Epidemiology of Bronchopulmonary Dysplasia in Korea: Multi-Center Study / 대한주산의학회잡지

PURPOSE: As the neonatal intensive care advanced, the incidence of neonatal bronchopulmonary dysplasia (BPD) has increased. We conducted a multi-center investigation of the prevalence of BPD in six hospitals to investigate the epidemiology of BPD in Korea. METHODS: Retrospective reviews ware performed for survival rate, prevalence of BPD of total 4,476 newborn infants who were admitted to neonatal intensive care unit in Konkuk university hospital, Sung-Ae General hospital, Kangbuk Samsung hospital, Chung-Ang university hospital, Konyang university hospital, and Gangneung Asan hospital between June, 2005 and May, 2007. By Ogawa, BPD was defined as oxygen dependency at 28 days after birth, with respiratory distress symptoms and the change of chest x-ray finding, and classified as 6 subtypes. Classic BPD was defined as oxygen dependency at 36 weeks of postmenstrual age. RESULTS: Survival rate at 28 day after birth was 98.7%. BPD infants by Ogawa classification were 70 (1.6% of overall newborn infants), classic BPD infants were 30 (0.7%). Especially, among 237 preterm infants with birth weight less than 1,500 gram who survived to 28 days of life, 60 (25.3%) had BPD by Ogawa classification and 23 (9.7%) had classic BPD. In Ogawa classification, infants with RDS as type I and II, were 17 infants (24.3%) and 44 infants (62.9%). Home oxygen therapy was performed 8 infants (11.4%). Prevalence of retinopathy of prematurity was 35 infants (50.0%), necrotizing enterocolitis was 3 infants (4.3%), and intraventricular hemorrhage was 6 infants (8.6%). CONCLUSION: Prevalence of BPD infants was 1.6% of overall newborn, 25.3% of preterm infants with birth weight less than 1,500 gram. Among 70 BPD infants, BPD by Ogawa classification with history of RDS as type I and II were 24.3%, 62.9% as the majority of BPD. This study would be the first report of epidemiology of Korean BPD infants by multi-center study.

Clinical Assessment of Rhinitis with Respiratory Pressure Meter / 소아알레르기및호흡기학회지

PURPOSE: Nasal stuffness is one of most common symptom in children who suffer from rhinitis although there is still debates at to the best measurable device. The aim of the study was to evaluate the sniff nasal inspiratory pressure (SNIP) with respiratory pressure meter and compare this with the clinical status of patients. METHODS: We enrolled 57 rhinitis patients who visited our hospital during June 2005 to July 2006. They were treated with intranasal steroid spray (mometasone furoate) for first 2 weeks. To evaluate the outcome of treatment, we used symptom score (SS) and measured the SNIP with respiratory pressure meter (Micro RPM, Micro Medical, Rochester, UK) and also measured peak nasal inspiratory flow (PNIF) with peak nasal inspiratory flow meter (Youlten peak flow meter, Clement Clarke Int., London, UK) before and after the therapy. Skin prick test was performed to all patient to classify the atopic (AR) and non-atopic rhinitis (NAR). RESULTS: Among 57 identified patients (median age, 7 years 9 months), 40 AR and 17 NAR were studied. Most patient showed clinically improvement with 2 weeks intranasal steroid therapy (0 wk SS=4.9, 2 wk SS=1.7 in AR; 0 wk SS=4.5, 2 wk SS=1.5 in NAR, P77.6 L/min, P>0.05). And there was no correlation between SNIP and PNIF measurement. CONCLUSION: The respiratory pressure meter is a useful device to evaluate the therapeutic effectiveness and clinical improvement in pediatric rhinitis patients.

A Child of Acute Suppurative Thyroiditis with Transient Thyrotoxicosis / 대한소아내분비학회지

Acute suppurative thyroiditis is an uncommon disease of thyroid, as thyroid gland is remarkably resistant to infection. In children, the most common route of infection is from a pyriform sinus fistula and then the inflammation spreads from the sinus to the perithyroidal space. It is important to differentiate acute suppurative thyroiditis with thyrotoxicosis from subacute thyroiditis. And if left untreated, acute suppurative thyroiditis can lead to thyroid abscess formation. A 11-year-old girl presented with acute illness of fever and tender neck swelling. Thyroid ultrasonogram and ultrasono-guided needle aspirated cytology confirmed acute suppurative thyroiditis. Although on computed tomography (CT) scan suggested acute suppurative thyroiditis due to pyriform sinus fistula, there was no evidence of fistula formation between thyroid and pyriform sinus on barium esophagogram. After treatment with antibiotics, she displayed clinical improvement and was discharged without complication. Here we report a child of acute suppurative thyroiditis with transient thyrotoxicosis controlled with antibiotics with literature review.

A Case of Spinal Muscular Atrophy with Extensive Involvement of Sensory Nerves

Spinal muscular atrophy(SMA) is an autosomal recessive disease characterized by diffuse proximal and distal weakness due to the deletions of the survival motor neuron(SMN) genes localized on the chromosome 5(q11.2-q13.3). One hypothesis is that the cause of SMA is a pathologic continuation of a process of programmed cell death that is normal in are embryonic life. The SMN genes are supposed to arrest apoptosis(programmed cell death) of motor neuroblasts. SMA is traditionally considered as a pure lower motor neuron disorder, for which a current definitive diagnosis can be established by a molecular genetic testing. We report a case of a female infant with severe hypotonia and frequent aspiration at the age of four months. She was diagnosed as SMA by a genetic study, but the nerve conduction studies showed more extensive sensory involvement in this case other than other classical cases of spinal muscular atrophy. To our knowledge, this is the first report of SMA with sensory nerve involvement in Korea.