• Parasites, Hosts and Diseases
• /
• v.32 no.3
• /
• pp.195-200
• /
• 1994

Malaria is estimated to have a worldwide incidence of more than 100 million clinical cases and approximately 1 miuion deaths per year. Korea, although previously tnlown as an endemic area of tertian malaria (Pzosmonin vivax), has been considered free from malaria as there had been no report on indigenous cases since 1984. Recently, however, we experienced an indigenous case of P. viuax infection in a young man who had never been abroad. The patient was a 23-year-old Korean soldier with 18-day history of recurrent fever and chill lasting 4 to 8 hours on alternative days since mid-July 1993. He had lived in Changwon, Hyongsangnam-do, before entering barracks located in Paiu-gun, Kyonggj-do on Jne 1992, and had never been out of Korea. He had no history of blood transfusion nor parenteral use of drugs. The peripheral blood smears showed typical ring forms, trophozoites, and gametocytes of p. uiuox, in addition to mild anemia and thrombocytopenia. After confirmation of the diagnosis, he was treated with hydroxychloroquine and primaquine. Follow-up blood smears no more revealed malaria parasites. It is not certain whether the present case is due to a resurgence of indigenous malaria or a secondary infection from introduced mnuia. Whichever the source of infection the domestic occurrence of mnuia cycle in Korea should be a warning sign in public health point of view.

• Clinical and Experimental Pediatrics
• /
• v.46 no.9
• /
• pp.883-888
• /
• 2003

Purpose : The etiology of hemolytic anemia can be classified as either cellular or extracellular defects of red blood cells. The aim of this study was to investigate the clinical and laboratory findings of hemolytic anemia concerning its etiological classification. Methods : Clinical and laboratory findings of the patients with hemolytic anemia treated from January 1987 to May 2002 at Severance Hospital were analyzed retrospectively. They were divided into two groups based on the types of red cell defects(group I : erythrocytic defect, group II : extraerythrocytic defect). Results : Twenty one cases were included in group I, thirty four cases in group II, and three cases were unclassified. In group I, nineteen cases(90.5%) were diagnosed as hereditary spherocytosis and were proved to have red cell membrane disorders while two cases(9.5%) were shown to have red cell enzyme deficiencies. In group II, thirteen cases(38.2%) were noted as autoimmune hemolytic anemia, eleven cases(32.4%) as traumatic or microangiopathic hemolytic anemia, four cases(11.8%) as drug induced hemolytic anemia, two cases(5.9%) were related with systemic lupus erythematosus and one case(2.9%) with malignancy. Hemoglobin at the time of diagnosis(7.5 g/dL vs. 6.2 g/dL, P<0.05) and the incidence of splenomegaly(85.7% vs. 18.2%, P<0.05) were higher in group I though blood urea nitrogen(9.0/0.4 mg/dL vs. 27.8/1.6 mg/dL, P<0.05) was higher in group II. Conclusion : Comparing the clinical features of pediatric hemolytic anemia, we concluded as following : In cases associated with extraerythrocytic defect, blood tests revealed significant initial lower hematocrit with higher level of BUN and Cr while cases with erythrocytic defect, splenomegaly were more common noted.

• Clinical and Experimental Pediatrics
• /
• v.45 no.12
• /
• pp.1512-1518
• /
• 2002

Purpose : Twins have a higher mortality and morbidity than singletons. Co-twin with one fetal death is particularly at risk. We investigated the neonatal outcome of live co-twins when one fetus had died after the 20th gestational week, and associated risk factors. Methods : A retrospective study was performed in fifteen cases of twin pregnancy with single intrauterine fetal deaths after the 20th gestational week during the period from January 1996 to December 2000 at Chonnam University Hospital. Results : Gestational age was $33.7{\pm}3.2weeks$, birth weight was $1,992{\pm}592g$. Interval between one fetal death being detected and the delivery of a live co-twin was $32.4{\pm}29.5days$. There were 11 cases(73.3%) of premature babies less than 37 gestational weeks. Main causes of preterm delivery were preterm labor and premature rupture of membranes. Hematologic findings suggesting disseminated intravascular coagulopathy(DIC) were not found in all mothers before delivery, and was not associated with DIC and encephalomalacia of the live co-twin. Perinatal outcome of fifteen live co-twins was as follows : six were normal(40%), three were DIC(20.0%), three were encephalomalacia(20.0%), one suffered intrauterine growth retardation, there was one case of twin to twin transfusion syndrome, and one of congenital heart disease(atrial septal defect with pulmonary stenosis). The occurrence of DIC and encephalomalacia in live co-twins was not related to placental chorionicity, birth weight, gestational week, and the interval between the detection one fetal death and the delivery of a live co-twin. Conclusion : We could not find any maternal hematologic problems in twin pregnancies complicated by one fetal death. Twenty percent of live co-twins showed DIC and encephalomalacia. However, its associated risk factors were not found. We need to investigate more closely the cases of live co-twins with one intrauterine fetal death.