No abstract available.
Humans ; Infant*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.
Erythroblastosis, Fetal* ; Infant, Newborn

No abstract available.
Anesthesia, Spinal* ; Cesarean Section* ; Female ; Humans ; Infant, Newborn* ; Pregnancy

Clinical observation was performed on 81 cases who were received exchange transfusion at Ilsin Christian Hospital from January, 1986 to Decrmber, 1990. The results obtained were as follows: 1) Among 6,388 cases of neonatal jaundice, the exchange transfusion was performed on 81 cases (1.27%). 2) There was no sex predominance (male 40, female 41). The birth weight of 75 cases(92.6%) ranged from 2,500 gm 4,000 gm. 3) The most predominant delivery type was normal vaginal delivery (66 cases, 81.5%). Instrumental delivery was 9 cases (11.1%) that was higher than control group (4.2%). 4) Analysing the exchanged 81 cases, sepsis accounted for 28 cases (34.6%) of the total exchanged group:ABO incompatibility 25 cases (30.9%), complicated causes 13 cases(16.0%), unknown causes 12 cases (14.8%) and Rh incompatibility 1 cases (1.2%). 5) Repeated exchange transfusion was required in 12 cases (16.0%). 6) In 20 cases (24.7%), exchange transfusion was performed on 7 days or more after birth. In 4 cases (4.9%), including 1 cases of Rh incompatibility, exchange transfusion was done within 24 hours after birth. 7) The most common organism of sepsis, which was the most predominant etiology of exchange transfusion was E. coli in 12 cases (31.5%). 8) After exchange transfusion, serum bilirubin, Hb and reticulocyte count were decreased by 24%, 22% and 36%, respectively.
Bilirubin ; Birth Weight ; Female ; Humans ; Infant, Newborn ; Jaundice, Neonatal ; Parturition ; Reticulocyte Count ; Sepsis

PURPOSE: Periventricular leukomalacia(PVL) is associated with various neurologic sequelae such as cerebral palsy and cortical blindness. The aim of this study was to analyse the correlation between the degree of PVL on MRI and clinical features or its severity. METHODS:Thirty-eight children with PVL on MRI among children brought to Pusan National University Hospital between January 1996 and August 1999 with development delay, cerebral palsy or epilepsy were included into the study group. We reviewed medical records of the patients including the gestational age, birth weight and neurologic sequelae. The grade for PVL was divided into 1 to 3, and it was based on abnormally increased signal intensity in periventricular white matter or a reduced amount of periventricular white matter or both, and compensatory focal ventricular enlargement. We analysed the relationship of the grade of PVL and various clinical findings. RESULTS: The age ranged from 11 months to 13 years old with a mean of 42 months. History of cesarean delivery and ventilator care were significantly frequent for the severe grade of PVL. Birth weight was significantly lower according to grade of PVL. Gestational age was lower according to the grade of PVL, but was not significant statistically. Incidence of cerebral palsy was significantly higher on the severe grade of PVL. Incidence of epilepsy and mental retardation were 34.2Yo and 23.9M, not associated with the grade of PVL. CONCLUSION: Incidence of cerebral palsy was associated with the severe grade of PVL, so we think MRI can be helpful in predicting neurodevelopmental outcome. (J Korean Pediatr Soc 2000;43 798-805)
Adolescent ; Birth Weight ; Blindness, Cortical ; Brain* ; Busan ; Cerebral Palsy ; Child ; Epilepsy ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Intellectual Disability ; Leukomalacia, Periventricular* ; Magnetic Resonance Imaging* ; Medical Records ; Ventilators, Mechanical

PURPOSE: To evaluate the health status of institutionalized handicapped children, a general health assessment was done in an asylum in Taegu in May 1998. METHODS: Body measurements, including height, weight, head circumference, skin fold thickness and mid-arm circumference, were done with physical examination on 53 children. Blood tests and chest radiography were done, and fat impedance was measured. RESULTS: Of the 53 children, height, weight and head circumference were below the third percentile in 37(69.8%), 35(66%) and 28(52.8%) children, respectively. Body mass index, skin fold thickness and mid-arm circumference were below the third percentiles in 77.3, 50.9% and 56.6% of the children, respectively. Although serum protein levels were within normal range, anemia was detected in 31 children(58.5%). Two children showed interstitial pneumonia on chest radiograms. And HBsAg was detected in three but their liver enzymes were within normal limits. CONCLUSION: Due to the poor nutritional status of handicapped children in the asylum, the prevalence of anemia was high. Evaluation of the nutritional status and hemoglobin measurernent must be included in the routine health assessment of these children.
Anemia ; Body Mass Index ; Child ; Daegu ; Disabled Children ; Disabled Persons* ; Electric Impedance ; Head ; Hematologic Tests ; Hepatitis B Surface Antigens ; Humans ; Liver ; Lung Diseases, Interstitial ; Nutritional Status ; Physical Examination ; Prevalence ; Radiography ; Reference Values ; Skin ; Thorax

PURPOSE: Kawasaki disease(KD) is known as one of the most important causes of acquired heart disease in children. But the incidence of acquired heart disease can be reduced by early diagnosis and treatment with large amounts of intravenous gamma-globulin(IVGG). For early diagnosis and treatment of atypical KD, we analyzed and compared the clinical features, laboratory findings and coronary lesions in patients with typical or atypical KD. METHODS: A retrospective chart review was conducted in all children with Kawasaki disease who were admitted to the Department of Pediatrics of Kwang-Hye Hospital between January 1998 and December 1999. Except for 15 cases who were not followed, 62 cases were involved in this study. We analyzed and compared the clinical features, laboratory findings and coronary lesions in patients with 39 typical cases and 23 atypical cases of KD. RESULTS: The lowest incidence among clinical symptoms was cervical lymphadenopathy in both groups. In atypical cases, cervical lymphadenopathy, polymorphous exanthema, and changes of peripheral extremities were significantly lower than in typical cases. The duration of fever was similar in both groups, the mean defeverescence time after administration of IVGG in atypical cases was significantly shorter than typical cases(atypical, 2.6 days, typical cases, 1.8 days). The coronary artery dilatation appeared in 4 cases(17.4%) of atypical and 17 cases(43.6%) of the typical group. In most cases of both groups, left coronary artery dilatation was detected. CONCLUSION: To decrease the incidence of serious coronary complications due to atypical KD, careful evauation of clinical findings, early study of echocardiography and early infusion of large doses of IVGG are needed.
Child ; Coronary Vessels ; Dilatation ; Early Diagnosis ; Echocardiography ; Exanthema ; Extremities ; Fever ; Heart Diseases ; Humans ; Incidence ; Lymphatic Diseases ; Mucocutaneous Lymph Node Syndrome* ; Pediatrics ; Retrospective Studies

PURPOSE: The aim of this study was to determine the genotype frequencies of interleukin 10 (IL-10) gene polymorphisms and to investigate their association with the risk of respiratory distress syndrome (RDS) in preterm Korean infants. METHODS: Two hundred fourteen preterm infants born at Ewha Womans University Mok Dong Hospital between November 2003 and July 2008 were studied. The cord blood of preterm neonates and the corresponding maternal blood were analyzed by PCR for IL-10 gene (IL-10 -1082A/G, -819T/C, and -592A/C) polymorphisms. The clinical data of patients were collected retrospectively by chart review. RESULTS: The genotype frequencies of IL-10 genes in Korean mothers with preterm infants differ from other reports. The prevalence of two promoter SNPs of the IL-10 cytokine gene was similar but none had the IL-10-1082GG homozygote. Multiple logistic regression analysis demonstrated the risk of RDS to be significantly lower in the infants of the mothers with an IL-10-592AC/CC genotype than in those with an AA genotype (P= 0.033). The risk of RDS was significantly lower in the mother with an IL-10-819TC/CC genotype than in those with a TT genotype (P=0.030). However, IL-10 polymorphisms in the cord blood were not significantly different in preterm infants with RDS compared with the preterm infants without RDS. When we compared the incidence of RDS and each IL-10 A-1082G/T-819C/A-592C haplotype, the ACC haplotype had a protective effect on RDS (P=0.007). CONCLUSION: We conclude that the maternal IL-10-592A/C and IL-10-819T/C polymorphisms may have a role in the development of the RDS in preterm infants.
Female ; Fetal Blood ; Genotype ; Haplotypes ; Homozygote ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Interleukin-10 ; Logistic Models ; Mothers ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Prevalence ; Retrospective Studies

BACKGROUND: Issues concerning with the classification accuracy of Korean Outpatient Groups (KOPGs) have been raised by providers and researchers. The KOPG is an outpatient classification system used to measure casemix of outpatient visits and to adjust provider risk in charges by the Health Insurance Review & Assessment Service in managing insurance payments. The objective of this study were to refine KOPGs to improve the classification accuracy and to evaluate the refinement. METHODS: We refined the rules used to classify visits with multiple procedures, newly defined chemotherapy drug groups, and modified the medical visit indicators through reviews of other classification systems, data analyses, and consultations with experts. We assessed the improvement by measuring % of variation in case charges reduced by KOPGs and the refined system, Enhanced KOPGs (EKOPGs). We used claims data submitted by providers to the HIRA during the year 2012 in both refinement and evaluation. RESULTS: EKOPGs explicitly allowed additional payments for multiple procedures with exceptions of packaging of routine ancillary services and consolidation of related significant procedures, and discounts ranging from 30% to 70% were defined in additional payments. Thirteen chemotherapy drug KOPGs were added and medical visit indicators were streamlined to include codes for consultation fees for outpatient visits. The % of variance reduction achieved by EKOPGs was 48% for all patients whereas the figure was 40% for KOPGs, and the improvement was larger in data from tertiary and general hospitals than in data from clinics. CONCLUSION: A significant improvement in the performance of the KOPG was achieved by refining payments for visits with multiple procedures, defining groups for visits with chemotherapy, and revising medical visit indicators.
Classification ; Drug Therapy* ; Fee-for-Service Plans ; Fees and Charges ; Health Care Costs ; Hospitals, General ; Humans ; Information Systems ; Insurance ; Insurance Claim Review ; Insurance, Health ; Outpatients* ; Product Packaging ; Prospective Payment System ; Referral and Consultation