An Analytic Study for Incidence of Childhood Leukemia in Pusan City, Korea / 대한소아혈액종양학회지

BACKGROUND: Cancer is the second cause of childhood death following accident, and leukemia is the most frequent childhood cancer in Korea. For the desirable control of childhood leukemia, of which the mortality is still high, the basic data for the incidence has a great importance. This is the second report from the data during 1991~1995 following the first one that analyzed the data from 328 cases of childhood leukemia during 1981~1990 in the same area, Pusan city, Korea. METHODS: The data were obtained from 138 new cases(84 males and 54 females from 0 to 15 years old) of childhood leukemia who had been living in the city of Pusan and were admitted to the 4 university hospitals and 11 general hospitals from 1991 to 1995. The cases were confirmed by CBC and bone marrow examination. RESULTS: The crude annual incidence rate per 100,000 population varied 1.50~5.30, 2.59~6.00 and 1.58~2.61 in the age group of 0~4 years, 5~9 years and 10~14 years, respectively. The standardized annual incidence rate per 100,000 population varied from 2.05 to 3.46(male 2.96~4.89, female 0.98~3.57). Sex ratio(male to female) was 1.58:1, 1.44:1, and 1.82:1 in total cases, ALL and AML, respectively, while incalculable in CML. By the major types of childhood leukemia, the cases were composed of 105 ALL (76.1%), 31 AML(22.5%), 2 CML(1.4%). CONCLUSION: It was concluded that the annual incidence rate of childhood leukemia per 100,000 population in Pusan city during 1991~1995 was similar to that of previous report during 1981~1990, while the proportion of ALL had tendency to increase up to that of United States, in contrast to the low proportions of ALL in the previous reports.

A Case of Congenital Lobar Emphysema

Congenital lobar emphysema has the clinical features of an air block' syndrome with- out the evidence of pulmonary infection or intrabronchial foreign body. The hyperinflated lung causes a compression of uninvolved lobes creating respiratory distress, cyanosis within the first weeks of life. We experienced a case of congenital lobar emphysema diagnosed incidentally by chest reontgenogram in an infant with frequent upper respiratory infection within a few weeks of life. Chest X-ray revealed extensive emphysematous changes in the left upper lobe, shifting of heart and medistinum to the right and compression of the right lung. Respiratory distress, cyanosis and chest wall retraction ensued and left upper lobe Lobectomy was performed successfully.

A Case of Septic Pulmonary Embolism in Neonate

Septic pulmonary embolization is an uncommon condition in which the clot or fibrin matrix, contaminated with micro-organisms, lodge in the pulmonary arterial tree, leading to infarction, suppuration and other complications. The septic emboli reach the lung from a variety of sources, including acute suppurative pelvic thrombophlebitis, infective endocarditis involving tricuspid and pulmonary valve, osteomyelitis, suppurative lesions of the neck, infected venous catheters or pacemaker wires and sepsis. Early clinical detection, along with prompt administration of broad- spectrum antibiotics, is an important factor in the prognosis of patients, but the initial clinical diagnosis is often difficult because of nonspecific findings in clinical and laboratory data. Recently, the characteristic appearance of septic emboli by chest computed tomography (CT) has been described, and chest CT is an important modality for confirming the presence of septic pulmonary emboli. We experienced a case of septic pulmonary embolism in a 14-day-old neonate with cough, fever dyspnea. Initial conventional chest radiogaphs revealed bilateral infilterate, but chest CT revealed the presence of multiple peripheral nodules, cavitation of nodules and a distinct vessel leading to a pulmonary nodule which is referred to as a feeding vessel sign, which diagnosis suggests. Coagulase negative staphylococcus was cultured in the blood stream and clinical and radiologic improvement was achieved after adminstration of antibiotics.

A Case Report of Ectopic Cords

No abstract available.

Study of Bilirubin Concentration on The Neonatal Jaundice

No abstract available.

A Statistical Study of Feeding Trends

A statistical study was done on the feeding trends of 2,965 children who had visited both the out-patient clinic and the well-baby clinic of Padiatric Department, St. Benedict Hosp., from Sept., 1979 to Aud., 1980. 1) Among the total 2,965 children, the distribution according to age was about the same. The percentage of male and female was 58.5% respectively. As for geographical area of the cases, the majority were from Busan City Kyung Nam Province and the percentage was 96% and 3% respectively. 2) As for the methods of feeding, breast-feeding was 65%, artificial-feeding 18% and mixed-feeding 15%. 81% among the total cases had been on breast-feeding at one time or another. 3) As for feeding trends according to age, the younger the chile was, the more frequent the chance of artificial feeding. 4) Breast-feeding was less common in the children of premature delivery than children of full-term delivery. 5) Breast-feeding was less common among children with difficult delivery than children with easy delivery. 6) Breast-feeding was less common among children of hospital delivery than children of home delivery. 7) The higher the education level of the mother, the less common breast-feeding was. 8) Breast-feeding was less common among children from Busan City than children from Kyung Nam Province. 9) As for the beginning of feeding, in case of breast-feeding 56% were from 3rd day after bitrh and also in case of mixed-feeding 56% were from 3rd day after birth. 10) As for the duration of breas-feeding children with more than 12months of breast-feeding were most common(48%) and children with less than 6months of breast-feeding least common(8%). 11) The reasons for breast-feeding or mixed-feeding were not enough breast-milk 59%), mother's job 8%), baby's illness 8%), mother's illness 6%) and mother's breast problem 4%) by its frequency.

Statistical Study for the Reasons of Artificial or Mixed Feeding and Breast Feeding

No abstract available.

A Case of Beckwith Syndrome

We experienced one case of Beckwith syndrome. This one day aged male neonate manifested macroglossia, umbilical hernia, visceromegaly, hypoglycemia, gigantism and polycythemia. A brief review of related literature is also presented.

Form Stability Test on Gastric Aspirate and Respiratory Distress Syndrome in Newborn Baby

Form stability test on gastric aspirate was performed on 102 cases of newborn within 30 minutes afterbirth, who were admitted to Special Care Unit of St. Benedict Hospital from Sep. 1977 to Aug. 1979, and following results were obtained. 1) There was no differnce between amniotic fluid and gastric aspirate in control group. 2) In all newborn infants with positive form stability test, respiratory distress syndrome was not developed. 3) Respiratory distress syndrome was observed in 75% by Clements method and 55% by Transwell's method in negative form stability test group. 4) The frequency of negative foam stability test and incidence of respiratory distress syndrome were higher in the group of younger gestational age, smaller body weight and lower Apgar score at birth respectively.

Guidelines on the serum bilirubin concentration for the management of neonatal jaundice and controlled clinical trial of phenobarbital and or phototherapy in reducing neonatal hyperbili-rubinemia

We studied the guidelines on the serum bilirubin concentration of 12mg% for the management of neonatal jaundice and compared the effectiveness of oral phenobarbital and continuous phototherapy with singularly phototherapy, in reducing neonatal hyperbilirubinemia in the 100 cases admitted to the department of pediatrics, St. Benedict Hospital from April 1977 to August 1977. The results were as follows; 1. Among the 35 full term normal newborn infants without any risk factors for kernicterus, 14 infants had serum bilirubin concentration below 12mg%. In this group, 5 infants received phototherapy (35.7%). 21 infants had serum bilirubin concentration above 12mg%. In the latter group, 5 infants received phototherapy (71.4%) 2. The mean rate of fall of serum bilirubin per day was 1.81mg% in phototherapy plus phenobarbital groups and 1.57mg% in singularly phototherapy. 3. The mean peak rate of fall of serum bilirubin was 2.28mg% per day in the third to fourth day of phototherapy and phenobarbital groups and 2.76mg% per day in the fourth to fifth day of singularly phototherapy. 4. The mean duration of phototherapy was 74 hours in phototherapy plus phenobarbital groups and 82 hours in singularly phototherapy.

A Case of Esophageal Aresia with Tracheoesophageal Fistula

Esophageal atresia with tracheoesophageal fistula is due to an error in ontogenetic development which occurs befose the sixth week of gestation. An ovearll incidence of one in 3,000 deliveries is generally accepted, and approximately 85 percent of the reported cases consist of esophageal atresia with a fistulous connection between the lower esophageal pouch and the trachea. Associated anomalies are common and often are the most significant factor influencing survival. The female, birth weight 2,450gm, was born at our hospital. After birth the infant cried immediately, breathed spontaneously and did well initially, but after minutes appeared excessive mucus in the pharynx, and sterile water was given 6 hrs later but immediately vomited, some of it regurgitating through the nose and mouth with chocking, coughing and cyanosis. A Nelaton catheter was inserted through the esophagus but met a solid obstructed region at 14cm from the noses. A plain abdomen showed air in the stomach and small intestine, and in esophagogram with Dionosil, esophageal atresia with tracheoesophageal fistula was shown. A brief review of related literature is also noted.

Two Cases of Necrotizing Enterocolitis

Necrotizing enterocolitis (NEC) is an acute fulminating disease of neonate characterized by diffuse or patchy intestinal necrosis accompanied by sepsis and often followed by perforation, peritonitis and death. We had experienced 2 cases of NEC recently which were diagnosed by clinical, X-Ray survey, histologic finding of operation. Review of the references concerning NEC was made briefly.