The Effect of Post-natal Weight Changes on the Development of Bronchopulmonary Dysplasia in Infants with Respiratory Distress Syndrome / 소아과

PURPOSE: The subjects were compared and measured for differences in the aspects of weight changes between the groups that developed bronchopulmonary dysplasia(BPD) after treatment and those that did not, to analyze the relations between the patterns of early weight change after birth and the development of BPD. METHODS: Retrospective analysis of medical records were performed for birth weight and a corresponding pattern of weight change after birth and a case history of 70 respiratory distress syndrome (RDS) patients born at Kyunghee Medical Center from September 1999 to December 2002. Patients who developed BPD after being treated for RDS were classified as group A and the rest as group B. Each respective group was subdivided into subgroups of birth weight greater and lesser than 1,500 grams. RESULTS: BPD was observed in 12(17.1%) patients. The duration of initial weight loss and the time to restitution of birth weight were meaningfully longer in group A, and the ratio of initial weight loss to birth weight was significantly greater in group A. On the other hand, when the above comparisons were executed in each group subdivided by birth weight above and below 1500 grams, no significant variables were generated. CONCLUSION: The postulated points to the duration of initial weight loss and time to restitution of birth weight being significantly longer in groups with BPD. It was also confirmed that this group had a greater ratio of initial weight loss(%) to birth weight were confirmed.

A Case of Cytomegalovirus Pneumonia in a Healthy Infant / 소아알레르기및호흡기학회지

CMV is a largest member of herpes viridae consisted of 230-240 Kb double stranded DNA, 20 protein matrix and envelope. It has specific replication cycle with 3 phase. Human immunity against CMV, cellular immune and humoral immune are envolved and specially CD + 8 cytotoxic cell and natural killer cell are important because they controll primary infection, recurrent infection and latent infection. Our patient was 2 month old, healthy female infant. She had acute pneumonia and then progressed fulminent respiratory failure, cardiomegaly, hydrocephalus and DIC. At first, we tried to find cause of this condition but couldn't anything. We performed several CMV serologic study and on hospital day 30th, Anti-CMV IgM was positive and increased IgG. And we report the case of CMV pneumonia in a healthy infant.

The Effects of 1alpha-(OH)D3 and Pamidronate on Steroid Induced Osteoporosis (SIO) in Children with Nephrotic Syndrome (NS)

PURPOSE: Corticosteroid has been used as the mainstay therapy of childhood NS. But SIO is one of the serious complications of long-term steroid therapy, especially in growing children. Recently calcium, calcitonin, PTH, vitamin D and bisphosphonate has been used to treat or prevent SIO in adult, which is rare in children with NS. We studied the effect of 1alpha-(OH)D3 and Pamidronate on SIO using dual energy X-ray absorptiometry (DEXA). PATIENTS AND METHODS: We studied thirty patients who admitted in the Dept. of Pediatrics of Kyung Hee Medical Hospital with NS. All patients was received longterm steroid therapy. There was no history of bone, liver, or endocrine disease. The samples, serum protein, albumin, BUN, creatinine, calcium, phosphorus, and BMD were obtained before and the six months after the dose of 1alpha-(OH)D3 and Pamidronate, respectively. RESULTS: The mean age was 6.9+/-3.3 and 6.5+/-2.5 years old. The mean duration of steroid therapy was 28.8+/-1.8 and 27.6+/- 1.0 months. The changes of serum protein, albumin, BUN, creatinine, calcium and phosphorus level between pre-treatment and post-treatment did not show statistical significance in both 1alpha-(OH)D3 and Pamidronate treatment group. However, BMD was increased in both from 0.472+/-0.12 and 0.457+/-0.10 g/cm2 to 0.533+/-0.12 and 0.529+/-0.09 g/cm2 after treatment. (P<0.05). CONCLUSION: Both 1alpha-(OH)D3 and Pamidronate appears to be effective in treating and preventing SIO in children with nephrotic syndrome requiring long-term steroid therapy.