• Clinical and Experimental Pediatrics
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• v.46 no.2
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• pp.192-194
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• 2003

A neonate born at 38 gestational weeks was admitted due to generalized tonic-clonic seizure and cyanosis. The neonate was born six days previously at home through normal delivery and the umbilical cord was cut using scissors sterilized in boiling water. The neonate weighed 3,180 g at admission. Physical examination revealed cyanosis, opisthotonus, trismus and reactive muscle spasms. Laboratory exam, brain sonogram and EEG showed no significant abnormal findings. Based on her history and physical examination, the neonate was diagnosed with tetanus and put in an incubator isolated in a quiet, dark room. Treatment with tetanus human immunoglobulin along with antibiotics (penicillin G) were started immediately, and mechanical ventilation, administration of neuromuscular blocking agent and muscle relaxant were also started off. The frequency of seizure episode decreased gradually, and on the 32nd hospital day, mechanical ventilatory support was stopped along with extubation two days later. Thereafter, the neonate was in continuous generalized hypertonic state and showed feeding difficulty, but there was gradual improvement. She was dismissed on the 49th hospital day and is currently under OPD follow-up, doing well with no special problems. Respiratory management is critical to neonatal tetanus. We report here a case of tetanus treated with inhibition of self-respiration, neuromuscular blocker and application of ventilator, and present this method as a useful direction for future treatment of neonatal tetanus.

• Journal of Oral Medicine and Pain
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• v.36 no.2
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• pp.117-121
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• 2011

Tetanus is fatal neurological disease caused by Clostridium tetani on contaminated wound that is characterised by muscle spasm, muscle pain, and autonomic dysfuction. C. tetani exist on contaminated wound frequently that developed clinical tetanus under low oxygen condition. Tetanus have four symptomatic form: generalized, localized, cephalic, and neonatal. The incubation period is about 7 days and mortality is high. The commonest presenting symptom is trismus and other is stiffness of neck and back(opisthotonos), muscle spasm, dysphagia, facial pain, risus sardonicus. Trismus is primary presenting symptom in 50~75% of the cases and this have high possibility of initial visit to dental office. This case report of a patient who visit in our department with trismus as chief complaint.

• The Korean Journal of Physiology and Pharmacology
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• v.11 no.3
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• pp.79-84
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• 2007

Because synaptic refinement of medial nucleus of trapezoid body (MNTB) - lateral superior olive (LSO) synapses is most active during the first postnatal week and the long term depression (LTD) has been suggested as one of its mechanisms, LTD of MNTB-LSO synapses was investigated in neonatal rat brain stem slices with the whole cell voltage clamp technique. In $Mg^{2+}$ free condition, tetanus (10 stimuli at 10 Hz for 2 min) in the current clamp mode induced a robust LTD of isolated D, L-APV-sensitive postsynaptic currents (PSCs) for more than 30 min ($n=6,\;2.4{\pm}0.4%$ of the control), while isolated CNQX-sensitive PSCs were not suppressed ($n=6,\;95.3{\pm}1.6%$). Tetanus also elicited similar LTD in the isolated GABAergic/glycinergic PSCs ($n=6,\;3.6{\pm}0.5%$) and mixed PSCs (GABAergic/glycinergic/glutamatergic) ($n=4,\;2.2{\pm}0.7%$). However, such a strong LTD was not observed in the mixed PSCs when 10 mM EGTA was added in the internal solution (n=10), indicating that postsynaptic $Ca^{2+}$ rise is needed for the strong LTD. This robust LTD might contribute to the active synaptic refinement occurring during the first postnatal week.

• Journal of Preventive Medicine and Public Health
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• v.10 no.1
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• pp.142-149
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• 1977

To use basic data for health planning and evaluation of Kangwha community health project of Yonsei University, a study on death rates and causes of death were investigated in two townships (Naega and Sunwon Myuns) in Kangwha County from April 1, 1975 to March 31, 1977 All death was identified and reported by family health workers who are living in each village and 2 trained public health nurses confirmed the death. The causes of death were investigated by 2 public physicians. Total number of deaths for 2 years was 230 and the followings are brief summary of the study. 1. Age-adjusted crude death rates of study area were 8.69 per 1,000 population in 1975 and 7.18 per 1,000 population in 1976. Age-adjusted crude death rates for male were 9.18 in 1975 and 6.38 in 1976 and for female were 8.33 and 7.80 per 1,000 population 2. Age specific death rate curves by year and sex showed 'U' shapes. 3. Infant and neonatal death rates were 30.08 and 22.56 per 1,000 live births in 1975, and the rates in 1976 were 18.18 and 13.64. 4. The most common cause of death was cerebrovascular disease and average cause specific death rate for the disease was 215.5 per 100,000 population. 5. Four leading causes of death were non-infectious origin; cerebrovascular disease, malignant neoplasms, senility and suicide. Pulmonary tubeculosis and pneumonia occupied 5th and 9th causes of death. 6. Stomach cancer and hepatoma occupied 61.3% of total death due to malignant neoplasms. 7. Most frequent cause of neonatal death was birth injury. Two deaths due to tetanus were found in 1975, but no death due to this disease was found in 1976. 8. About half of deceased received care from physician before death.