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KMID : 0367419690100040029
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Journal of Korean Pediatric Society
1969 Volume.10 No. 4 p.29 ~ p.40
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Environmental studies on Paragonimiasis
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尹德鎭/Yun, Duk Jin
李琦寧/安泳謙/李倫鎬/Lee, Ki Yung/Ahn, Yung Kyum/Lee, Yoon Ho
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Abstract
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With several kinds of laboratory studies including blood chemistry and electrocardiograms, the author had clinically observed 78 cases of the epidemic encephalitis, which were admitted in P.N.U. Hospital during the epidemic summer of 1964.
1) Age and sex distribution: Among the 78 cases, boys were twice than girls as 52 cases and more than 50 per cent of all were between 5 to 8 years of age, of which 5 years of age group were the majority.
2) In the most of cases the onset was unuasual or not typical cases which were manifested only sustained high fever without other symptoms and signs.
3) In general, there were a moderate degree of leukocytosis in acute atage, showing an average of 15,000 cells per cubic millimeter and it lasted relatively long until 20th days of illness without secondary infections.
The erythrocyte sedimentation rates were abnormally increased in 79 per cent during acute stage and in 57 per cent(16/28 cases) the serum total cholesterol concentration showed hypocholesterolemia under 100mg.% during acute stage, but it returned to normal limits except for one case in the recovery period. And the serum alkaline phosphatase activity was slightly increased in 28.2 per cent(11/39 cases) above the normal limits during acute stage. But that of recovery stage was also within normal limits except for one case.
4) The mean cell count of cerebro-spinal fluids was about 100 per cubic millimeter and its differential count showed a prominent polymorphonuclear cells during acute stage, while a prominent lymphocytic element in the recovery stage, which fits what is previously reported. The alkaline phosphatase activity in cerebro-spinal fluids varied from 0 to 1.3 S.J.R. Units in 30 cases, showing an average 0.38 S.J.R. Units during acute stage and in the recovery stage, the mean was 0.16 S.J.R. Units ranging from 0 to 0.5 S.J.R. Units.
On the other hand, in the control of 5 normal children, the mean was 0.05 S.J.R. Units ranging feom 0 to 0.18 S.J.R. Units.
5) The electrocardiograms of 13 cases in acute stage and 15 cases of recovery period were analyzed. In the former, there, were 3 cases of arrhythmias, 1 case of mild incomplete right bundle branch block, and 1 case of right atrial hypertrophy. There were, however, no arrhythmias in the latter, but 1 case of myocardial anoxia or damage and 1 case of mild right bundle branch block were seen.
Although about a half of the cases represented right axis deviation, it seemed to have no significance considering of its physiologic possibilities under the age of 7 years. In conclusion, no characteristic changes of E.C.G. were found in the epidemic encephalitis during both acute and recovery period.
6) Medications were consisted of a chemotherapy and corticosteroid injections besides symptomatic and supportive therapy. There were no differences in effects between the patients who were given a chemotherapy with steroids and those who were treated without them. Symptomatic and supportive managements, such as nasal feeding, oxygen inhalation, cardiotonica, fluids and electrolytes, and vitamins seemed to be more important. The effects of hypothermia, especially in acute febrile stage, could be recognized and it should be emphasized.
7) Total mortality was 22% and various residuals including speeking disturbances and spasticity of the extremities were found in 8 patients until one month after recovery.
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