• Title/Summary/Keyword: Infantile diseases

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The Usefulness of MRCP in the Evaluation of Pancreaticobiliary Diseases in Children (소아에서 담췌관 질환에 대한 자기공명 담췌관조영술의 진단적 유용성)

  • Uhm, Ji Hyun;Lee, Seung Yeon;Chung, Ki Sup
    • Clinical and Experimental Pediatrics
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    • v.45 no.11
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    • pp.1381-1388
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    • 2002
  • Purpose : Magnetic resonance cholangiopancreatography(MRCP) is a noninvasive method for imaging the pancreaticobiliary tree. The aim of this study was to evalute the usefulness of MRCP for the diagnosis of pancreaticobiliary diseases in children. Methods : From October 1996 to May 2001, 67 patients with obstructive jaundice and three patients with chronic recurrent pancreatitis were evaluated with abdominal ultrasonography and MRCP. The final diagnosis was based on the operative and pathologic findings with biopsy specimen including clinical and laboratory findings. Results : A total of 70 patients, consisting of 31 males and 39 females, with a mean age of $2.6{\pm}3.3$ years were studied. The final diagnosis was biliary atresia in 25, neonatal cholestasis in 18, choledochal cyst without anomalous pancreatobiliary duct union(APBDU) in nine, choledochal cyst with APBDU in seven, cholestatic hepatitis in five, chronic recurrent pancreatitis in three, sclerosing cholangitis in two, and secondary biliary cirrhosis in one case. The overall diagnostic accuracy of abdominal ultrasonography was 75.7% and that of MRCP was 97.1%. The sensitivity and specificity of MRCP were 100% and 98% for biliary atresia, 87.5% and 100% for choledochal cyst with APBDU, 100% and 100% for choledochal cyst without APBDU, sclerosing cholangitis and chronic recurrent pancreatitis, respectively. Conclusion : MRCP is a fast, non-invasive and reliable method for diagnosing pancreaticobiliary diseases in children and will be the standard diagnostic procedure in the future.

A Prospective Study on Emergency Room Utilization in Children with Nonsurgical Gastrointestinal Disorders (비외과적 소화기질환 환아들의 응급실 이용양상에 대한 전향적 조사연구)

  • Lee, Kyung-Ja;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.54-62
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    • 2001
  • Purpose: There have been few reports about common gastrointestinal diseases in children visiting emergency room. The aim of this study was to present basic data and their meanings about emergency room utilization in children with nonsurgical gastrointestinal disorders. Methods: The authors prospectively studied 1,228 consecutive children with gastrointestinal diseases, amongst 6,179 nonsurgical pediatric patients who visited the emergency room of Seoul Red Cross Hospital from Jan. 1st 1998 to Dec. 31st 1999. Results: 1) First visit was 60.7% of total visits and 30.7% were between 1 and 3 years of age while 80.4% were below 6 years of age. Male patients were predominant by a ratio of 1.3:1. 2) The peak month of visits was December (12.1%), and the peak time of visits was between 8:00 pm and midnight (35.9%). Average length of stay at emergency room of the total patients were 0.86 hour. 3) Five major diseases were acute gastroenteritis (44.3%), fecal impaction &/or constipation (21.3%), acute gastritis (16.4%), intussusception (4.6%), and infantile colic (4.3%) in order. 4) 19.6% of the total patients were hospitalized. Conclusion: There were differences in various distributions regarding each nonsurgical gastrointestinal disease entity in children visiting emergency room even though distributions of the total patients in our study were not so different from those in previous reports by others.

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The First Report on Clinical Manifestation of Cryopyrin-Associated Periodic Syndrome in Korean Children

  • Kim, Kwang Yeon;Kim, Sae Yun;Park, Su Eun;Lee, Jina;Lee, Hyunju;Lee, Soyoung;Kim, Joong Gon
    • Pediatric Infection and Vaccine
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    • v.25 no.3
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    • pp.113-122
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    • 2018
  • Purpose: The aim of this study was to evaluate the clinical characteristics of children diagnosed as cryopyrin-associated periodic syndrome (CAPS) in Korea. Methods: Diagnosis was made based on clinical features and confirmed by a mutation in the cold-induced autoinflammatory syndrome 1 (CIAS1) gene. Especially, osteocartilaginous overgrowth in the patella or distal femur was so characteristic that its presence warranted a diagnosis of chronic infantile neurologic cutaneous and articular/NOMID. Results: We observed the clinical features of 9 Korean CAPS patients. All the patients suffered from an urticarial rash with recurrent fever. Among the 9 patients, 6 presented with rash and 4 with fever on the 1st or 2nd days of birth. Eight patients showed myalgia, and 7 patients showed arthralgia in the joints, and 6 patients showed radiologic findings of arthropathy including cupping of the metaphysis, excessive growth of the epiphysis, osteopenia or overgrowth of the cartilage. Four patients showed brain atrophy, enlarged ventricles or leptomeningeal enhancement on magnetic resonance imaging. Intellectual disability was observed in 1 patient. Five patients had eye involvement as conjunctivitis, uveitis, chorioretinitis, avascular area or papillary edema, and 3 patients showed progressive hearing loss. All 9 patients showed increased C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Conclusions: All the patients carried a mutation on exon 3 of the CIAS1 gene. After the anakinra (interleukin-1 receptor antagonist) therapy, the fever and rash immediately disappeared, and CRP and ESR were improved.

Clinical Features of Eosinophilic Colitis Developed in Early Infancy (영아 초기에 발생한 호산구성 대장염의 임상적 고찰)

  • Kwak, Jeong Won;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.122-129
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    • 2005
  • Purpose: Eosinophilic colitis is a disease characterized by gastrointestinal symptoms, peripheral eosinophilia, eosinophilic infiltration of the colonic wall. The etiology and pathogenesis of this disease is not clear and it is considered to be idiopathic. This study aimed to ascertain the clinical features, treatment and prognosis of eosinophilic colitis in early infancy. Methods: We reviewed 6 infants retrospectively, presented with bloody stool in early infancy, who were diagnosed with eosinophilic colitis in Pusan National University Hospital between August 2002 and February 2004. Results: Five males and one female were included. The mean age when bloody stool was identified was $79.2{\pm}56.1$ days (10~145 days). All but one infant with atopic dermatitis did not have other allergic diseases. Nobody had a family history of allergic disease. No specific dietary history in infants and their mothers related to food allergy was identified. Peripheral eosinophilia (total WBC count $11,763{\pm}3,498/mm^3$, eosinophils $17.0{\pm}4.3%$, absolute eosinophil count $2,044{\pm}996/mm^3$) was observed in all infants. Colonoscopy in six infants revealed diffuse erythema, congestion and granulation pattern of mucosa in the rectosigmoid colon. Histopathologic findings of colononic biopsies showed chronic inflammation with severe eosinophilic infiltration in the mucosa. Two infants were treated with hydrolyzed casein-based formula and four infants with prednisolone. Gastrointestinal symptoms and peripheral eosinophilia resolved completely with prednisolone and partially with a hydrolyzed casein-based formula. Relapse was not observed during the follow-up period. Conclusion: Our study demonstrated that there is no evidence of a definite relationship between eosinophilic colitis and food-allergic disorders. Clinical course and prognosis of infantile form of eosinophilic colitis is very favorable and treatment with prednisone was effective.

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A Comparison of Clinical Findings According to the Duration of Pyuria in Infants with Urinary Tract Infections (영아 요로 감염에서 농뇨의 지속기간에 따른 임상적 비교)

  • Lee, Jeong-Eun;Lee, Seung-Woo;Park, So-Hyun;Kim, Jong-Hyun;Koh, Dae Kyun
    • Pediatric Infection and Vaccine
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    • v.17 no.1
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    • pp.23-29
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    • 2010
  • Purpose : Urinary tract infection (UTI) in children is the most common disease during the infantile period, therefore early diagnosis and treatment are important. Pyuria is a useful clinical parameter for the initial diagnosis of a UTI. In this study we aimed to compare the clinical, laboratory, and imaging findings in relation to the duration of pyuria in infants with UTIs. Methods : Three hundred seventy-four infants <12 months of age who were admitted between January 1995 and December 2005 for the first episode of a febrile UTI were retrospectively reviewed. Patients were divided into two groups according to the duration of pyuria as follows: group 1, pyuria resolved <3 days after initial treatment; and group 2, pyuria lasted at least 3 days after initial treatment. Results : There were no significant differences between the two groups in relation to gender, age, total duration of fever, and organisms in the urine. Group 2 had a significantly higher peripheral blood leukocyte count ($14,360.86{\pm}5,526.16cells/mm^3$ vs. $11,822.55{\pm}5,687.26cells/mm^3$, P <0.001), erythrocyte sedimentation rate ($32.81{\pm}19.34mm/hr$ vs. $23.74{\pm}20.43mm/hr$, P <0.001), and C-reactive protein ($6.84{\pm}5.68mg/dL$ vs. $3.78{\pm}3.99mg/dL$, P <0.001) than group 1. There was a significantly higher incidence of hydronephrosis and a higher grade of vesicoureteral reflux (VUR) in group 2 compared to group 1. Conclusion : In infants with UTI, pyuria of longer duration is related to severe UTI and higher grade VUR, therefore aggressive radiologic studies may be necessary.

A Study on Residual Hearing of Hearing Impaired Children (고도난청아(高度難聽兒)에 대(對)한 잔존청력(殘存聽力))

  • Rhee, Kyu-Shik;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.6 no.1
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    • pp.51-63
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    • 1973
  • This paper illustrate residual hearing and socio-medical background on the hearing impaired children, 207 comming to Deaf School. attached to Hankuk Social Work College, Taegu, Korea. The survey was performed through interview with their parents and testing by diagnostic audio-meter (TRIO, AS 105 type) at soundproof room from March 10, to November 28, 1973. The results obtained were as follows. 1) The attendance rate of the compulsory primary school was markedly lower tendency in female than male according to directly proportional to prevalence rate of deafness among them. If was showed the deeper gap in the more superior school (middle and high school). 2) Who entered at the suitable age to each school (six years old to primary school, 12 years to middle and 15 years to high) was 11.3%. And who were enrolled in school age to each school (6-11 years for primary. 12-14 years for middle and 15-17 years for high) was 45.9% (43.7% in male, 50.0% in female). 3) As causative disease, congenital case, were 23.6% included of 13.5% of heredity and 10.1% of troubles during pregnancy; the total acquired cases were 47.9%, it was classified as 11.6% of convulsion from any other diseases, 7.7% of measles, 7.7% of other febrile diseases, 3.4% of drug (the most of streptomycin) intoxication, 2.4% of meningitis, 1.5% of epidemic encephalitis and 31.3% of other diseases; and unknown cases were 28.5%. 4) 31.4% of who included congenital cases lost their hearing within six months old, 11.6% in 6-11 months. 9.7% in 1-2 years old and 14.0% in 2-3years old. Consequently we obtained that the most cases 90.0% were lost their hearing within 3 years after birth. 5) According to qualities of hearing leases the most of cases were perceptive, 197(97.5%), only two cases were conductive, and eight cases were mixed. 6) The status of residual hearing according to average grade of hearing loss. $B(=\frac{a+2b+c}{4}$ as table 13) were as follows. Two cases were normal (one was mute and another was severe speach disorder). Ten cases, moderate. Moderately severe cases were 40 (19.3%). Severe cases, 38(18.4%). Scale out, profound cases, 48 (23.3%). And impossible testing cases because that were infantile or had some mental disorder were 69 (33.3%). 7) The using rate of hearing aides was only 12.0%. Among them who had some more residual hearing and could showed hearing effect with hearing aide have used more many proportionary but who were difficult to expect that effect were rare.

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