Discovering hidden information in biosignals from patients using artificial intelligence / 대한마취과학회지

Biosignals such as electrocardiogram or photoplethysmogram are widely used for determining and monitoring the medical condition of patients. It was recently discovered that more information could be gathered from biosignals by applying artificial intelligence (AI). At present, one of the most impactful advancements in AI is deep learning. Deep learning-based models can extract important features from raw data without feature engineering by humans, provided the amount of data is sufficient. This AI-enabled feature presents opportunities to obtain latent information that may be used as a digital biomarker for detecting or predicting a clinical outcome or event without further invasive evaluation. However, the black box model of deep learning is difficult to understand for clinicians familiar with a conventional method of analysis of biosignals. A basic knowledge of AI and machine learning is required for the clinicians to properly interpret the extracted information and to adopt it in clinical practice. This review covers the basics of AI and machine learning, and the feasibility of their application to real-life situations by clinicians in the near future.

Enhancement of Platelet Aggregation by Ursolic Acid and Oleanolic Acid

The pentacyclic triterpenoid ursolic acid (UA) and its isomer oleanolic acid (OA) are ubiquitous in food and plant medicine, and thus are easily exposed to the population through natural contact or intentional use. Although they have diverse health benefits, reported cardiovascular protective activity is contentious. In this study, the effect of UA and OA on platelet aggregation was examined on the basis that alteration of platelet activity is a potential process contributing to cardiovascular events. Treatment of UA enhanced platelet aggregation induced by thrombin or ADP, which was concentration-dependent in a range of 5-50 microM. Quite comparable results were obtained with OA, in which OA-treated platelets also exhibited an exaggerated response to either thrombin or ADP. UA treatment potentiated aggregation of whole blood, while OA failed to increase aggregation by thrombin. UA and OA did not affect plasma coagulation assessed by measuring prothrombin time and activated partial thromboplastin time. These results indicate that both UA and OA are capable of making platelets susceptible to aggregatory stimuli, and platelets rather than clotting factors are the primary target of them in proaggregatory activity. These compounds need to be used with caution, especially in the population with a predisposition to cardiovascular events.

An Epidemiological Survey on Serological Diagnosis of Legionnella Infection in Seoul, Korea

Serological investigation of antibodies to Legionella species in 1,802 sera collected in seoul was conducted with indirect fluorescent antibody assay (IFA). With an antibody titer of > or =1:128 to be positive, 17 (0.9%) of these sera were positive and 6 (35.3%) of positive sera showed cross-reactions between Legionella species. The number of sera with antibody titers of > or =1:128 to L. pneumophila serogroup 1, L. pneumophila serogroup 4, L. pneumophila serogroup 5, L. bozemanii, L. micdadei, L. anisa were 6 (35.3%), 3 (17.6%), 3 (17.6%), 2 (11.8%), 1 (5.9%), 2 (11.8%) respectively. Among 17 positive sera, 10 (58.8%) sera were from male and 7 (41.2%) from female. An average age of them was 68.9 (+/-15.3; 27~89). Except for one serum, 16 (94.1%) of positive sera were from those older than 50 years old. The result suggests that the aged over 50 years old should be more careful of Legionella infection.

A Follow-Up Study of Cow's Milk-Sensitive Enteropathy: Clinical Outcome / 대한소아소화기영양학회지

PURPOSE: Following up the cases of cow's milk-sensitive enteropathy (CMSE), We observed the development of clinical tolerance with cow's milk and other foods. We investigated the clinical outcome of CMSE. METHODS: We reviewed the clinical records of patients who had been admitted and diagnosed as CMSE by responses to cow's milk challenge and elimination test and the findings of small intestinal biopsy at Department of Pediatrics, Taegu Catholic University Hospital from March 1992 to March 1997. All of them were being fed with protein hydrolysate before 6 months old, and tried cow's milk and other foods challenge test at following each two month. Twenty-one cases of them returned to be followed. The age at admission was 30.7+/-8.8 (18~47) days old and at survey was 43.4+/-23.7 (16~84) months old. RESULTS: 1) Although the body weight at birth of the patients was 25~75 percentile, all on admission was below 3 percentile. The body weight on interview was 25~75 percentile. 2) The development of clinical tolerance in cow's milk was observed at 16~24 months of age and the tolerance rate was 61% at 12 months of age, 90% at 16 months of age. The development of clinical tolerance in other foods was observed at 10~24 months of age and the tolerance rate was 33% at 12 months of age, 80% at 18 months of age. 3) Adverse reactions after challenge test with cow's milk were observed at 19 cases, manifestated as vomiting (31%), diarrhea (31%), irritability or lethargy (21%), skin rash (10%), and abdominal distention (5%). 4) Comparing serum IgE and milk RAST positive group on admission (5 cases) and negative group on admission (16 cases), there was no significant difference at the age of tolerance in cow's milk (p>0.05), the age of tolerance in other foods (p>0.05), allergy history in family, and the incidence of other allergic diseases. 5) The history of family allergy was observed in 3 cases (14%) in 21 patients and 3 cases (14%) showed rhinitis, urticaria or asthma through a follow-up interview. CONCLUSION: The development of clinical tolerance in cow's and other foods was sharply increased at 12 months of age and most of all tolerated within 24 months of age. CMSE is a temporary disorder of infancy.

The Three Types of Clinical Manifestation of Cow's Milk Allergy with Predominantly Intestinal Symptoms / 대한소아소화기영양학회지

PURPOSE: During the first year of life, cow's milk protein is the major offender causing food allergy. Cow's milk allergy (CMA) affects 2~7% of infants, of which approximately one-half show predominantly gastrointestinal symptoms. We studied the clinical types of cow's milk allergy with predominantly gastrointestinal symptoms (CMA-GI) of childhood. METHODS: The retrospective study was performed on 30 (male 22, female 8) patients who had diagnosed as CMA-GI during 2 years and 3 months from March 1995 to June 1997. RESULTS: 1) Children with CMA-GI presented in the three types of clinical manifestation on the basis of time to reaction to milk ingestion: Quick (Q) onset (5 cases), Slow (S) onset (20 cases), Quick & Slow (Q&S) (5 cases). 2) Age on admission of the three groups was significantly different (p<0.05): (Q onset: 81.4+/-67.1 days, S onset: 31.9+/-12.7 days, Q&S: 366.0+/-65.0 days). Although the body weight at birth was 10~95 percentile in all patients, body weight on admission was different: (Q onset: 10~50 percentile, S onset: below 10 percentile, Q&S: 10~25 percentile). S onset group was significantly different compared with other groups (p<0.05) and 90% of this one was failure to thrive below 3 percentile. 3) Peripheral leukocyte counts were as followings: (Q onset: 5,700~12,300/mm(3), S onset: 10,000~33,400/mm(3), Q&S 5,200~14,900/mm(3)). Slow onset group was significantly different compared with other groups (p<0.05). Serum albumin levels on admission were as followings: (Q onset: 4.2+/-0.4g/dl, S onset: 3.0+/- 0.3g/dl, Q&S: 4.0+/-0.3g/dl). S onset froup was significantly different compared with other groups(p<0.05) and 85% of this one was below 3.5g/dl. 4) Although morphometrical analysis on small intestinal mucosa did not show enteropathy in Q onset and Q&S groups, all cases of S onset revealed enteropathy: 45% of this one showed subtotal villous atrophy, 55% showed partial villous atrophy. 5) Allergic reaction test to other foods was not performed in S onset group because of ethical problem and high risk in general condition. In Q onset group, allergic reaction to one or two other foods: soy formula, weaning formula and eggs. Q&S group revealed allergic reactions to several foods or to most of all foods except protein hydrolysate formula: eggs, potatos, some kinds of sea food, apples, carrots, beef and chicken. 6) Serum IgE level, peripheral eosinophil counts, milk RAST, soy RAST, skin test were not significantly different among groups. CONCLUSION: CMA-GI may present in three clinical ways on the basis of time to reaction to milk ingestion, typical clinical findings and morphologic changes in the small bowel mucosal biopsy specimens. This clinical subdivision might be helpful in diagnostic and therapeutic approaches in CMA-GI. Early suspicion is mandatory especially in S onset type because of high risks with malnutrition and enteropathy.

Short-term Result of Radiofrequency Catheter Ablation in Pediatirc Patients with Paroxysmal Tachycardia

PURPOSE: To find out the efficacy, safety and early complication of radiofrequency catheter ablation(RFCA) in pediatric patients with paroxysmal tachycardia, we compared short-term results of RFCA in pediatric patients to adult patients. METHODS: We studied 25 patients(11 pediatric patients, 14 adult patients), who underwent RFCA due to paroxysmal supraventricular tachycardia(PSVT) or idiopathic ventricular tachycardia(VT) from November 1997 to August 1998. We evaluated PSVT or idiopathic VT mechanism and compared total procedure times, total energy durations and complication rates between pediatric patients and adult patients. RESULTS: Among the 25 patients, the mechanisms of tachycardia were atrioventricular reentrant tachycardias in 14 patients, atrioventricular nodal reentrant in 10 patients and idiopathic left ventricular in 1 patient. Among the 11 pediatric patients, atrioventricular reentrant was found in 9 patients, atrioventricular nodal reentrant in 1 patient and idiopathic left ventricular in 1 patient. while among the 14 adult patients, atrioventricular reentrant was found in 5 patients and atrioventricular nodal reentrant in 9 patients. Total procedure time was 190+/-52 minutes in pediatric patients and 161+/-49 minutes in adult patients(P=0.17). Total energy duration was 244+/-223 seconds in pediatric patients and 187+/-122 seconds in adult patients(P=0.45). There were no major complications related to RFCA except minor hematomas at puncture sites. CONCLUSION: Considering the total procedure time, total energy duration and complication rates, there were no significant differences between pediatric patients and adult patients. RFCA showed relatively high success rate and one recurrence after initial success. Thus, we consider RFCA is as a good therapeutic modality which can cure tachycardia, especially PSVT.

Clinical Observations of Coarctation of the Aorta

PURPOSE: Due to controveries surrounding in the incidence of coarctation of aorta which reports previously stated rare among Orientals, we evaluated clinical characteristics, natural courses of coarctation of aorta and effects of different surgical modalities. METHODS: Medical records of 51 patients with coarctation of aorta, diagnosed by 2-dimensional echocardiography in Kyungpook University Hospital Pediatric Cardiac Laboratory from June 1985 to August 1997, were retrospectively reviewed. RESULTS: This study involved 32 male and 19 female patients(male-female ratio 1.7 : 1) aged 12 days to 11 years and 8 months(13 newborns, 32 infants and 6 children over 1 year of age). The coarctation patients consisted of 1.2% of all congenital heart disease patients diagnosed by cross-sectional echocardiography during study periods. Of the accompanying cardiac defects, patent ductus arteriosus(56.9%) and ventricular septal defect(49.0%) were the most common. Congestive heart failure was encountered in 35.3% of patients, weak or absent femoral pulse 80.4%, and higher upper limb blood pressure than lower limb 75.6%. Among the types of coarctation, juxtaductal types accounted for 30 cases(58.8%) and tubular hypoplasias 21 cases(41.2%). Preoperative Doppler gradients through the coarctation were significantly decreased(14.0+/-14.3 mmHg) after 3.7+/-3.5 years follow up. Ages at operation, follow-up periods, and residual Doppler systolic gradients through the coarctation according to different surgical methods did not show significant differences except during follow-up periods. CONCLUSION: It is of utmost importance to palpate the pulses and check the blood pressures of upper and lower extremities in diagnosing coarctation of aorta, and there were no significant prognostic differences among different surgical methods after midterm follow-up periods.

Activation of Eosinophil in Cow's Milk Allergy(CMA)-Related Chronic Diarrhea / 소아알레르기및호흡기학회지

PURPOSE: Cow's milk allergy(CMA) is one of common problems during first yearof life. Sometimes it causes chronic intractable diarrhea and serious nutritional problems in young infants. CMA is defined as an immunologically mediated adverse reaction against cow's milk antigens. Eosinophil granules contain cationic proteins, which have been known to be tissue-destructive. Detection of eosinophil-derived granular proteins reflects earlier activation and degranulation or cytolysis of eosinophils and provides evidence of involvement of these cells. The purpose of this study was to investigate the involvement of eosinophils in the mechanism of immunoinflammatory reaction of CMA-related chronic diarrhea. METHODS: The study population included 13 patients, aged from 18 days to 124 days who were admitted with chronic diarrhea and proved to have CMA by challenge test with cow's milk. The activation of eosinophil was evaluated by measurement of serum and urine eosinophil cationic protein(ECP) levels(by CAP, Pharmacia). The measurement were repeated on admission, and before and mean 27 hours after the challenge with cow's milk. RESULTS: 1) Serum and urine ECP levels on admission showed no significant difference from those of age matched controls. 2) During cow's milk challenge, serum ECP level increased from 5.49+/-3.08micorgram/L to 13.6+/-8.3micorgram/L(P<0.005) without significant change in urine ECP level. CONCLUSION: The activation of eosinophil might be one of important immunologic mechanisms of CMA-related chronic diarrhea in young infants.

The Significance of Increased Circulating Intercellular Adhesion Molecule 1 (cICAM-1) in Neonatal Sepsis

PURPOSE: The early and efficient diagnosis of neonatal sepsis still remains a difficult task. Reliable laboratory test is not available yet and treatment is mainly based on the physical appearance of infants. And high number of negative blood cultures in cases of clinically diagnosed sepsis further emphasize the need for a more reliable index for early diagnosis. Intercellular adhesion molecule 1 (ICAM-1) has been known important in various immunological processes early in inflammation, and recently circulating ICAM-1 (cICAM-1) has been detected in serum and supernatant of cytokine-activated endothelial cell cultures. The purpose of our study was to evaluate cICAM-1 as a marker in neonatal sepsis. METHODS: Using enzyme linked immunosorbent assay (ELISA), we measured serial cICAM-1 over the first week of admission in 48 neonates who were admitted at NICU due to clinically suspected sepsis. RESULTS: We found the levels of cICAM-1 on admission in 9 culture proven and 20 clinically dignosed septic neonates (1723.3+/-669.7ng/ml and 994.9+/-358.5ng/ml, respectively) were significantly higher (P<0.001) than those in neonates showing systemic inflammatory signs without evidence of sepsis and healthy controls (380.6+/-235.8ng/ml and 238.8+/-96.6ng/ml, respectively). The cICAM-1 levels on admission in septic neonates with high severity score were higher than those with low severity score (P<0.01). Fatal cases exhibited higher cICAM-1 on admision than did survivals (1710.8+/-634.5ng/ml versus 963.4+/-411.4ng/ml, P<0.0001) and there seemed to be a positive correlation between cICAM-1 levels and mortality. The elevation of cICAM-1 on admission in septic neonates appeared earlier than the rise of c-reactive protein (CRP) above 10mg/L. CONCLUSIONS: The measurement of cICAM-1 on admisson might be useful for the early detection of neonatal sepsis and high cICAM-1 level suggests poor prognosis.

The Significance of Increased Circulating Intercellular Adhesion Molecule 1 (cICAM-1) in Neonatal Sepsis

PURPOSE: The early and efficient diagnosis of neonatal sepsis still remains a difficult task. Reliable laboratory test is not available yet and treatment is mainly based on the physical appearance of infants. And high number of negative blood cultures in cases of clinically diagnosed sepsis further emphasize the need for a more reliable index for early diagnosis. Intercellular adhesion molecule 1 (ICAM-1) has been known important in various immunological processes early in inflammation, and recently circulating ICAM-1 (cICAM-1) has been detected in serum and supernatant of cytokine-activated endothelial cell cultures. The purpose of our study was to evaluate cICAM-1 as a marker in neonatal sepsis. METHODS: Using enzyme linked immunosorbent assay (ELISA), we measured serial cICAM-1 over the first week of admission in 48 neonates who were admitted at NICU due to clinically suspected sepsis. RESULTS: We found the levels of cICAM-1 on admission in 9 culture proven and 20 clinically dignosed septic neonates (1723.3+/-669.7ng/ml and 994.9+/-358.5ng/ml, respectively) were significantly higher (P<0.001) than those in neonates showing systemic inflammatory signs without evidence of sepsis and healthy controls (380.6+/-235.8ng/ml and 238.8+/-96.6ng/ml, respectively). The cICAM-1 levels on admission in septic neonates with high severity score were higher than those with low severity score (P<0.01). Fatal cases exhibited higher cICAM-1 on admision than did survivals (1710.8+/-634.5ng/ml versus 963.4+/-411.4ng/ml, P<0.0001) and there seemed to be a positive correlation between cICAM-1 levels and mortality. The elevation of cICAM-1 on admission in septic neonates appeared earlier than the rise of c-reactive protein (CRP) above 10mg/L. CONCLUSIONS: The measurement of cICAM-1 on admisson might be useful for the early detection of neonatal sepsis and high cICAM-1 level suggests poor prognosis.

A Clinical Evaluation of the Esophagogastroduodenoscopy Studies in Infants and Early Children

PURPOSE: Even though the causes and appearance of upper gastrointestinal tract lesions vary with age, attention has seldomly been focused on the infancy and early childhood. This study aimed to provide, as basic material, the experience of esophagogastroduodenoscopy(EGD) in infants and early children. METHODS: The objects were 66 patients(male 40, female 26) who underwent EGD examination in case of endoscopic indication at department of pediatrics of Taegu Hyosung Catholic University Hospital from March 1993 to February 1996. The scope of study included age distribution, chief complaints, endoscopic findings, final diagnosis. RESULTS: 1) The frequency of age distribution was 31.8% under 12 months, 16.6% in 13-24 months, 7.5% in 25-36 months, 7.5% in 37-48 months, 19.6% in 49-60 months and 16.6% in 61-72 months. The 48.4% of total application was done in children under 24 months. 2) The indications were vomiting(29.4%), epigastric pain(20.0%), melena or hematemesis(20.0%), chronic diarrhea(12.9%), recurrent abdominal pain(8.2%), foreign body ingestion(3.5%), drug intoxication(2.3%), chronic cough(1.1%), generalized edema(1.1%) and diagnosis of Peutz-Jeghers syndrome(1.1%). 3) Endoscopic findings were chronic gastritis or duodenitis(21.2%), gastric or duodenal ulcer(13.6%), acute gastritis or duodenitis(7.5%), acute hemorrhagic gastritis or duodenitis(6.0%), reflux esophagitis(4.5%), pyloric stenosis(4.5%), pseudomembranous esophagitis(1.5%), esophageal varix(1.5%), gastric polyp(1.5%), dilatation of distal esophagus (1.5%), whitish discharge through the duodenum(1.5%) and nonspecific findings(34.8%). 4) Final diagnosis were gastroduodenal mucosal lesions with unidentified underlying diseases(37.8%), protracted diarrhea(16.6%), gastroesophageal reflux disease(4.5%), cyclic vomiting syndrome(4.5%), cow's milk allergy(4.5%), idiopathic hypertrophic pyloric stenosis(4.5%), foreign body removal(4.5%), recurrent abdominal pain syndrome(3.0%), drug intoxication(3.0%), Henoch-Schoenlein purpura(1.5%), Peutz-Jeghers syndrome (1.5%), portal vein thrombosis(1.5%), esophageal web(1.5%), intestinal lymphangiectasia (1.5%), small intestinal hemangioma(1.5%), fungal esophagitis(1.5%) and unidentified underlying disease(6.0%). 5) The practices of EGD in infants and early children were done without serious adverse effects. The occurrence of bradycardia was developed in a newborn case during the procedure and was improved shortly after removal of scopy. CONCLUSIONS: The EGD studies were useful means of identifying the upper gastrointestinal anatomy and pathology in infants and early children with upper gastrointestinal symptoms. The practice of pediatric EGD in infants and early children was done without serious side effects. Pediatric EGD is now an integral part of the practice of pediatric gastroenterology.

A Clinical Evaluation of the Esophagogastroduodenoscopy Studies in Infants and Early Children

PURPOSE: Even though the causes and appearance of upper gastrointestinal tract lesions vary with age, attention has seldomly been focused on the infancy and early childhood. This study aimed to provide, as basic material, the experience of esophagogastroduodenoscopy(EGD) in infants and early children. METHODS: The objects were 66 patients(male 40, female 26) who underwent EGD examination in case of endoscopic indication at department of pediatrics of Taegu Hyosung Catholic University Hospital from March 1993 to February 1996. The scope of study included age distribution, chief complaints, endoscopic findings, final diagnosis. RESULTS: 1) The frequency of age distribution was 31.8% under 12 months, 16.6% in 13-24 months, 7.5% in 25-36 months, 7.5% in 37-48 months, 19.6% in 49-60 months and 16.6% in 61-72 months. The 48.4% of total application was done in children under 24 months. 2) The indications were vomiting(29.4%), epigastric pain(20.0%), melena or hematemesis(20.0%), chronic diarrhea(12.9%), recurrent abdominal pain(8.2%), foreign body ingestion(3.5%), drug intoxication(2.3%), chronic cough(1.1%), generalized edema(1.1%) and diagnosis of Peutz-Jeghers syndrome(1.1%). 3) Endoscopic findings were chronic gastritis or duodenitis(21.2%), gastric or duodenal ulcer(13.6%), acute gastritis or duodenitis(7.5%), acute hemorrhagic gastritis or duodenitis(6.0%), reflux esophagitis(4.5%), pyloric stenosis(4.5%), pseudomembranous esophagitis(1.5%), esophageal varix(1.5%), gastric polyp(1.5%), dilatation of distal esophagus (1.5%), whitish discharge through the duodenum(1.5%) and nonspecific findings(34.8%). 4) Final diagnosis were gastroduodenal mucosal lesions with unidentified underlying diseases(37.8%), protracted diarrhea(16.6%), gastroesophageal reflux disease(4.5%), cyclic vomiting syndrome(4.5%), cow's milk allergy(4.5%), idiopathic hypertrophic pyloric stenosis(4.5%), foreign body removal(4.5%), recurrent abdominal pain syndrome(3.0%), drug intoxication(3.0%), Henoch-Schoenlein purpura(1.5%), Peutz-Jeghers syndrome (1.5%), portal vein thrombosis(1.5%), esophageal web(1.5%), intestinal lymphangiectasia (1.5%), small intestinal hemangioma(1.5%), fungal esophagitis(1.5%) and unidentified underlying disease(6.0%). 5) The practices of EGD in infants and early children were done without serious adverse effects. The occurrence of bradycardia was developed in a newborn case during the procedure and was improved shortly after removal of scopy. CONCLUSIONS: The EGD studies were useful means of identifying the upper gastrointestinal anatomy and pathology in infants and early children with upper gastrointestinal symptoms. The practice of pediatric EGD in infants and early children was done without serious side effects. Pediatric EGD is now an integral part of the practice of pediatric gastroenterology.

A Clinical Evaluation of the Gastrofiberscopy Studies in Children

No abstract available.

A Follow-up Study of Intractable Diarrhea in Early Infancy: Clinical Features of Cow's Milk Allergy and Cow Milk-Sensitive Enteropathy

No abstract available.

Intractable Diarrhea in Early Infancy: Clinical Features on Admission and A Nutritional Management

No abstract available.

Angiodysplasia Involving the Sigmoid Colon in Children

No abstract available.

Congenital Lobar Emphysema

We had experienced a case of congenital lobar emphysema in a 3 months old male infant. Chief symptoms included tachypenea, respiratory difficulty, cyanosis, Chest X-ray or chest CT scan revealed extensive emphysematous changes of the right upper and middle lobes, compression of the right lower lobe and shifted of mediastinum to the left side. This condition was appeared in the absence of infection and foreign body in the bronchus and its failure to respond to conservative treatment. This patient was treated by the right upper and right middle lobes pneumonectomy. A brief review of literature was made.

Statistical observation on neonate

A statistical observation was performed on 13,317 cases of neonates who had been delivered at Taegu Catholic Hospital during the past 3 years from Jan, 1st 1988 to Dec. 31st 1990. The results obtained were as follows: 1) Among 13,317 neonates, the male was 7,234 and the female 6,083, with the sex ratio of male to female being 1.19:1 2) Percentage distribution by birth weight was 5.6% for 2.500gm or less, 3.3% for 4,001gm or more. The mortality rate was 8.4 per 1,000 live births and 61.1% for very low birth weight infants. 57.1% of neonatal death occured within 24 hours after birth and the most common cause of death was prematurity (53.6%). 3) The mean growth data at birth were as following: Weight: 3,253+/-484gm in male, 3,160+/-456gm in female; Height: 50.11+/-2.59cm in male, 49.57+/-2.50cm in female; Head circumference: 33.60+/-1.74cm in male, 33.12+/-1.64cm in female; Chest circumference: 32.83+/-1.83cm in male, 32.41+/-1.75cm in female. 4) Among 13,317 noenates, 352 (2.6%) were under 37 wks and 555 (4.2%) above 42 wks and 92.6% very low birth weight infants under 37 wks. 5) 44.2% of 13,317 neonates, was the highest-density distribution which was between 47.5~52.4cm by length and 3,001~3,500gm by weighing. 6) The admission rate was 13.7% and the causes of admission in order of frequency were neonatal infection (47.9%), premature or low birth weight infant (12.9%), neonatal jaundice (11.3%), asphyxia neonatorum (6.9%), respiratory disress syndrome (5.4%), etc. 7) Among all neonates, 2.2% had neonatal asphyxia (a 1-minute Apgar score of 6 or less). The highest incidence was 19.7% in the breech delivery group by delivery mode and 33.6% in the prematurity by gestational age. 8) The types of delivery in order of frequency were spontaneous vaginal delivery (72.5%), Cesarean section (21.9%), vacuum delivery (5.0%), breech delivery (0.5%) and forceps delivery (0.1%). 9) The incidence of twin babies was 182 (91 pairs), 1.37% of all neonates, 1 pair per 145 neonates. Of all twins, 50.5% were below 2,500gm of birth weight and 20.9% premature. 10) The incidence of neonatal jaundice was 63.0%. Of icteric neonates, 8.2% had pathologic jaundice treated by phototherapy or exchange transfusion. 11) Among all neonates, there were 7,705 cases (57.9%) with high risk factors; the order of frequency was Cesarean section (37.8), meconium stained (13.3%), premature rupture of membranes over 24 hours (12.7%), birth weight 2,500gm or less (9.6%), etc.

A case of collodion baby

This is a rare typical case of collodion baby. The patient is a one-day-old newborn male who has been suffering from the tightly collodion or parchment-like coverings over the entire skin surface with ectropion, eclabion, fixed semiflexion position of the limbs and fissures on the flexual area. The family history was noncontributory with no consanguinity. This patient was desquamated from collodion-like membrane and returned to normal looking skin from the seventh day of life to one month. Diagnosis of collodion baby was established by clinical features and histopathological study. A brief review of literature was made.

A case of Sq2 trisomy

No abstract available.