ABSTRACT
Congenital lobar emphysema (CLE) is an overinflation of infantile pulmonary lobe caused by air trapping within the affected area. This is usually diagnosed on radiological findings postnatally. Most cases present in the neonatal period with signs of acute or chronic respiratory distress. There are only a few reports of CLE in the literature with prenatal sonographic feature documented. The routine use of prenatal sonography has helped to find fetal anomalies, such as fetal lung mass, that pose a challenge to early diagnosis, appropriate counselling, postnatal follow-up, and better outcome. A boy with CLE was detected by prenatal sonogram. He had a uniformly echogenic right lung with mediastinal shift to the left which was suspected type III congenital cystic adenomatoid malformation prenatally. He showed no evidence of respiratory distress at birth, but experienced progressive tachypnea and chest retraction. He had right middle lobectomy on the seventh postnatal day and pathologic diagnosis of CLE had been made. We report this rare case with brief review of literature. This is the first domestic case which was detected prenatally and confirmed pathologically after lobectomy.
Subject(s)
Humans , Male , Cystic Adenomatoid Malformation of Lung, Congenital , Diagnosis , Early Diagnosis , Emphysema , Follow-Up Studies , Lung , Parturition , Tachypnea , Thorax , UltrasonographyABSTRACT
OBJECTIVE: To investigate the understanding of breast-feeding in pregnant woman and the proper way of encouraging breast-feeding. METHODS: Each questionnaire included items about demographic characteristics and the understanding of breast-feeding. The questionnaires were filled up by pregnant women visiting obstetric clinics in Seoul and its vicinities, Busan, Choongjoo and Chungjoo from July 2001 to August 2001. One thousand, two hundred ninety questionnaires were analysed by Chi square tests and multiple logistic regressions. RESULTS:The majority of pregnant women(87.4%) planned breast-feeding. Forty three percent of them had plans to breast-feed for 4-6 months. There were no differences in the level of education, the family size and the source of information about breast-feeding in planning to breast-feed (P>0.05). The main reasons for not choosing to breast-feed were returns to work(41.3%), previous failures of breast-feeding(17.4%), concerns about insufficient amount of breast milk(10.9%), breast and nipple problems(10.3%) and maternal illness(9.4%). The average score on the test of the understanding about breast-feeding was 59.7/100. The average scores on the understanding about the methods and advantages of breast-feeding were 45.3/100 and 86.1/100, respectively. The maternal status of employment, previous history of breast-feeding, the time of decision to breast- feed, person advocating breast-feeding and the understanding on the advantages of breast-feeding were significant determinant factors in planning to breast-feed(P<0.05). CONCLUSION: Pediatricians should take steps to make an effort to increase the breast-feeding rate and to encourage breast-feeding by timely education. Beyond the medical field, political and social supports for breast-feeding are urgently needed.
Subject(s)
Female , Humans , Pregnancy , Breast , Education , Employment , Family Characteristics , Logistic Models , Nipples , Pregnant Women , Surveys and Questionnaires , SeoulABSTRACT
We encountered a case of neonatal alloimmune thrombocytopenia (NAIT) due to anti-HLA-B62+B75. We incidentally find thrombocytopenia (14,000/uL at birth and decreased to 4,000/uL at 12 hours after birth) in a female fullterm neonate. Petechial skin lesions are developed on her back and buttock at second day of birth. Her mother suffered from preeclamsia during her last trimester, but her platelet count was 167,000/uL and she had no history of abnormal bleeding. Anti-HLA-B62+B75 antibody was identified in mother's serum by panel reactive antibody test and was reactive with father's platelet by mixed passive hemagglutination assay. Platelet concentrate was transfused at the second and 5th days and patient's platelet count rose up to 58,000/uL just after transfusion but decreased to 21,000/uL eventually. From the 8th day, gamma globulin (1g/kg/day) was started intravenously for 3 days and platelet count rose up to 128,000/uL at 13th day and remained within normal limit thereafter.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Blood Platelets , Buttocks , gamma-Globulins , Hemagglutination , Hemorrhage , Mothers , Parturition , Platelet Count , Pregnancy Trimester, Third , Skin , Thrombocytopenia , Thrombocytopenia, Neonatal AlloimmuneABSTRACT
PURPOSE: Gastroesophageal reflux (GER) has been found to be the causative factors of apnea, stridor, feeding intolerance, poor weight gain, and sudden infants death syndrome (SIDS) in infants. GER is a well-described in infants and children, but only scant mention of the premature infants with GER can be found in the literature. METHODS: Esophageal pH was measured during 24 hour in 21 healthy preterm infants, using a silicone microelectrode with an external reference electrode connected to a portable recorder. The mean age of the patients was 29+/-8 days, mean gestational age was 30(+5)+/-2(+0) weeks, mean birth weight was 1,468+/-329 g, mean postconceptional age was 34(+6)+/-1(+4) weeks and mean weight was 1,750+/-329 g. We evaluated the following reflux parameters; number of acid reflux, number of long acid reflux, longest acid reflux minutes, and reflux index. RESULTS: Pathologic GER was detected in 12 (57%) subjects and most interesting parameters are reflux index and number of episodes with a pH<4 during 24 hour (high correlation with postprandial reflux index). Reflux was not correlated to gestational age, birth weight, age, postconceptional age, weight, sex and medication of the theophylline. CONCLUSION: Gastroesophageal reflux is common in preterm infants, but it is usually not apparent, even with severe reflux.
Subject(s)
Child , Humans , Infant , Infant, Newborn , Apnea , Birth Weight , Electrodes , Esophageal pH Monitoring , Gastroesophageal Reflux , Gestational Age , Hydrogen-Ion Concentration , Infant, Premature , Microelectrodes , Respiratory Sounds , Silicones , Theophylline , Weight GainABSTRACT
PURPOSE: Intussusception is one of the most common causes of intestinal obstruction in children under the age of 2 years, especially in male. In this study, we compared the results of pressure reductions for various treatment methods and identified the factors related to reduction failure. METHODS: From Jan. 1996 to Dec. 1997, 87 barium reductions and 127 air reductions were performed for childhood in tussusception. Success rates of these non-operative managements and factors affecting those rates were analyzed. RESULTS: 1) When only ileocolic intussusceptions were considered in order to exclude the effect of different type of intussusceptions, the success rate for air reduction (AR) was 83.5%, which was significantly higher than 71.8% in barium reduction (BR). 2) Factors affecting reduction failure were history of preceding upper respiratory infection, fever (> or =38oC) and symptom duration in BR, and abdominal distension, leukocytosis (> or =10,000/mm3), and symptom duration in AR. 3) Bowel perforations were occurred in 3 cases of AR, but all of these cases showed bowel wall infarction requiring bowel resection, and complications due to perforations were minimal. There were no BR-related complications in BR. 4) Intussuception recurred in 7.4% of all cases; 4.9% after BR, 9.3% after AR. The mean intervals between previous reduction and recurrence were 37.0 (range 1-88) days in BR and 64.3 (range 2-283) days in AR. Recurrences occurred within 48 hours after reduction in 2 cases of BR and in 3 cases of AR. CONCLUSION: Compared with conventional barium reduction, air reduction had a relatively higher success rate in managing childhood intussusception, in spite of a slightly higher risk of bowel perforation. However, perforation did not significantly affect the clinical course. Therefore, air reduction is one of the good alternative of conventional barium reduction for managing childhood intussusception.
Subject(s)
Child , Humans , Male , Barium , Fever , Infarction , Intestinal Obstruction , Intussusception , Leukocytosis , RecurrenceABSTRACT
Several different tumors in different tissues(including the central nervous system, heart, kidney, liver, bone, and soft tissues) are found to be associated with tuberous sclerosis. In the brain, this tumor characteristically arises from the floor of the lateral ventricle and often occluded the foramen of Monro. Cardiac tumor is among the earliest signs of tuberous sclerosis and occurs in over half of affected patients, but symptomatic primary heart tumors are rare in newborn. Thus, early detections are rare in asymptomatic cases. We experienced a case of tuberous sclerosis, in a 2-day-old female newborn who presented with dilatation of lateral ventricle detected by fetal ultrasonography. Diagnosis was confirmed by brain MRI and echocardiogram demonstrated multiple cardiac tumor. Brief review and related literatures were also presented.
Subject(s)
Female , Humans , Infant, Newborn , Brain , Central Nervous System , Cerebral Ventricles , Diagnosis , Dilatation , Heart , Heart Neoplasms , Hydrocephalus , Kidney , Lateral Ventricles , Liver , Magnetic Resonance Imaging , Tuberous Sclerosis , Ultrasonography, PrenatalABSTRACT
Reye syndrome is characterized by an encephalopathy and fatty infiltration of the liver and other organs. Reye syndrome is usually associated with influenza B or varicella. Frequently these patients have been treated with aspirin-containing compounds. Other disorders may mimic the phenotypes of Reye syndrome, and these conditions include various intoxications and some inborn problems of metabolism. This is to report our experience in a case of Reye like syndrome combined with the aspirin medication after Kawasaki disease. We present this case with a brief review of related literatures.
Subject(s)
Humans , Aspirin , Chickenpox , Influenza, Human , Liver , Metabolism , Mucocutaneous Lymph Node Syndrome , Phenotype , Reye SyndromeABSTRACT
PURPOSES: Rotaviruses are the main cause of infantile diarrheal diseases worldwide. The purpose of this study is to obtain epidemiologic data of rotavirus infections in Korea. METHODS: Stool specimens were collected from 150 patients with acute diarrheal symptoms, who were admitted to Yonsei Medical Center and Chungbuk National University Hospital. After isolating the virus from the specimens, the viruses were identified as rotaviruses by electron microscope and fluorescent microscope after staining with rotavirus VP6-specific monoclonal antibody. RNA was extracted from the specimens by modified phenol/chloroform method. Electropherotying was done with extracted RNA samples after silver staining of the gels. Rotavirus serotyping was done using commercial serotyping ELISA kit. RESULTS: Rate of infection from rotavirus stool samples was 60%. Isolated rotaviruses were all serogroup A and a majority(46.0%) of these viruses were long type. Serotypes 1 and 2 were identified with serotype 1 being the majority(52.2%). There were no differences in these types between 1991 and 1992, and also between Seoul and Cheongju area. CONCLUSION: Electropherotype of rotavirus epidemic in Korea was serogroup A, and long type in the majority. Serotypes of rotavirus epidemic in Korea were type 1 and type 2. These results show that the rotavirus reassortant vaccine developed in America could also handle the rotaviral disease in Korea.
Subject(s)
Humans , Americas , Diarrhea , Enzyme-Linked Immunosorbent Assay , Gels , Korea , Prevalence , RNA , Rotavirus Infections , Rotavirus , Seoul , Serotyping , Silver StainingABSTRACT
PURPOSE: Studies conducted on both animal and adult human subjects have demonstrated that a decrease in cerebral blood flow (CBF) causes cerebrocortical dysfunction resulting in an abnormal electroencephalogram (EEG). Although it is assumed that in premature infants with patent ductus arteriosus (PDA), the shunt will decrease CBF and alter the cerebrocortical function thus resulting in an abnormal EEG, this has yet to be firmly established. This comparative study, therefore, measures EEG as effected by CBF before and after PDA closures. Furthermore, in order to observe the effect of PDA on CBF and EEGs, the results were compared against a control group made up of premature infants without PDA. METHOD: All subjects were premature infants admitted to the neonatal intensive care unit of Chungbuk National University Hospital between February and August of 1997, were under gestational age (GA) 36 weeks, and weighed less than 2 kilograms: PDA group (group I consisted of 8 with PDA and respiratory distress syndrom (RDS); group II of 5 with PDA but without RDS) and Control group (group III of 6 without PDA but with RDS; group IV of 12 with neither PDA nor RDS). Studies were performed on the third and seventh day after birth and continued weekly throughout the period of study. Using Acuson 128XP/10c Doppler Echo cardiography, we measured the peak systolic velocity (PVS), the end-diastolic velocity (EDV) and the area under the velocity curve (AUVC) of the anterior cerebral artery (ACA), the blood flow of the left carotid artery and the descending aorta, calculated the LA/Ao ratio and conducted EEG's. RESULTS: 1) Birth weight and gestational age There was a significant difference between group I and group IV. However, when contrasting the two control groups overall, we found no significant variation. 2) In the PDA group, the infants were treated as follows: four infants were performed PDA ligations and seven were administrated indomethacine, resulting in 5 successful closures. Two infants had PDA which closed naturally without any treatment.3) PSV, DV, AUVC in the PDA group before and after closureThe incidence of decreased cerebral blood flow tended to increase after the PDA closure; however, the variation was not significant. In the groupes with RDS, on the other hand, the increase of CBF was significant after treatment, especially in group III.4) Incidence of abnormal EEGsThe preliminary EEG was abnormal for the above infants, with the background EEG appearing as suppressed or sharp and spike wave discharges. There was no significant difference in the results of the two groups and all EEG's were normalized in subsequent examinations. CONCLUSION: The decreased cerebral blood flow in premature infants with PDA increased following closure of the shunt; however, this increase was not significant. In groupes with RDS, the decreased cerebral blood flow significantly increased as the RDS improved, especially in group III. Nonetheless, despite the observed changes in CBF, we were unable to detect a corresponding change in the EEGs of the newborns in this study.
Subject(s)
Adult , Animals , Humans , Infant , Infant, Newborn , Anterior Cerebral Artery , Aorta, Thoracic , Birth Weight , Carotid Arteries , Ductus Arteriosus, Patent , Electroencephalography , Gestational Age , Hand , Incidence , Indomethacin , Infant, Premature , Intensive Care, Neonatal , Ligation , ParturitionABSTRACT
PURPOSE: To investigate the spontaneous closing time of PDA in term and preterm infants without respiratory distress syndrome. METHOD: For twenty four term and sixteen preterm infants without RDS, prespective echocardiography was performed within 24hr of birth, which was repeated everyday till spontaneous closure of ductus. At the same time, LA/Ao ratio in M-mode echocardiography and blood pressure were checked. RESULT: In term infants, spontaneous ductal closure rate was 15% in the first day of life, 57.7% in the second day, 88.5% in the third day, and 100% in the fourth day. For the preterm infants without RDS, the spontaneous ductal closure rate was 25%, 73.3%, 86.7%, 93.3% in each day. One preterm infant dided of meningitis at second day of life was excluded. One preterm infant (11,23 who had patent ductus arteiosus at fourth day of llife showed persistent ductus at 6 months of life. CONCLUSION: Spontaneous closure of patent ductus arteriosus will not occur if there is persistent shunt after 4th day of life in term and preterm infants without RDS.
Subject(s)
Humans , Infant , Infant, Newborn , Blood Pressure , Ductus Arteriosus, Patent , Echocardiography , Infant, Premature , Meningitis , ParturitionABSTRACT
Potter's syndrome including bilateral renal agenesis or polycystic renal disease, bilateral pulmonary hypoplasia and characteristic face was first described in 1946. Although a great number of cases of Potter's syndrome was reported, Potter's syndrome with adult polycystic kidney disease(Potter type III) was very rarely found. In this report, we described an autopsy case of Potter's syndrome having adult polycystic kidneys disease, bilateral pulmonary hypoplasia and characteristic face in conjunction with multiple hepatic cysts, features of congenital hepatic fibrosis and a pancreatic cyst. Microscopically, all cysts were lined by cuboidal epithelial cells, showing positive for epithelial membrane antigen and cytokeratins.
Subject(s)
Adult , Humans , Autopsy , Epithelial Cells , Fibrosis , Keratins , Mucin-1 , Pancreatic Cyst , Polycystic Kidney DiseasesABSTRACT
We experienced 3 cases of Candida esophagitis in infancy which were diagnosed by esophageal endoscopy. First case, 10 month-old boy with combined immune deficiency had suffered from oral thrush and poor feeding for more than 4 months. Esophageal endoscopy revealed multiple whitish creamy patches on the friable erythematous and necrotic mucosa of the esophagus. He was firstly treated with amphotericin-B but in vain. Then he was treated with fluconazole (5 mg/kg/day) and in a few days oral thrush nearly disappeared and endoscopy after 2 weeks revealed complete healing of the esophagitis. Second case, 6 month-old boy with some cellular immue defect also suffered from oral thrush, poor feeding and intermittent fever. He was treated with fluconazole and oral thrush was imporved. He was discharged without follow up endoscopy. Third case, 4 month-old girl with liver cirrhosis due to infantile cholestasis had Candida sepsis. Esophagitis was found incidentally during the endoscopic examination of esophageal varix. First 2 cases showed multiple small filling defects and decreased motility on esophagography. Candida antigen was not detected in the sera of all 3 cases of candidiasis. We conclude that Candidia esophagitis should be suspected when an infant has been suffering from long-term treatmet-resistant oral thrush and poor feeding and that esophageal endoscopy can be easily performed in infants also and useful in diagnosing esophagitis and assessing the outcome of treatment.
Subject(s)
Female , Humans , Infant , Male , Candida , Candidiasis , Candidiasis, Oral , Cholestasis , Endoscopy , Esophageal and Gastric Varices , Esophagitis , Esophagus , Fever , Fluconazole , Liver Cirrhosis , Mucous Membrane , SepsisABSTRACT
To estimate the child and infant mortality rates among Korean children, a mortality survey was carried out in the province of Kyongsangnam,buk-do. The study population are the beneficiaries of Korea Medical Insurance Coorporation (KMIC), Kyongsangnam,buk-do area, among which the 3,867 and 1767 deaths occurred from January, 1989 to December, 1990 in Kyongsangnam-do area and from January, 1991 to December, 1991 in Kyongsangbuk-do area respectively. We reviewed the data to confirm the causes of death. These were based on the death certificates and medical utilization records before dying which were available through the computerized databases on medical care utility of KMIC. The survey conducted along three steps. At first, the death certificates were examined, as a second step, medical utilization records were reviewed, and finally direct contacts to the family members of the deceased were done. As a result, 115 deaths were found under 20 years of age. Using them, age specific mortalities and causes of death were estimated. Mortality rate in this area was estimated 129 per 100,000 person-years during 1 month to 11 months of age, 67 during 1 year to 4 years of age, 23 during 5 years to 9 years of age, 10 during 10 years to 14 years of age, and 29 during 15 years to 19 years of age, respectively. And the frequent causes of death were congenital anomalies, central nervous system (CNS) diseases, certain condition originating from perinatal period during 1 months of age; accidents, congenital anomalies, malignancies, CNS diseases, and pneumonia or bronchiolitis during 1 to 4 years of age; accidents, malignancies, CNS diseases, and congenital anomalies during 5 to 14 years of age; and accidents, suicide, malignancies, and CNS diseases during 15 to 19 years of age.