A study was conducted to present clinical and statistical analysis of pediatric patients admitted to Severance Hospital between Jan. 1966 and Dec. 1975. Remakable progress has been made in the field of pediatrics and pediatric surgery, particularly in physiology, anesthesiology and operative technique. However, the ultimate result hasn't been totally satisfactory, largely due to the lack of cognizance of early diagnosis and prompt treatment. Futhermore, most of the patients with associated abnormal conditions, such as congenital heart disease, other associated G.I. anomalies and chromosomal anomalies, require surgery, urgently A total of 250 cases were analyzed according to systems. The following results were obtained; 1. 1. In the sex ratio male to female was 6-7:1. 2. 2. The order of frequency of diseases was as follows; Congenital megacolon 50 cases(20.0%), Imperforated anus 45 cases (18.0%), Congenital hypertrophic pyloric stenosis 41 cases(16.4%), Congenital anomalies of intestine 29 cases (11.6%), Congenital anomalies of hepatobiliary system 25 cases(10.0%), Meckel's diverticulum 18 cases(7.2%), Situs inversus 11 cases (4.4%), Congenital diaphragmatic hernia 6cases(2.4%), Congenital anomalies of cecum 6 cases(2.4%), Esophageal diverticulum 6 cases (2.4%), Esophagealatresia 4 cases (1.6%), Congenital anomalies of pancreas 4 cases (1.6%), Patent omphalomessentric duct 2 cases (0.8%), Congenital intestinal perforation 2 cases (0.8%), and Congenital stomach perforation 1 cases (0.4%). 3. There was an overall mortality rate of 36 cases (18.9%), the causes of death were frequently associated with respiratory failure. 4. Associated congenital anomlies were found in 57 cases. They were G. I. Anomalies, congenital heart diseases, Down's syndrome and cleft palate. 5. Of significance was the fact in this study, congenital megacolon had the highest incidence which was in sharp contrast to accidental series in which congenital hypertrophic pyloric stenosis showed the peak incidence. These figures are very similar to that reported in various publications. This analysis suggest that a more keen understanding of neonatal physiology, embryology, surgical technique and improved post-operative care for anomalous patients, may certainly improve the ultimate outcome of corrective surgery.
Anal Canal ; Anesthesiology ; Cause of Death ; Cecum ; Cleft Palate ; Digestive System* ; Diverticulum, Esophageal ; Down Syndrome ; Early Diagnosis ; Embryology ; Female ; Heart Defects, Congenital ; Heart Diseases ; Hernia, Diaphragmatic ; Hirschsprung Disease ; Humans ; Incidence ; Intestinal Perforation ; Intestines ; Male ; Meckel Diverticulum ; Mortality ; Pancreas ; Pediatrics ; Physiology ; Pyloric Stenosis, Hypertrophic ; Respiratory Insufficiency ; Sex Ratio ; Situs Inversus ; Statistics as Topic* ; Stomach

PURPOSE: Childhood acute immune thrombocytopenic purpura (ITP) is a benign hematologic disease. Therapy does not affect the natural history of the illness. We evaluated the clinical and laboratory findings, treatment and prognosis of childhood acute ITP in Korea through a retrospective multicenter study. METHODS: We analyzed retrospectively the data of 1, 829 children with acute ITP through survey of 33 hospitals among 43 hospitals in Korea from Sep. 1992 to Aug. 2001. RESULTS: Male to female ratio was 1.3: 1 and the median age at the diagnosis of ITP was 2.9 (0.1 17) years. Median duration of follow up was 6 months. One hundred and forty nine cases of the total 1, 829 patients (8.1%) received no treatment. The initial median platelet count of the non-treated group was 42, 500/mm3. Among the 861 cases who were followed up over 6 months, 315 cases (36.6%) progressed into chronic ITP. Associated with this high rate of chronicity of childhood acute ITP patients in Korea, we must consider the fact that acute ITP patients with fast improvement in the first episode tend not to follow up. Considering that fact, the rate of chronicity becomes 17.2% of the 1, 829 acute ITP patients. The treated group used many kinds of treatment methods. Intravenous immunoglobulins (IVIG) with or without prednisolone (PD) (67.5%) were the most commonly used regimens. In the group treated with IVIG alone, the platelet count began to rise above 50, 000/mm3 at 2.6 days, 100, 000/mm3 at 3.7 days and 150, 000/mm3 at 4.9 days. Four hundred and twenty two cases of the 1, 686 (25.0%) cases followed up after first episode of ITP relapsed. The relapse rate was significantly higher in older patients and in girls than in younger patients and in boys (P< 0.05). The chronicity of ITP statistically increased with age (P< 0.05) and that was the only valuable factor. CONCLUSION: Despite the fact that childhood acute ITP is a pretty common disaese, there is no agreement on the best treatment method for this disease. The establishment of Korean treatment guideline of childhood acute ITP, based on an analysis of multicenters, seems to be needed.
Child ; Diagnosis ; Female ; Follow-Up Studies ; Hematologic Diseases ; Humans ; Immunoglobulins, Intravenous ; Korea* ; Male ; Natural History ; Platelet Count ; Prednisolone ; Prognosis ; Purpura, Thrombocytopenic, Idiopathic* ; Recurrence ; Retrospective Studies