• Title/Summary/Keyword: 입원 환아

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A Case of IgG Subclass Deficiency with Growth Failure (재발성 호흡기 감염과 성장 부전을 보인 IgG 아형 결핍증 1례)

  • Choi, Yong-Sung;Hong, Jung-Mi;Rha, Young-Ho;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.201-205
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    • 2006
  • Immunodeficiency affected by antibody formation is most common among primary immuno-deficiencies. Selective IgA deficiency is more common but, one or more IgG subclass level is low or deficient in some patients. Patients with antibody production deficiency are vulnerable to pneumococci, staphylococci and H.influenzae leading to sinusitis, otitis media and pneumonia. A 10-year-old girl had suffered from frequent upper respiratory infections, a history of tuberculous lymphadenitis tuberculosis medication, and frequent pneumonia that requires hospital adimission. Her height and weight were below 3 percentile normal growth as a manifestation of failure to thrive. When she had another severe pneumonia, all the immunologic test was normal at first, and then we checked the IgG subclass levels. Her IgG1 was within normal, IgG2 was very low, IgG3 and IgG4 was not detected. We report a case of IgG subclass deficiency in frequent upper respiratory infection and failure to thrive.

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The Clinical Aspects of Acute Septic Arthritis and Acute Osteomyelitis in Children (소아기 급성 화농성 관절염과 급성 골수염의 임상적 고찰)

  • Kim, Jin-Man;Lee, So-Yeon;Kim, Young-Ho;Shin, Eon-Woo;Oh, Phil-Soo;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.149-156
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    • 2005
  • Purpose : Acute septic arthritis and acute osteomyelitis are not rare diseases in pediatric population. But when the diagnosis is delayed or inappropriate treatments are given, permanent disabilities of joint or bone can be followed. We analysed clinical manifestations, laboratory findings, X-ray findings, causative microorganisms and antibiotic susceptibility results of the two diseases in children. Methods : During January 1992 and May 2002, we conducted a retrospective study of 103 children who were diagnosed as acute septic arthritis and acute osteomyelitis. We selected out 34 children who had positive culture results in the blood or involved sites. Results : 19 cases were diagnosed as acute septic arthritis and 15 cases were acute osteomyelitis. These diseases were most common in preschool children and next in neonates. Hip joints and tibia were the most common sites in each disease. X-ray findings showed abnormalities in 6 cases(36%) of acute septic arthritis and 7 cases(50%) of acute osteomyelitis on admission. The most common microorganism isolated from the involved sites was Staphylococcus aureus; 12 out of 14 cases in acute septic arthritis and 6 out of 13 cases in acute osteomyelitis. Conclusion : It is difficult to make a clear initial diagnosis of the two diseases. We could not find any differences between these two diseases on clinical manifestations such as fever, swelling, tenderness and limitation of movements in joint and bone. The most common microorganism was Staphylococcus aureus.

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Determination of Short Term Prognosis Among Chronic Obstructive Lung Disease with Acute Respiratory Failure According to Simplified Acute Physiology Score (만성 폐쇄성 폐질환에서 급성 호흡부전 발생시 Simplifed Acute Physiology Score에 따른 단기예후의 평가)

  • Lee, Sang-Pyo;Sung, Yun-Up;Kim, Sang-Hoon;Kim, Bong-Sik;Kim, Young-Jun;Park, In-Won;Choi, Byung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.532-539
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    • 1993
  • Background: Physician's estimates of patient survival often influence clinical decisions, especially those near the end of life. In addition. clinical decisions frequently reflect trade-offs between morbidity and length of survival. As a result, accurate estimates of survival can be extremely useful in clinical decision. When the episode of acute respiratory failure in chronic obstructive lung disease, evaluation of the severity of the condition and short term prognosis is difficulit based on the available clinical or paraclinical data at the time of admission. Method: In this study, we performed a retrospective study in Chung Ang University Hospital, 74 patients (51 males, 23 females), who were hospitalized with chronic obstructive lung disease with acute respiratory failure from 1980 to 1992. We evaluated these patients to determine lung prognostic factors at time of admission in the Intensive Care Unit (ICU) that predict short term survival, and to determine the possible application of the Simplified Acute Phsiology Score (SAPS) to this population, All patients were treated with similar regimen during the hospitalization. Results: The results were as follows: 1) Hospital mortality was 34%(25/74 patients) and surival rate was 66%(49/74 patients) in COPD with acute respiratory failure. The prognosis of the older age was much poorer than those of the young age. 2) There was no difference in mortality according to the results of basal pulmonary test and arterial blood gas analysis. 3) The SAPS at admission was higher in those patients who expired(10.8) than the survived(6.5), and there was positive correlation between SAPS and mortality (r=0.91, p<0.05). 4) Prognostic factors in acute respiratory failure complicating COPD which were identifiable at time of admission to the ICU were as follows: cachexia, encephalopathy, serum creatinine and phosphate. Conclusion: In conclusion, the SAPS might have a good prognostic value for determination of short term survival among chronic obstructive lung disease with acute respiratory failure.

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The Significance of Interleukin-6 in $Henoch-Sch\"{o}nlein$ Purpura Nephritis in Children ($Henoch-Sch\"{o}nlein$ Purpura 신염에서 Interleukin-6의 의의)

  • Lee Jae-Seung;Kwon Min-Joong
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.130-135
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    • 1997
  • Purpose : Interleukin-6(IL-6), a multifunctional cytokine, has been found to have growth and differentiation activities on a wide variety of tissues and cells, including mesangial cells. It has been known that IL-6 is an autocrine growth factor for the proliferation of mesangial cells. Several studies have been performed for revealing the clinical significance of IL-6 in mesangial proliferative glomerulonephritis. Methods : The author measured serum and urinary IL-6 in 30 patients with $Henoch-Sch\"{o}nlein$ purpura (HSP), 18 patients with HSP nephritis, and 10 normal children as a control group. Results : The serum level of IL-6 was increased significantly in the patients with HSP and HSP nephritis compared to normal control. The level of urinary IL-6 was increased significantly in the patients with HSP nephritis compared to both HSP and normal control groups. The level of urinary IL-6 was not correlated with the level of serum. Conclusion : IL-6 was correlated with the amount of proteinuria. These data suggest that IL-6 may be involved in the pathological proliferation of mesangial cell in HSP nephritis.

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Risk factor of influenza virus infection to febrile convulsions and recurrent febrile convulsions in children (인플루엔자 바이러스 감염에서 소아 열성 경련과 열성 경련의 재발에 관한 위험인자)

  • Moon, Jae Won;Kang, Jang Hee;Kim, Hyun Ji;Byun, Soon Ok
    • Clinical and Experimental Pediatrics
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    • v.52 no.7
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    • pp.785-790
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    • 2009
  • Purpose : Febrile convulsions are a common pediatric neurological disease, and it is important to prevent such a disease by controlling the risk factors that may recur. A recent report states that influenza virus infections have a high probability of a relationship with febrile convulsions; therefore, it is necessary to identify the clinical properties of febrile convulsions in relation to domestic influenza virus infections. Methods : Between November 2005 and February 2008, children hospitalized because of febrile convulsions and subsequently confirmed to have influenza infections were enrolled as subjects (patient group, n=11). The control subjects were those admitted with influenza virus infections but no febrile convulsions (control group 1, n=46) and those who developed febrile convulsions without influenza virus infection (control group 2, n=53). Results : The patient group showed a higher maximum body temperature ($39.3{\pm}0.5^{\circ}C$), more histories of past febrile convulsions (72.7%), and a shorter total duration of fever ($2.9{\pm}1.2$ days) than control group 1. When multivariate analysis was performed, the probability of febrile convulsions was found to be as high as 225.9 times in patients who had influenza virus infections with a past history of febrile convulsions (OR=225.9, 95% CI: 1.7-4780.0, P<0.05). When patients with febrile convulsions were compared based on the symptoms of influenza virus infections, the patient group showed a shorter duration of fever ($0.9{\pm}0.7$ days) before convulsion than control group 2; these convulsions were mostly a recurrence of febrile convulsions. When multivariate analysis was performed, the cases with a past history of febrile convulsions showed 5.5 times (OR=5.5, 95% CI: 1.2-25.1, P=0.03) the probability of convulsions when infected with the influenza virus, and this probability decreased by 0.3 times over one-day increments of the febrile period until febrile convulsions (95% CI: 0.1-0.9, P=0.02). Maximum body temperature, total duration of fever, family history of febrile convulsions, and complex febrile convulsions did not show a statistical significance. Conclusion : In cases of pediatric influenza virus infection, the past history of febrile convulsions could be identified within the risk factor of recurrent febrile convulsions. Therefore, influenza vaccination of children having a past history of febrile convulsions will be helpful to avoid the recurrence of these convulsions.

Chlamydia trachomatis respiratory infection in Korean young infants (국내 영유아에서의 Chlamydia trachomatis 호흡기 감염)

  • Hong, Ki Bae;Shin, Youn Shim;Roh, Eui-Jung;Chung, Eun Hee
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.729-735
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    • 2008
  • Purpose : Chlamydia trachomatis is one of the most common sexually transmitted diseases and is also a cause of pneumonia in infants. Respiratory infections by respiratory viruses are also common for infants. The objectives of this study were to identify the clinical manifestations and to determine the prevalence of C. trachomatis respiratory infections and coinfections by respiratory viruses in infants younger than 6 months of age. Methods : For this study, we enrolled 6 months or younger infants who were admitted to the Dankook University Hospital between January 2002 and July 2007, with respiratory symptoms. Nasopharyngeal aspirates or throat swabs were collected within s d of hospitalization and C. trachomatis was detected using polymerase chain reaction (PCR). Patients who tested positive underwent multiplex PCR for respiratory viruses. Results : A total of 690 patients underwent chlamydial PCR testing and 36 (5.2%) had positive results. Of the 36, 28 (78%) were male; 30 were vaginally delivered. From the 36 patients positive for C. trachomatis, 26 underwent multiplex respiratory viral PCR; 12 were coinfected with viruses. Respiratory syncytial virus (RSV) was the most frequent pathogen that was detected in 6 patients. Increased C-reactive protein and fever were significant in patients coinfected with respiratory viruses. Conclusion : C. trachomatis can infected in infants delivered by cesarean section as well as in 6 months old or younger infants. Infant with C. trachomatis respiratory infections can also be coinfected with respiratory infection also coinfected with respiratory viruses. Further studies are needed to better understand the prevalence rates of the this infection and its coinfection rate with respiratory viruses.

Usefulness of Chest High-Resolution CT in Patients with Chronic Cough Below 2 Years of Age (2세 미만의 만성 기침 환아에서 흉부 고해상 전산화 단층 촬영의 유용성)

  • Kim, Myung Hyun;Kim, Jung Hee;Lim, Dae Hyun;Son, Byong Kwan;Lee, Kyung-Hee
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.339-345
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    • 2002
  • Purpose : The purpose of this study was to evaluate the clinical usefulness of chest high-resolution computed tomography(HRCT) in patients with chronic coughs or persistent wheezing with normal chest X-ray finding. Methods : We reviewed the charts, chest X-rays, and HRCT findings of patients with chronic coughs or persistent wheezing of less than 2 years of age. The records were sourced from the Department of Pediatrics, Inha University Hospital covering the period from July, 1999 to June, 2000. Chronic cough was defined as a cough which was prolonged for more than 3 weeks. Results : The sample consisted of 24 patients(male 15 and female 9, mean age $4.7{\pm}3.8$ months old). Among them, 16 patients showed normal findings(66.7%) and 8 patients showed abnormal (33.3%) in simple chest X-rays. Among 16 patients who had the normal chest X-rays, 13 patients showed abnormal chest HRCT findings(81.3%) such as air space consolidation of the dependent portion(62.5%), bronchiolitis obliterans(12.5%), and bronchopulmonary dysplasia(6.3%). Conclusion : We suggest that the chest HRCT is a useful diagnostic tool in the evaluation of patients with chronic cough or persistent wheezing with normal chest X-ray, especially below 2 years of age.

The Risk Factors of Morbidity and Mortality after Pulmonary Resection (폐절제술후 사망율과 이환율에 영향을 미치는 요소)

  • 서연호;김민호;구자홍;조중구;김공수
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1100-1105
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    • 1999
  • 배경 :폐절제술은 절제가능한 폐암 또는 염증성 폐질환 선천성 폐질환의 치교적 술식이 된다. 술후 경과에 영향을 줄수 있는 예측기능 요소를 인지하는 것은 중요하나 합병증에 이환된 경향이 높은 환자에 대하여 각별한 주의를 기울임으로서 술후 합병증 및 사망률은 감소시킬수 있을 것이다 방법 및 대상: 술후 결과에 영향을 미치는 요소를 예측하기 위해 1994년부터 1998 년까지 본 병원에서 종양성 및 염증성 폐질환으로 폐절저술을 시행받은 153명의 환자를 대상으로 입원챠트를 열람하여 연구하였다 평균 연령은 54.3$\pm$10.6세였다. 96명 (62%) 의 환자는 폐암화자였으며 47명 (30%)의 환자의 염증성 폐질환자였고 10명 (7%)의 환자는 선천성 폐질환자이거나 기타 폐질환자였다. 결과: 전체 153명중 폐엽절제술이 118례 전폐절제술이 29례 폐분엽절제술이 6례 시행되었다. 7명 (4.5%)의 환자가 술후 사망하였다 술후 원내 사망률의 가장 유의한 예측요소는 동반된 내과적 질환의 유무(p<0.001)과 70세 이상의 고령이다(p<0.003) 총 57명의 환자에게 67가지의 합병증이 발병되었다 그중 수술자체와 관련된 합병증이 50례 (32%) 호흡기계 합병증이 14례(9.1%) 심혈관계가 1례(0.6%) 기타 합병증이 2례(1.3%)였다 술후 합병증 이환율에 영향을 미치는 요소는 70세 이상의 고령이었다(p<0.004) 결론 : 동반된 내과적 질환과 70세 이상의 고령은 술후 사망률에 영향을 미치는 유의한 예측요소가 되며 또한 70세이상의 고령은 술 후 합병증 이환율에도 영향을 미치는 요소이다.

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Study on Determinants of Nursing Needs of Mothers with Hospitalized Children (입원환아 어머니의 간호요구에 대한 영향요인 분석)

  • Moon Ho-Jin;Shin Sung-Rae
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.2
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    • pp.234-243
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    • 2003
  • Purpose: The purpose of this study was to analyze the factors influencing nursing needs of mothers caring for children suffering from acute diseases and being treated in hospital. Method: The data were collected, using a nursing needs, social support, burden, and stress questionnaire. Data collection was done from July 10, to October 20, 2001 in the pediatric department of a general hospital. The data were analyzed by using descriptive statistics. Result: The results of this study are as follows. There were statistically significant differences in nursing needs according to differences in age, education level, marital status, religion, family income and relationship with spouse. The relationship between the nursing needs of the mother and anxiety (r=.758, p <.01), social support (r=-.659, p<.01), stress (r=.324, p <.01) were the most significant variables. The stepwise multiple regression analysis showed that anxiety, social support and stress define nursing needs at 57.5%, 4.3% and 1.1% respectively. Conclusion: Consideration needs to be given to anxiety, social support and stress when developing nursing intervention programs for mothers whose children are hospitalized with acute diseases.

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The Changes in the Outbreak of Rotavirus Gastroenteritis in Children after Introduction of Rotavirus Vaccines: A Retrospective Study at a Tertiary Hospital (로타바이러스 백신 도입 후 로타바이러스 위장관염의 추이: 일개 3차 병원의 후향적 연구)

  • Park, Dong Kyu;Chung, Ju-Young
    • Pediatric Infection and Vaccine
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    • v.21 no.3
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    • pp.167-173
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    • 2014
  • Purpose: This study aimed to examine the changes in the outbreak of acute gastroenteritis, rotavirus gastroenteritis after the introduction of the rotavirus vaccine in Korea. Methods: The current study investigated the number of inpatients in the pediatric ward of Inje University Sanggye Paik Hospital during the periods of 2005-2006 and 2011-2012. A retrospective analysis was conducted on the medical records of 2,840 patients <5 years of age who were hospitalized at Inje University Sanggye Paik Hospital in these time periods. Results: When we compared 2 separate sets of data from before (2005-2006) and after (2011-2012) vaccine introduction, there were statistically significant decreases in the number of patients who were hospitalized for acute gastroenteritis across all of the groups of patients <5 years of age except those <2 months of age. The number of patients with rotavirus gastroenteritis in all age groups declined except for children <2 months of age and those 2-5 months of age. Conclusion: These results show that after the introduction of a rotavirus vaccine in Korea, the incidence of rotavirus gastroenteritis decreased in 6-59-month-old patients hospitalized for acute gastroenteritis.