Rehospitalization for Respiratory Illness in Very Low Birth Weight Infants during the First Year of Life / 소아알레르기및호흡기학회지

PURPOSE: The aims of this study were to investigate the incidence of rehospitalization for very low birth weight (VLBW) infants due to respiratory illness during the first year of life, and to examine the association between rehospitalization with respiratory distress syndrome (RDS) and duration of mechanical ventilation. METHODS: Twenty-three VLBW infants admitted to neonatal intensive care unit (NICU) at Dae-Dong Hospital from January 1996 to December 2002 were studied. Twenty-three of full-term infants born from January 2001 to December 2002 at Dae-Dong Hospital were studied as control group. Parental questionnaire were collected and hospital records of VLBW infants and control group were reviewed retrospectively. RESULTS: The rate of rehospitalization for respiratory illness in VLBW infants (16/23, 69%) was greater than that of term infants (6/23, 26%) (P< 0.05). Ventilated group with RDS (14/ 19, 73%) in VLBW infants had more rehospitalization compared to non-ventilated group (2/4, 50%) (P< 0.05). Those with ventilator care longer than 7 days (7/7, 100%) had more rehospitalization than those with ventilator care less than seven days (7/12, 58%) (P< 0.05). Fifty nine percent of rehospitalization occurred from December to March. Sixty five percent of rehospitalized infants required admissions between 5 and 8 months after NICU discharge. CONCLUSION: VLBW infants are more likely to have rehospitalization with respiratory illness during first year, especially VLBW infants with RDS and prolonged care of mechanical ventilation. It is important to prevent these susceptible infants from respiratory infections and to follow-up them periodically because VLBW infants tend to show decreased pulmonary function subsequently.

A Role of Routine Lumbar Puncture in Children Presented with Their First Seizure with Fever / 대한소아신경학회지

PURPOSE: This study was performed to find out the role of routine lumbar puncture in children presented with their first seizure with Fever. METHODS: This study included 220 children, over a 5 year period, from April 1999 to March 2003, who visited or were admitted at Dae Dong Hospital with their first febrile convulsion. Lumbar puncture was performed in all children. We analyzed their age, family history, type of seizure, duration of seizure, cause of fever, and the results of lumbar puncture. RESULTS: In the sex distribution, males(58.6%) outnumbered females(41.4%) and the ratio was 1.2:1. 81.7% of the patients had febrile convulsion from 6 months- to 3 years of age(P<0.05). 30.5% also had family history of febrile convulsion. The types of seizure were generalized tonic-clonic(72.7%), generalized tonic(17.7%), and generalized clonic(6.4 %). For the duration of seizure, 90.4% of the patients were estimated less than 15 minutes(P<0.05). The causes of fever were pharyngotonsilitis(40.5%), gastroenteritis(19.1 %), pneumonia or bronchitis(13.2%), meningitis(11%), otitis media, urinary tract infection, and exanthem subitum. However, 9.1% of the patients were diagnosed meningitis, with 18 of 20 patients under 3 years of age. CONCLUSION: In the first seizure with fever, lumbar puncture is a useful method for meningitis, especially under 3 years of age.

A Case of Familial Hemiplegic Migraine / 대한소아신경학회지

Familial hemiplegic migraine(FHM) is an autosomal dominant subtype of migraine with aura, characterized by the occurrence of hemiplegia during the aura. Two subforms of FHM families exist; pure FHM in 80% and FHM families with cerebellar symptoms in 20%. Half of the known FHM families show genetic linkage to chromosome 19p13, and in these families FHM is caused by missense mutations in a neuronal P/Q type calcium channel alpha-1 subunit gene(CACNA1A gene). Linkages to 1q31 and 1q21-23 have also been established. Other families are linked neither to chromosome 19 nor 1. Clinical variabilities are partially associated with the various types of CACNA1A gene mutations. FHM is distinguished from more frequent migraine types by a clear, dominant inheritance pattern and the relative absense of other headache types. Further investigation of FHM will help to clarify the genetics of more common migraine. We describe a male patient with FHM with a brief review of the literature.