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This report reviews the manifestations in fifteen children of proved adenoviral pneumonia. Patients' ages ranged from 43 days to 4 years and 1 month. Twelve cases were younger than 2 years old. Adenoviral infections were proved by positive viral cultures or a four-fold increase of the complement fixation titer. Prolonged fever and cough were found in all cases. In 13 patients, respiratory distress occurred; 5 needed mechanical ventilation. Injected throats, conjunctivae and ear drums were common. Other clinical pictures included abdominal discomfort, hepatomegaly, skin rash, convulsion and bleeding tendency. Abnormal laboratory findings were mild anemia, leukopenia, thrombocytopenia, elevated erythrocyte sedimentation rate and C-reactive protein, impaired liver function test, and prolonged prothrombin time and partial thromboplastin time. Anemia (11 cases), leukopenia (7 cases) and elevated transaminases levels (7 cases) were more common than previously reported. All patients had para-hilar peribronchial infiltrates in chest roentgenography. Segmental atelectasis and compensated hyper-expansion were found frequently. Pleural effusion were noted in six of our cases. Air leak syndrome occurred in three patients who had received mechanical ventilation. Three of the 15 patients expired: one had a preceding measles infection, all had disseminated intravascular coagulopathy. For patients with antibiotic-resistant pneumonia, adenoviral studies should be done. Extrapulmonary manifestations, and some abnormal laboratory findings, i.e., mild anemia, leukopenia, impaired liver function are clues to adenoviral infections, while bleeding tendency can be regarded as a poor prognostic sign for children with adenoviral pneumonia.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:Adenoviral pneumonia in children. 132 94

Ten patients with corticosteroid-dependent asthma were treated with long-term and low dose methotrexate (MTX) for its corticosteroid-sparing effect. The average age was 51.2 years (ranged 24 to 67). Three were women. Despite the use of maximal doses of bronchodilators, their daily prednisolone dosages were always more than 10 mg during an average period of 2.75 years (ranged 1 to 6 years). Following the use of oral MTX, 15mg weekly from more than 6 months (averaged 11.8 months; ranged 6 to 15 months), the average daily requirement of prednisolone decreased from 14.5 to 6.5 mg (p < 0.01). Among them, four did not need steroid and the other six had a marked subjective improvement in breathing, cough and nocturnal dyspnea. However, three of them could not have steroid dose reduced. As for adverse reactions to MTX in ten patients, two patients had nausea and vomiting, two had skin eruption, three had somnolence, and one had elevated sGOT (78 U/L). The adverse effects were all transient. Neither oral ulcer, nor leukopenia was found among them. This study suggests long-term low dose oral MTX may have a steroid-sparing effect in steroid-dependent asthmatic patients. Their adverse effects were mild and transient.
Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi 1992 Nov
PMID:[Long term and low dose treatment with methotrexate in corticosteroid-dependent asthma--two-year clinical experience]. 134 43

To evaluate the effect of a combination of corticosteroid and beta-2 bronchodilator on acute, young, wheezing patients, a total of 80 patients, ages below 36 months who were hospitalized for this condition during the period November 1988 to March 1990 were studied. They were divided into three groups. Group A consisted of 29 cases, under 12 months old, and treated with hydrocortisone and procaterol; Group B included 23 cases, between 12 and 36 months old, treated as in Group A; Group C, of 28 cases younger than 12 months, received neither drug. The clinical severity scores for Group B were significantly more improved than Group A on days 4 and 5 (p less than 0.05 and p less than 0.05, respectively), and better than that of Group C on days 3, 4, and 5 (p less than 0.05, 0.005, and 0.05, respectively). No significant difference was found between Group A and C from days 1 to 5. The previous wheezy coughing episodes were significantly more frequent in Group B than in Groups A and C (p less than 0.05). Two-thirds of the quick responders to hydrocortisone and procaterol were 12 months old or older. The personal and family allergic history, serum IgE level, and total eosinophil count could not be used as parameter to predict responsiveness to the combined therapy of hydrocortisone and procaterol.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:Clinical trial of corticosteroid and beta-2 bronchodilator in acute wheezing infants. 168 65

During a 2-year period from January 1988 to December 1989, 125 patients (68 boys, 57 girls), aged 30 days to 9 years, were diagnosed as rotavirus gastroenteritis at this hospital. Diagnosis was made by identification of the rotavirus antigen in stool samples by latex agglutination assay. Ninety-nine (79.2%) of them were under 2 years of age. The seasonal peak in incidence was from January to March. The most common clinical characteristics were watery diarrhea (100%), followed by vomiting (68.8%), fever (68.0%), cough (42.4%), rhinorrhea (17.6%), convulsions (6.4%) and moderate to severe dehydration (1.6%). Fecal occult blood was positive in 4 patients and fecal leukocytes were positive in one patient. Stool cultures revealed concomitant infections with enteropathogenic Escherichia coli in 4 patients. Of the 106 patients who underwent serum electrolyte examinations, serum sodium concentrations ranged from 135-145 meq/L in 81.9% (86/106) and serum potassium concentrations ranged from 3.5-5.0 meq/L in 86.8% (92/106). Leukocyte counts greater than 15,000/mm3 were found in 10.8% (13/120) of the patients. All 125 patients recovered from the diarrheal illness on follow-up. Our results showed a different seasonal distribution of this disease from that of a previous observation between 1983-1984 in Taipei City and provides original clinical information on rotavirus gastroenteritis in children living in an area of Taipei County. Using the simple and rapid latex agglutination assay, we can make early diagnosis of rotavirus gastroenteritis. Thus, early treatment and early isolation of patients to prevent nosocomial infection among hospitalized patients is possible.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:Rotavirus gastroenteritis in children: a clinical study of 125 patients in Hsin-Tien area. 206 88

This report describes the clinical, roentgenologic, pathologic, and virologic findings in a 2 years and ten months old girl who died from a severe pneumonia. Initially, the patient presented with fever and cough for 2 days. Physically, the patient appeared lethargic, and breathing sounds revealed diffuse rales and wheezing. Hemogram showed mild leukocytosis and lymphocyte predominant. Chest X ray revealed diffuse interstitial infiltration of the right upper lung, left upper and left lower lung field. Bacteria infection was first impressed. Although treated with several antibiotics (ampicillin, cefuroxime, amikacin, penicillin, cephazolin, imipenem and vancomycin) in three different hospitals, the patient's condition went downhill and the patient died 2 weeks later. Finally, adenoviurs type 3 was isolated from sputum specimen taken before death and necropsy lung tissue. The lung pathology showed diffuse necrotizing inflammation with fibrinopurulent exudate, and eosinophilic intranuclear inclusion bodies were also noted in the alveolar cells. These data proved the diagnosis of adenovirus pneumonia. This case adds to the evidence that adenovirus type 3 infection during childhood may cause fatal disease.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:A fatal case of viral pneumonia in a child infected with adenovirus type 3. 227 28

Pulmonary plasma cell granuloma is very rare in pediatric field. Most of them are asymptomatic, and are usually found to have lung tumor accidentally by chest X-ray examination. The granuloma is characterized by the proliferation of plasma cells along with other mesenchymal elements. We report a case of 10-year-old boy who suffered from dry cough, pale face and body weight loss for a long time. Chest X-ray and CT scan revealed a lung tumor which was proved to be plasma cell granuloma after wedge biopsy. He was regularly followed up at OPD with stationary status. He may receive surgical resection in future.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:[Pulmonary plasma cell granuloma: report of one case]. 263 1

A case of double aortic arch is reported. The male patient, 11-month-old, had breathed with a constant stridor since his birth and had frequent attacks of respiratory tract infection and dyspnea. The child was admitted because of restlessness, fever, stridor and cough. Dyspnea with cyanosis appeared later, and required intubation and mechanical ventilation. After then, three attempts to extubate the infant were made, but failed. A double aortic arch was suspected by bronchogram, esophagogram, and confirmed by cardiac catheterization. Through a left thoracotomy, the smaller left arch and the ligmentem arteriosum were divided to relieve the obstruction of trachea from the compression of the vascular ring. Postoperative convalescence was normal. Symptoms of double aortic arch vary with the degree of obstruction of the trachea and esophagus, ranging from mild to life-threatening respiratory obstruction and apnea. Inspiratory stridor, dyspnea, and wheezing, which are accentuated with feeding, crying, or respiratory infections, are characteristic clinical findings. The diagnosis is established by aid of an esophagography. Left thoracotomy, with division of the smaller aortic arch, is the only satisfactory treatment.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:[Double aortic arch: report of one case]. 263 8

The bronchoprovocation test has been widely used in diagnosis of bronchial asthma. Forty-eight cases under tentative diagnosis of bronchial asthma, with complaints of cough, shortness of breath, and wheezing, were studied by using histamine and methacholine. Their baseline pulmonary functions were all normal. Among the Fourteen cases, histamine and methacholine provocation tests were both negative in 14 cases (29%) (Group 1). There were 18 cases (37%) of allergic asthmatics with positive challenge to either histamine (2 cases) or methacholine (1 case) or both (15 cases) (Group 2). There were 16 cases (34%) of nonallergic asthmatics with positive challenge to either histamine (2 cases) or methacholine (3 cases) or both (11 cases) (Group 3). In Group 2, the average PD20 FEV1 for methacholine and histamine was 25.8 +/- 8.2 BU and 22.9 +/- 7.1 BU respectively; the average PD25 FEF25-75 for methacholine and histamine was 19.4 +/- 7.0 BU and 21.1 +/- 7.1 BU respectively. The sensitivities, compared between both agents, were nearly the same. In Group 3, the average PD20 FEV1 for methacholine and histamine was 35.1 +/- 9.0 BU and 54.5 +/- 9.6 BU respectively; the average PD25 FEF25-75 for methacholine and histamine was 27.9 +/- 8.6 BU and 50.2 +/- 9.6 BU respectively. Methacholine is more sensitive in detecting airway hyperreactivity in this group. When these two groups of asthmatics were compared, Group 2 patients were more sensitive to challenges with histamine and methacholine (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi 1986 May
PMID:Bronchoprovocation test in the normal and in asthmatics. 354 1

Adenoviral pneumonia, while most common in infancy and young childhood, is rare in school childhood. Here, we report one case, a 13 years old otherwise healthy girl, suffered from fulminating pneumonia caused by adenovirus infection. She had dry cough, pharyngitis, lethargy, myalgia and fever in the beginning. Four days later, the patient became tachypneic, dyspneic and drowsy, and developed hypoxemia and diffuse bilateral infiltrates on chest radiographs. The laboratory data revealed elevated SGOT, CPK and LDH. Adenovirus was isolated from patient's endotracheal suction tube tips. Fortunately, weaning from mechanical ventilation was accomplished on the fifth day of hospitalization, despite of the high fatality rate of adenoviral pneumonia in this age group. The clinical characteristics and therapeutic management of our case are discussed and literatures reviewed.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi
PMID:[Fulminating adenovirus pneumonia: report of one case]. 794 37

Salbutamol in controlled release tablet form was compared to salbutamol in standard tablet form for the management of patients with bronchial asthma. A total of twenty asthmatic patients enrolled in the study were classified into two groups, ten patients each, for a cross-over study. Group 1 received controlled release tablets for a 2 to 3 week period, and were then shifted to standard tablets for another similar period. Group 2 received standard tablets first and was then shifted to controlled release tablets. Patients were required to record symptom scores during therapy, including sleep disturbance, chest tightness, wheezing, cough, sputum production and inhalational bronchodilator use. Measurements of peak expiratory flow rate (PEFR) were also done, as well as record made of side effects experienced. The result showed that a lower symptom score was found in patients receiving controlled release tablets than in patients receiving standard tablets (p < 0.001 for sleep disturbance, p < 0.005 for sputum formation and p < 0.001 for total score). There was a higher PEFR in patients receiving controlled-release tablets than in patients receiving standard tablets (p < 0.001). Side effects with tremor were observed in 30% of both groups of patients with a slightly higher degree in the patients receiving standard tablets (statistically not significant). In conclusion, salbutamol of controlled release tablet form obtains a better therapeutic response than standard tablets in the management of patients with bronchial asthma.
Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi 1993 Aug
PMID:Salbutamol in treatment of bronchial asthma--comparison of controlled release tablet with standard tablet. 798 68


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