Effect of Oral Administration of Dioctahedral Smectite and Cholestyramine with Phototherapy in the Treatment of Neonatal Hyperbilirubinemia

PURPOSE: Dioctahedral smectite is an alumina silicate of phyllitic structure and absorbs bile acid in the intestine, forming a non-absorbable complex preventing enterohepatic circulation. The purpose of this study is to clarify the value of dioctahedral smectite and the adequate dosage, in combination with phototherapy, as well as to confirm whether it shortens the duration of hospitalization and to compare dioctahedral smectite with cholestyramine. METHODS: Total 45 full-term neonate with a total bilirubin level greater than 12 mg/dl were studied. The neonate were randomly divided into three groups : 1) Only phototherapy group (A) 2) 3.0 g/day dioctahedral smectite with phototherapy group (B) 3) 1.0 g/kg/day cholestyramine with phototherapy group (C). RESULTS: The mean serum bilirubin level of group B and C decreased significantly compared to group A at 48, 72 and 96 hours after the beginning of the study. The duration of phototherapy and hospitalization significantly decreased in group B and C. CONCLUSION: The data revealed that oral administration of dioctahedral smectite not only increased the efficacy of phototherapy, but also shortened the duration of phototherapy and can substitute for cholestyramine.

Distribution of Rotavirus G Serotypes in ChungJu Area / 대한소아소화기영양학회지

PURPOSE: It is important to have the epidemiologic data of rotavirus serotypes for the application of polyvalent rotavirus vaccines. Epidemiological studies of rotavirus serotypes in Korea have been reported only in limited areas with small number of cases. Authors tried to investigate the distribution of rotavirus G serotypes in ChungJu area with RT-PCR. METHOD: Stool specimens were collected from 202 children with acute diarrheal symptoms, who admitted to or visited Kon-Kuk University Hospital in ChungJu from June 1998 to May 1999. Samples were screened for rotavirus with EIA method (TestPack Rotavirus, Abbott Laboratories) and rotavirus G Serotypes were determined by RT-PCR. RESULTS: Rotavirus was positive in 46.6%. The incidence of G serotypes was as follows; G1 10%, G2 10%, G3 28%, G4 26%, and G9 20%. There were three cases of multiple serotypes; G1 with G9, G2 with G9, and G4 with G9. Serotype of G8 was not found. CONCLUSION: The proportion of G serotypes in ChungJu is much different from previous reports. Serotype of G9 was found which had not been reported in Korean children till now. Long term plans for the investigation of rotavirus serotypes must be needed in wide area.

Clinical and Physiologic Study of Encopresis

The pathophysiology of pediatric encopresis has been incomprehensible. The current study was designed to assess its clinical and physiologic findings. Moreover, outcome of treatment was evaluated. METHODS: The clinical and functional findings of 18 patients (13 boys, 5 girls) were analyzed, retrospectively. Physiologic studies for cooperative child included anal manometry (n=12), cinedefecography (n=3), and PNTML (pudendal nerve terminal motor latency, n=1). For exclusion of the organic cause, barium contrast study was carried out in all case. Patients were categorized by leading symptom as constipation or incontinence. Physiologic findings and outcome of treatment were analyzed based on the categorized groups. Biofeedback therapy by using newly-developed anal sphincter control system (KONTINENCE CLINICAL(TM)) in my institute, was underwent a mean 4.1 (range, 2~12) sessions. The outcome was analyzed in the period of 5.4 (range, 1~33) months follow-up. RESULTS: Patients were categorized as having constipation (group I, n=12) or incontinence (group II, n=6) group. In the manometric parameters, there were no statistical differences between the values of the mean resting pressure (RP), the maximum RP, and the maximum voluntary contraction between group I and II. In the cinedefecography, 3 of group I patients revealed as having the pelvic floor dyssynergia. The findings of PNTML were not specific in group II (n=1). Regarding to the therapeutic outcome, 8 of 10 patients were cured or improved. CONCLUSIONS: There were no differences in the resting and squeeze profiles of manometric parameters between two groups. However, pelvic floor dyssynergia was identified in the cinedefecography of constipated group. Conventional and biofeedback treatment for encopretic children provides acceptable outcome.

Observation of Social Background and Disease Patterns of Children in an Institute for Adoption(the 3rd report)

OBJECTIVE: A Study was undertaken to assess the family background of abandonment and clinical and social aspects in an institute for foreign adoption. The results were compared to the previous two reports from the institute. METHOD: A sample of 1,728 children from 1987 to 1992 formed the subjects of the study by the medical records in the institution. RESULTS: 1) The unmber of girls were more than that of male and ratio of male to female was 1:1.1, which was reduced compared to previous study. 2) The distribution less than one month of age was most commonly and increased compared to previous study. 3) The Place at birth was hospital most commonly. 4) The type of delivery was full-term one(61.5%) and tend to be increased. 5) Age distribution of monthers was from 16 years to 25 years mainly, 1,081 of them(62.5%) were from unmarried one and 409(37.4%) were from married one. 6) By classifying the cause of adoption, unmarried mothers occupied main one(62.5%), poverty(13.4%) extramarital relations(5.2%), divorce(2.9%) and death of parents in the order of frequency, tend to increased in unmarried mothers. 7) Disease pattern showed respiratory disease, jaundice, acute gastroenteritis, pneumonia, urinary tract infection, conjunctivitis in order of frequency. By care of foster mother at private home since 1988, the incidence of the transmissible disease was reduced. 8) Congenital anomalies were cleft and palate, hydrocele, umbilical hernia and congenital heart disease in order frequency. 9) Three hundred and eighty two babies were admitted to general hospital. The main disease were bhaline membrane disease. Jaundice, pneumonia and urinary tract disease, sepsis in the order of frequency. CONCLUSIONS: The ratio of male to female in the institution showed no definite difference and the age was tend to be younger. The cause of adoption was unmarried mother mainly. Respiratory disease in the institution and hyaline membrane disease in the hospitalized was most common.