Clinical Study of Foreign Body Aspiration in Infants and Children

A clinical study was done on 42 cases of inpatients, who had been admitted for foreign body aspiration form January 1979 to June 1992. We obtained the following results by analysing the records of their treatment during that time. 1) 31(73.8%) of these cases were below the age of 3 years. 25(59.4%) were below the age of 2. The ratio of male to female was 2:1 2) In 23 cases(54.8%) onset of the symptoms and diagnosis was less than 24 hours after aspiration. 3) Most of the cases(83.3%) had a history of foreign body aspiration; 7 other cases did not. 4) The most common symptoms of bronchial foreign bodies were cough, dyspnea and fever, whereas those of laryngotracheal foreign bodies were dyspnea and cough, in that order. 5) Common complications were obstructive emphysema, pneumonia and atelectasis, in that order. These complications were observed more frequently in the cases of vegetable foreign bodies. 6) Chest X-ray at the time of admission showed obstructive emphysema (42.9%) and pneumonia(40.5%). 11 cases(26.2%) were normal. 7) The most comon site of foreign body enlodgement was the right main bronchus(38.1%), and 4 cases(9.5%) were discovered in other bronchial sites. 8) Vegetable foreign bodies occupied 54.8% of the cases, peanuts being the most common.

Diagnostic Value and Relationship of the between Stable Microbubble Rating Test and Shake Test for the Prediction of Neonatal Respiratory Distress Syndrome

Respiratory distress syndrome (RDS) in the newborn infants remains a major cause of mortality and morbidity in the newborn period despite much improvements in neonatal intensive care and artificial ventilatory techniques. Gastric fluid was obtained from 151 patients within 6 hours after delivery. The sensitivity, specificity, and predictive value of the simple shake test (133 cases) and stable microbubble rating (SMR) test (151 cases) were assessed in the diagnosis of RDS, as well as the relation between both tests and RDS. We carried out both tests of on gastric aspirates all newborn who admitted to NICU of Presbyterian Medical Center from June 1991 to August 1992. The results were summarized as follows: 1) Among the total 151 cases, RDS were found in 41 cases(27.2%). 2) RDS occurence rate of the simple shake test was 11/11 in 0 group, 17/26 in +1 group, 8/28 in +2 group, 2/41 in +3 group, and 2/27 in +4 group. RDS occurence rate was high the 0 and +1 group. 3) RDS occurence rate of the SMR test was 4/4 in very weak group, 32/36 in weak group, 1/33 in medium group, and 4/78 in strong group. RDS occurence rate was high in the very weak and weak group. 4) Among the positive group of the SMR test 95 cases, positive group of the shake test were found in 87 cases. Among negative group of the SMR test 38 cases, negative of the shake test were found in 29 cases (correlation coefficient=0.763). 5) Sensitivity of the shake test and SMR test were 70%, 87.8% respectively. Specificity of the shake test and SMR test were 93.3%, 96.4% respectively. Positive predictability were 75.7%, 90% respectively and negative predictability were 87.5%, 95.5% respectively. The shake test, as Well as SMR test, has significant value to diagnosis of the RDS. We predict RDS occurence rate of the SMR test was significantly higher than shake test.

Neurosonographic diagnosis of periventricular-intraventricular hemorrhage in low birth weight infants

Periventricular-intraventricular hemorrhage (PV-IVH)is one of the most important neurologic lesion of the low birth weight infants. Serial neurosonographic exeaminations were performed in 113 low birth weight infants who were admitted to the neonatal intensive care unit of Presbyterian Medical Center from November 1, 1990to July 31, 1991. The results were summarized as follows: 1) The incidence of PV-IVH in the study was 54% 2) According to Papile's grading system of PV-IVH, grade I was 32.8%, grade II was 45.9%, grade IIIwas 11.5% and grade IV was 9.8%. 3) The onset of PV-IVH was within the first 7 days of life in 82%. 4) Poor activity, apnea, bradycardia and hypotension were statistically significant clinical findings associated with PV-IVH(P<0.05). 5) The risk factors associated with PV-IVH were gestational age, birth weight, hyaling membrane disease, patent ductus arteriosus and artifical ventilation. 6) The mortality of PV-IVH was 0% for grade I, 10.7% for grade II,42.9% for grade III and 83.3% for gradeIV.