The general anesthesia experience of deletion 8p syndrome patient: A case report / 대한마취과학회지

A deletion 8p syndrome is a relatively uncommon congenital disease characterized by mental retardation associated with multiple malformation that make anesthetic management a challenge. Anesthetic management of a patient with deletion 8p syndrome may pose a serious problem mainly from difficult tracheal intubation, aspiration complication and cardiac malformation. We experienced a case of 10 year-old boy with a deletion 8p syndrome who underwent appendectomy under the general anesthesia. Intubation was performed by video glidescope after unsuccessful attempt with Macintosh laryngoscope. A high arched palate, short neck, poor patient cooperation due to mental retardation and occasional autistic behaviour made airway management difficult. This case should alert anesthesiologists to the greater difficulties of managing patients with deletion 8p syndrome.

Trends in Epidemiology of Neonatal Sepsis in a Tertiary Center in Korea: A 26-Year Longitudinal Analysis, 1980-2005

There were many reports of longitudinal changes in the causative organisms of neonatal sepsis in Western countries but few in Asia. We aimed to study longitudinal trends in the epidemiology of neonatal sepsis at Seoul National University Children's Hospital (SNUCH), a tertiary center in Korea, and compared the results to previous studies of Western countries. The medical records of all of the neonates who were hospitalized at SNUCH from 1996 to 2005 with positive blood cultures were reviewed. We also compared the findings to previous 16-yr (1980-1995). One hundred and forty-nine organisms were identified in 147 episodes from 134 infants. In comparison with the previous 16-yr studies, there was a decrease in the number of Escherichia coli infections (16.2% vs 8.7%: odds ratio [OR] 0.495; 95% confidence interval [CI], 0.255-0.962; P = 0.035), but an increase in Staphylococcus aureus (16.6% vs 25.5%: OR 1.720; 95% CI, 1.043-2.839; P = 0.033) and fungal infections (3.3% vs 18.7%: OR 6.740; 95% CI, 2.981-15.239; P < 0.001), predominantly caused by Candida species. In conclusion, the incidence of sepsis caused by E. coli decreases, but S. aureus and fungal sepsis increases significantly. Compared with Western studies, the incidence of sepsis caused by S. aureus and fungus has remarkably increased.

The Computerized Measurement for the Radiological Severity of Hallux Valgus / 대한족부족관절학회지

PURPOSE: To study the reliability of intra- and interobserver reliability in angular measurement of hallux valgus deformity by assessing hallux valgus angle (HVA) and the 1st to 2nd intermetatarsal angle (1-2 IMA) through using computerized system. MATERIALS AND METHODS:20 cases of moderate to severe hallux valgus patients were included in this study. With the standing anteroposterior view of foot, the HVA and 1-2 IMA were calculated by computerized measurement system of Infinity cooperation, called phi-view, with its software tools. Using the statistical software program, SPSS (version 12th), we interpreted the results which were measured by two independent observers. RESULTS:In the intraobserver measurement, the HVA of observer A showed reliability (32.5 degrees +/-6.9 and 33.1 degrees +/-6.8)(p005). In the results of observer B, HVAs were measured as 35.7 degrees +/-7.6 and 36.2 degrees +/-7.7, and were not reliable (p>005). 1-2 IMA in observer B was not reliable as well (17.0 degrees +/-0.8 and 20.8 degrees +/-1.5)(p>005). In the interobservers' measurements, the first and the second results of HVA were 3.2 degrees +/-3.6 and 3.1 degrees +/-3.1, reliable within the 95% confidence interval (p005). CONCLUSION: In the angular measurement of the hallux valgus by computerized system, the HVA and 1-2 IMA showed less error range in the interobserver's results, compared with the previous studies about the manual measurement. However, our results failed to show the statistical reliability of intra- and interobserver's measuring. Therefore, even the computerized angular measurements in the severity of hallux valgus require development of the measuring methods and software tools.

A Case of Congenital Intrahepatic Portosystemic Shunt Associated with VSD Detected by Antenatal Sonography and Treated with Four Coil Embolizations and Open Heart Surgery after Birth

A congenital portosystemic shunt is a very rare portosystemic vascular anomaly which leads to jaundice, hypoglycemia, hyperammonemia, liver cirrhosis, hepatic coma, and pulmonary hypertension. Anatomically, portosystemic shunts are divided into intra- and extra- hepatic shunts. Congenital intrahepatic portosystemic shunts are rare anomalies, and the early diagnosis is important to prevent hepatic encephalopathy and hypoglycemia. We report a case of an infant with symptoms of heart failure due to a congenital intrahepatic portosystemic shunt and a ventricular septal defect (VSD), which were treated successfully with four coil embolizations and open heart surgery for the VSD.

A case of congenital vallecular cyst associated with gastroesophageal reflux presenting with stridor, feeding cyanosis, and failure to thrive / 소아과

Vallecular cyst is an uncommon but potentially dangerous condition causing stridor and has been associated with sudden airway obstruction resulting in death due to its anatomical location in neonates. It may also present with various degrees of feeding problems resulting in failure to thrive. When a vallecular cyst is suspected clinically, endoscopic laryngoscopy is necessary to visualize it. Other conditions leading to neonatal stridor such as laryngomalacia and other laryngotracheal abnormalities should be ruled out. Marsupialization with a CO2 laser is the most effective and safest treatment to prevent recurrence. We report a case of a 1-month-old male infant with a vallecular cyst synchronous with gastroesophageal reflux, and failure to thrive. He was referred to our hospital because of hoarseness, inspiratory stridor, feeding-cyanosis, chest retraction and failure to thrive. Diagnostic workup revealed a cyst at the tongue base, suggesting a vallecular cyst. The cyst was removed by laryngomicrosurgery with CO2 laser. After the surgery, the symptoms improved and the body weight increased steadily. We report a successfully treated case of neonatal vallecular cyst with symptoms of upper respiratory obstruction, gastroesophageal reflux, and failure to thrive.

Clinical Manifestations of Ureaplasma urealyticum Colonization in Infants / 대한주산의학회잡지

OBJECTIVE: Ureaplasma urealyticum colonization is a significant cause of fetal and neonatal pneumonia and is associated with the prevalence of bronchopulmonary dysplasia (BPD) in preterm infants. This study was aimed to evaluate the relationship between U. urealyticum colonization and neonatal morbidity. METHODS: We tested 476 infants for U. urealyticum on the first day of life among infants admitted to the neonatal intensive care unit of Bun-dang Seoul National University Hospital from June 2003 to July 2006. Urine and endotracheal aspirates were processed by PCR (polymerase chain reaction) or culture for U. urealyticum colonization. We compared the morbidity in the colonized group with the non-colonized group. RESULTS: The study group consisted ot 136 infants less than 32 weeks of gestational age and 340 infants more than 32 weeks of gestational age. In infants less than 32 weeks of gestational age, 18 (13%) of 136 infants had 1 or more positive specimens by culture or PCR. BPD occurred more in the colonized group than in the non-colonized group (p=0.058) and respiratory distress syndrome (RDS) occurred significantly less in the colonized group (p=0.043). Total WBC counts on the third day of life was significantly increased in the colonized group (p=0.003) and this significance was prominent in the neutrophil fraction (p=0.001). There was no significant relation between U. urealyticum colonization and IgM levels nor C-reactive protein (CRP) level nor U. urealyticum colonization of the mother. Twenty-three(7%) of 340 infants more than 32 weeks of gestational age had 1 or more positive specimens by culture or PCR. BPD didn't occur and RDS didn't decrease significantly in the colonized group (p=0.605). Total IgM levels didn't increase significantly in the colonized group (p < 0.006) but total WBC counts and CRP levels didn't increase significantly in the colonized group. There was no significant relation between U. urealyticum colonization and U. urealyticum colonization of the mother (p=0.21). CONCLUSION: U. urealyticum colonization in infants less than 32 weeks of gestational age was associated with an increased prevalence of BPD and a decreased prevalence of RDS.

Frequency and Etiologies of Hypotension in Extremely Low Birth Weight Infants

PURPOSE:Hypotension is common in extremely low birth weight infants (ELBWI) and the treatment becomes important as the survival rate of ELBWI is increasing. This study is to investigate frequency and etiologies of hypotension in ELBWI. METHODS:40 patients admitted to the NICU of Seoul National University Children's Hospital from September 2004 to June 2006 were included retrospectively. Definition of hypotension was 1) mean arterial blood pressure below 30 mmHg or below the gestational age, 2) decreased urine output or metabolic acidosis, and 3) use of inotropics. Hydrocortisone was used for inotrope-resistant hypotension. Clinical characteristics of patients with hypotension were compared with those of others without hypotension. RESULTS:Mean gestational age and mean birth weight of 40 patients was 26(+6)+/-2(+1) weeks and 787+/-149 g. 20 patients had hypotension. 17 events were within 1 week of postnatal age, 5 from 1 to 2 weeks, and 9 after 2 weeks. The etiologies of hypotension within 1 week were PDA in 12 cases, and bleeding in 4 cases. PDA, post-operative condition, adrenocortical insufficiency, and sepsis were the probable etiologies of hypotension after 2 weeks. Among 12 patients recieved hydrocortisone, 9 responded to hydrocortisone. Patients with hypotension were significantly low in gestational age and birth weight. Incidence of IVH and ROP were significantly high in patients with hypotension. CONCLUSIONS:Hypotension was frequent in ELBWI and the etiologies of hypotension were various according to postnatal ages. Significant proportion of hypotension was inotrope-resistant in ELBWI. Further studies about etiologies are in need with reference of this study.

Perinatal Outcome in Preterm Infants with Abnormal Umbilical Artery Doppler Results : Emphasizing on Early Onset Thrombocytopenia and its Risk Factors

PURPOSE:Umbilical artery Doppler study is a commonly used non-invasive tool in high risk pregnancies because of its good correlation with the degree of placental insufficiency. We analyzed hematologic profiles and perinatal outcome of preterm infants with abnormal umbilical artery Doppler results and the risk factors of early onset thrombocytopenia. METHODS:We retrospectively reviewed the medical records of preterm infants under 35 weeks of gestational age at birth who were admitted to the neonatal intensive care unit of Seoul National University Children's Hospital from January 1, 2002 through December 31, 2004, and whose mothers had undergone umbilical artery Doppler studies within 5 days before delivery. Sixty two neonates were divided into three groups; the 1st group was defined as the patients with normal umbilical artery (UA) systolic/diastolic (S/D) ratio, the 2nd group, with increased UA S/D ratio above 95 percentile, and the 3rd, with absent or reversed end-diastolic flow (AREDF). RESULTS:Mean nucleated red blood cell (nRBC) counts per 100 white blood cells (WBCs) were 14.2 (0-150), 91.0 (0-262), 301.4 (6-884) (P<0.001), mean WBC counts were 10.8 (0- 34.1), 9.2(3.4-23.9), 5.9(0.5-15.2) (x1,000/mm(3)) (P=0.007), and mean platelet counts were 215.5+/-69.2, 185.9+/-96.7, 100.2+/-50.3 (x1,000/mL) (

Diagnostic classification and clinical aspects of floppy infants in the neonatal and pediatric intensive care units / 소아과

PURPOSE: The purpose of this study is to make a diagnostic classification and discuss a diagnostic strategy of floppy infants by investigating clinical, neurological, electrophysiological, and genetic analysis of infants admitted to intensive care units with the complaint of hypotonia. METHODS: A retrospective study was performed from Jan. 1993 to Dec. 2005 in neonatal and pediatric intensive care units of Seoul National University Children's Hospital. Clinical features and all tests related to hypotonia were investigated. RESULTS: There were 21 cases of floppy infants admitted to intensive care units. Final diagnosis was classified as centra (7 cases[33.3 percent]), peripheral (11 cases [52.4 percent]), and unspecified (3 cases [14.3 percent]). Among the central group, three patients were diagnosed as hypoxic ischemic encephalopathy, two patients as Prader-Willi syndrome, one patient as chromosomal disorder, and one patient as transient hypotonia. Among the peripheral group, four patients were diagnosed as myotubular myopathy, three patients as SMA type 1, two patients as congenital myotonic dystrophy, one patient as congenital muscular dystrophy, and one as unspecified motor-neuron disease. Motor power was above grade 3 on average, and deep tendon reflex was brisk in the central group. Among investigations, electromyography showed 66 percent sensitivity in the peripheral group, and muscle biopsy was all diagnostic in the peripheral group. Brain image was diagnostic in the central group, and Prader-Willi FISH or karyotyping was helpful in diagnosis in central group. Morbidity and mortality was more severe in the peripheral group CONCLUSION: Classification of diagnosis by clinical characteristics in this study, and application of investigations step by step, may provide an effective diagnostic strategy.

Recent outcome of extremely low birth weight infants: The use of CRIB(clinical risk index for babies) II score for analyzing the survival rate / 소아과

PURPOSE: The survival rate of infants weighing less than 1,000 g at birth(extremely low birth weight infants, ELBWI) has increased due to recent advances in perinatal and neonatal intensive care. The purpose of this study was to evaluate the survival rates of ELBWI born at Seoul National University Hospital during the last six years. METHODS: A total of 99 infants were divided into three groups(period I : 2000 to 2001, period II: 2002 to 2003, period III: 2004 to 2005) based on date of birth. We compared the survival rate of ELBWI over the three periods, using CRIB II score for adjustment for clinical severity. RESULTS: Overall survival rate of ELBWI was 74.7 percent. The survival rate of ELBWI increased over the three periods(period I: 60.7 percent, period II : 73.3 percent, period III: 85.3 percent). The threshold of viability(defined as survival of at least 50 percent of infants) was 25 weeks of gestation and 600 g at birth. The birth weight-specific survival rates increased considerably over the three periods for infants < 750 g at birth(period I: 10 percent, period II: 46.2 percent, period III: 70.6 percent). The survival rates of ELBWI over the three periods increased much remarkably after adjustment for clinical severity by CRIB II score. CONCLUSION: In our institution, survival rates of ELBWI during the last six years continued to improve, particularly for infants weighing < 750 g at birth. This increase in survival rates was not associated with the clinical severity of ELBWI.

Influence of Lens Factor and Effect of Selected Cataract Extraction on Acute Angle-Closure Glaucoma

PURPOSE: To analyze the affecting factor of lens in pathogenesis of acute primary angle-closure glaucoma (APACG) and the effect of selected cataract extraction with intraocular lens (IOL) implantation. METHODS: A survey was conducted on 25 eyes of 21 patients with acute angle-closure glaucoma accompanied by senile cataract against 21 eyes of 16 age-matched normal persons. Biometric measurements were made in both groups in order to analyze an affecting factor of lens in APACG. Before and after selected cataract extraction, other clinical findings were also evaluated. RESULTS: Biometric measurements such as anterior chamber depth (ACD), lens thickness (LT), ACD/axial length (AXL), LT/AXL, and relative lens position (RLP) were significantly larger for the 25 eyes of the 21 patients with APACG than the 21 eyes of the 16 age-matched normal persons (P<0.05). After selecting cataract extraction with IOL implantation, improved biometric measurements and clinical findings revealed the effectiveness of that operation. CONCLUSIONS: Selected cataract extraction with IOL implantation could be successful as primary surgery in APACG accompanied by senile cataract over intraocular pressure control and visual acuity improvement for lens factor removal of APACG.

Subacute Sclerosing Panencephalitis: Clinical Experience of 6 Cases

PURPOSE: Subacute sclerosing panencephalitis(SSPE) is a severe and usually fatal neurodegenerative disorder of childhood and adolescence. The etiology is related to previous measles infection especially during the first 2 years of life. Since recent measles epidemics in Korea may increase the late risk of SSPE, the authors investigated the clinical characteristics of SSPE focusing on brain MRI. METHODS: Six cases(4 males, 2 females) of SSPE patients were retrospectively reviewed for clinical, EEG, laboratory and brain MRI findings. RESULTS: Four of 6 had a history of measles infection in the first year of life. Clinical manifestations were as follows:myoclonus(6), falling(4), ataxia(4), dysarthria(3), seizures (2), involuntary movements(2), tremor(2), head drop(1), sleep disturbance(1). In all cases, CSF IgG, CSF IgG/albumin ratio, and CSF/serum IgG index increased, oligoclonal bands were positive, and CSF antimeasles antibodies were positive. Frontal high amplitude sigma activities and anteriorly-accentuated multifocal epileptiform discharges were noted on EEG. Brain MRI revealed T2-weighted high signal intensity of the deep white matter. CONCLUSION: The diagnosis of SSPE depends on characteristic clinical features and elevation of measles antibodies in CSF, supported by others including EEG, CSF and brain MRI findings. We hope the clinical characteristics we mentioned may be useful for the early diagnosis and active management of SSPE in Korea.

Predictors of Clinical Outcome in the Newborns of Persistent Pulmonary Hypertension Treated with Inhaled Nitric Oxide

PURPOSE: Inhaled nitric oxide (iNO) has been known to improve oxygenation in newborns with persistent pulmonary hypertension (PPHN). This study was performed to evaluate the predictors of clinical outcome in the newborn infants with PPHN treated with iNO. METHODS: Between September 1998 and August 2002, 23 newborn infants with PPHN treated with iNO were enrolled in this study. Reduction of oxygenation index (OI) and AaDO2 to 30% or more were defined as clinical response. Accoding to the response time within or after 12 hours, the clinical response was sub-categorized as early or delayed response, respectively. RESULTS: The mean gestational age and birth weight of 23 newborn infants were 36.7+/-4.4 weeks and 2,644+/-907 g. The mean baseline OI and AaDO2 were 22.20+/-13.63 and 477.16+/-127.96. There were ten non-responsders, eight early responsders and five delayed responders. Eleven neonates showed sustained response for 24 hours. The mean AaDO2, and PaO2 were decreased after 12 hours (P<0.05), while there was no difference in oxygenation index, arteral pH and PaCO2. The mortality rates of non-responders or not- sustained responders were higher than those of responders or sustained responders (P< 0.05). The birth weight of death group was lower than that of survival group and AaDO2, and OI at 12 hours after iNO therapy in survival group were lower than those in death group. CONCLUSION: Predictors of the clinical outcome of iNO therapy were clinical response patterns after iNO therapy, time taken until clinical response, duration of response and change of oxygenation at 12 hours after iNO therapy.

Predictors of Clinical Outcome in the Newborns of Persistent Pulmonary Hypertension Treated with Inhaled Nitric Oxide

PURPOSE: Inhaled nitric oxide (iNO) has been known to improve oxygenation in newborns with persistent pulmonary hypertension (PPHN). This study was performed to evaluate the predictors of clinical outcome in the newborn infants with PPHN treated with iNO. METHODS: Between September 1998 and August 2002, 23 newborn infants with PPHN treated with iNO were enrolled in this study. Reduction of oxygenation index (OI) and AaDO2 to 30% or more were defined as clinical response. Accoding to the response time within or after 12 hours, the clinical response was sub-categorized as early or delayed response, respectively. RESULTS: The mean gestational age and birth weight of 23 newborn infants were 36.7+/-4.4 weeks and 2,644+/-907 g. The mean baseline OI and AaDO2 were 22.20+/-13.63 and 477.16+/-127.96. There were ten non-responsders, eight early responsders and five delayed responders. Eleven neonates showed sustained response for 24 hours. The mean AaDO2, and PaO2 were decreased after 12 hours (P<0.05), while there was no difference in oxygenation index, arteral pH and PaCO2. The mortality rates of non-responders or not- sustained responders were higher than those of responders or sustained responders (P< 0.05). The birth weight of death group was lower than that of survival group and AaDO2, and OI at 12 hours after iNO therapy in survival group were lower than those in death group. CONCLUSION: Predictors of the clinical outcome of iNO therapy were clinical response patterns after iNO therapy, time taken until clinical response, duration of response and change of oxygenation at 12 hours after iNO therapy.

Treatment of B-cell Acute Lymphoblastic Leukemia and B-cell Lymphoma / 대한소아혈액종양학회지

PURPOSE: We report here the improved survival rate of B-cell acute lymphoblstic leukemia (B-ALL) and B-cell non-Hodgkin's lymphoma (B-NHL) treated with a short, intensive multiagent chemotherapy and the treatment related toxicities and complications. METHODS: From Oct. 1997 to Apr. 2002, 10 patients were enrolled. Patients were classified into three groups (Group A, B, C) according to tumor burden and were treated with CCG 5961, UKCCSG 9600, and LMB96 protocol. Induction chemotherapy included cyclophsophamide, vincristine, prednisolone, doxorubicin and high dose (HD) methotrexate (COPADM). Consolidation chemotherapy included HD methotrexate, HD cytarabine and etoposide (CYM; group B, CYVE; group C). In one patient, HD chemotherapy with stem cell rescue was used because residual disease was detected after consolidation chemotheapy. RESULTS: Four patients were B-ALL and six patients were B-NHL (A; 1, B; 2, C; 7). Regimen was changed in 1 patient because of residual disease (B--

A Study for Incidence of Childhood Leukemia in Kyongnam Province, Korea / 대한소아혈액종양학회지

PURPOSE: Of the cancers in childhood, leukemia is the most frequent one. For the desirable control of childhood leukemia, the basic data for the incidence has a great importance. The authors made a report about the incidence of leukemia in childhood, which analyzed the data from 126 cases in Kyongnam province, Korea, during 1991~1995. METHODS: The data were obtained from 126 new cases of childhood leukemia who had been living in the Kyongnam province and were diagnosed at the 26 university hospitals or general hospitals in the Kyongnam area and other cities from 1991 to 1995. RESULTS: The age-and-sex adjusted annual incidence rate per 100,000 population during 1991~1995 varied from 1.82 to 2.86, and cumulative annual incidence rate was 2.41 (male 2.26 and female 2.57 respectively). Male to female sex ratio was 1:1 in total cases. By the major types of childhood leukemia, the cases were composed of acute lymphocytic leukemia 70.6%, acute myelocytic leukemia 26.9% and chronic myelocytic leukemia 2.5%. The cumulative annual incidence rate per 100,000 population (crude rate) during 1991~1995 were 2.77 in Ulsan city, 2.62 in Chinju city and 2.34 in the whole area of Kyongnam province. CONCLUSION: It was concluded that the age-and-sex adjusted annual incidence rate per 100,000 of childhood in Kyongnam province was 2.41, which was lower than that in Pusan city in the same period. And, there was no significant difference of the cumulative annual incidence rate between Ulsan area and Chinju area in the same period.

Partial purification of protein farnesyl cysteine carboxyl methyltransferase from bovine brain

C-terminal farnesyl cysteine carboxyl methylation has been known to be the last step in the post-translational modification processes of several important signal transduction proteins in eukaryotes including ras related GTP binding proteins and the gamma-subunit of heterotrimeric G proteins. Protein farnesyl cysteine carboxyl methyltransferase (PFCCMT; EC, 2.1.1.100) catalyzing the reaction is well characterized as being stimulated by guanosine 5'-O-(3-thiotriphosphate) (GTP gamma S) and suppressed by N-acetyl-S-farnesyl-L-cysteine (AFC). As an initial step to understand the physiological significance of the process, we attempted to purify the enzyme, which was partially purified 130-fold (specific activity, 143 pmol of methyl group transferred/min/mg of protein) with yield of 1.8% after purification by fast protein liquid chromatography (FPLC) on a Superdex 75 column. The enzyme was further purified with non denaturing polyacrylamide gel electrophoresis (ND-PAGE) and sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). The molecular weight of PFCCMT was determined to be about 30 kDa based on Superdex 75 FPLC as well as photoaffinity labelling with S-adenosyl-L-[methyl-3H] methionine ([methyl-3H]SAM). The partially purified enzyme (Superdex 75 eluate) was found to be characteristically affected by GTP gamma S, being activated about 40-fold in 2 mM, in contrast to ATP which did not show any effect on enzyme activity. Meanwhile, the enzyme was found to be markedly inhibited by AFC, reaching 0 activity in 2 mM. These observations strongly suggested that the partially purified enzyme was PFCCMT.

Effect of Low Lactose Special Formula (MF-1)for the Treatment of Acute Diarrhea in Infants / 영남의대학술지

To evaluate the effect of low lactose special formula (MF-1) for the treatment of acute diarrhea, we studied thirty nine infants who were admitted with acute diarrhea to the Department of Pediatics, Yeungnam University Hospital. 39 infants of under 6 months of age who had been fed on formula feeds were randomly allocated to receive either a diluted regular formula milk or a low lactose special formula. Each infant received intravenous rehydration during fasting for 6-12 hou s. Group 1 (n=15) was fed half strength of regular. formula (80-100cc/kg/day) for the first 24 hours, three quarters strength formula (100-120cc/ kg/day) for the next 24 hours, and continued feeding with the full strength regular formula milk. Group 2 (n= 24), who fed the same amount of milk as Group 1, continued feeding with the full strength low lactose special formula from the start of feeding. Male to female sex ratio was 1.6 to 1. The characteristics of infants on admission were comparable in the age, the duration of diarrhea and the stool frequency before admission, the degree of dehydration. There were no significant differences in the duration of hospitalization, changes in stool weight and stool frequency after admission between two groups.(p>0.05) The Body weight and skin fold thickness were increased in group 2 who fed low lactose formula, but those who fed diluted regular formula showed reduction of body weight and skin fold thickness (64.251.48 vs -11.452.2g, 0.60.8mm vs -0.10.3mm

Histopathologic Change and Clinical Use of Glycerin-stored Corneosclera

Corneoscleras were stored in 4 degrees C, 98% glycerin and were examined histologically at various storage periods. There were no remarkable pathologic changes in the stainability or arrangement of collagen fibers in stored corneoscleras from one month to 33 months. 12 eyes of 12 patients underwent tectonic or therapeutic keratoplasty with them. The integrity of the globe was maintained in all cases and vision improved in three cases without the second operation. One case achieved visual improvement by optical keratoplasty. In four cases, the vision may be improved by the second operation, such as optical keratoplasty and keratoprosthesis.

The Effect of the Local Anesthetic Cream in Alleviating Pain form Vaccination / 영남의대학술지

To evaluate the effect of a new topical anesthetic cream (EMLA : Eutectic mixture of local anesthetics) on reducing pain associated with DPT vaccination, we conducted a clinical observation on eighty infants who were brought to well baby clinic of Yeungnam University Hospital for DPT vaccination. 80 Infants, who were between 2 months and 8 months in age, were divided into two groups. EMLA treated group and control group. Male to femle sex ratio was 1.4 to 1. EMLA cream was applied 60 minutes before DPT vaccination, the effect of reducing pain was assessed by using McGrath's face scale, Oucher pain scale and modified behavioral pain scale (MBPS) and also evaluated by measuring the duration and time of crying (the time of the first crying after iniection, duration of the first crying, total duration of crying). The scores of those scales were lower in EMLA treated group than in control group significantly (P<0.01 in McGrath's face scale. MBPS and p<0.05 in Oucher pain scale). There was no difference in the time of the first crying after vaccination in both groups. The duration of the first crying was shorter in EMLA treated group than control group of crying was also shorter in EMLA treated group (EMLA treated group 9.0±12.5 sec, p<0.05). Transient skin erythema was noted in 5 infants after EMLA application, but no other adverse effects were observed. We conclude that the application of EMLA cream before vaccination seems to be an effective and safe way to reduce the pain from vaccination, but it takes usually 60 minutes to get the anesthetic effect of EMLA and it is expensive, so EMLA cream can not be recommended in routine vaccination in infants now.