevated concentration of serum mast cell tryptase.
Aged ; Anaphylaxis* ; Anesthesia ; Basophils ; Batroxobin* ; Bothrops ; Female ; Hemorrhage ; Histamine ; Humans ; Liver ; Mast Cells* ; Tryptases* ; Venoms

The prognosis of patients with Philadelphia chromosome positive acute lymphoblastic leukemia (Ph ALL) who relapsed after allogeneic stem cell transplantation (allo-SCT) is poor. Imatinib mesylate (Glivec (R) ) is an inhibitor of the ABL tyrosine kinase with potent antileukemic activity in advanced Ph ALL. The clinical effects of imatinib on Ph ALL recurring after allo-SCT have not been established. We describe the clinical activity of imatinib in a 7 year-old boy with Ph ALL relapsing after unrelated donor stem cell transplantation. Imatinib as a single agent resulted in rapid elimination of leukemic cells with ensuing prolonged neutropenia and thrombocytopenia. Subsequent hematological recovery by donor-derived cells was associated with grade 3 graft-versus-host disease (GvHD), which responded to cyclosporine A and steroid. Imatinib successfully induced hematologic, cytogenetic and molecular remission of Ph ALL, and restored complete donor chimerism, along with controllable GvHD.
Child* ; Chimerism ; Cyclosporine ; Cytogenetics ; Graft vs Host Disease ; Humans ; Hydrogen-Ion Concentration ; Male ; Mesylates* ; Neutropenia ; Philadelphia Chromosome* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prognosis ; Protein-Tyrosine Kinases ; Stem Cell Transplantation* ; Stem Cells* ; Thrombocytopenia ; Tissue Donors ; Unrelated Donors* ; Imatinib Mesylate

OBJECTIVE: This study was performed to evaluate relationship of burdened work and musculoskeletal symptoms in small-to-medium sized enterprises. METHOD: After a questionnaire survey was administered to 9,950 workers in 122 workplace, 7,626 workers(76.6%) were finally selected for the study analysis. Industrial hygienists visited 122 small-to-medium sized enterprises to investigate the presence of burdened works within the workplace. The selection of jobs with significant burden was based on the Ministry of Labor's recent notification in 11 types of job description associated with musculoskeletal disorders. The subjects of this study were then divided into three categories. 1) non-burdened white collar workers, 2) non-burdened blue collar workers, and 3) burdened workers (include some VDT workers). Multiple logistic regression was used to evaluate the relationship between burdened work and musculoskeletal symptoms. RESULTS: The burdened workers reported significantly more musculoskeletal symptoms than non-burdened white collar workers and non-burdened blue collar workers(OR:1.57, 95% CI: 1.314-1.875). There was no significant difference in reports of musculoskeletal symptoms between non-burdened white and blue collar workers. CONCLUSION: To prevent or diminish musculoskeletal disorders in small-to-medium sized enterprises, we need to better manage burdened works.
Job Description ; Logistic Models ; Questionnaires