PURPOSE: We report clinical charateristics of percutaneous central venous catheteriza- tion(PCVC) that is performed commonly as a vascular access procedure in the neonatal intensive care unit(NICU) including comparision between the success rate and com- plication rate of groups performed by a doctor and by nurses who were accustomed to the IV procedure. METHODS: We evaluated a total of 158 PCVC cases performed in the NICU of Soonchunhyang Chunan hospital over 2 years 5 rnonths from May, 1995 to September, 1997. The 24 cases of PCVC were performed by doctors and 134 cases of this proce- dures were performed by well trained nurses. We have compared success rates, clinical characteristics, insertion sites, indwelling time, causes of removal of the catheters, and associated complication of both doctor performed group (D) and nurse performed group (N) retrospectively. RESULTS: The mean gestational age, birth weight, weight at the time of insertion were significantly lower in the doctor performed group than in the nurse group(P<0.001). There were significant differences in postnatal age and mean duration per catheter in both groups. The overall success rate of insertions was 89.9%(142/158), the success rate of doctor performed group was 54.2%(13/24) and nurse group was 96.3%(129/134) and there was significant difference(P<0.001). In the doctor performed group, 100% were axillary however in the nurse group 43.4% were axillary, 38.8% were antecubital, 9.4% were temporal, and 5.4% were hand. The most common cause of the removal of the catheter was elective in both groups but there was also substantial spontaneous removal by the patients and mechanical complication. Cultures of catheter tips were done after removal in 110 cases, among then were positive in 36 cases(33.6%), the most common causes were Staphylococcus aureus and Candida albicans. CONCLUSION: In this report, the authors emphasize that percutanous central venous catheterization performed by well trained nurses has a higher success rates than the doctor performed group and can be considered safe. We would also like to emphasize that more attention should be paid to the maintanace of PCVC.
Birth Weight ; Candida albicans ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Chungcheongnam-do ; Gestational Age ; Hand ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Retrospective Studies ; Staphylococcus aureus

A case of supracardiac type of total anomalous pulmonary venous return into the superior vena cava is reported which was successfully diagnosed using spiral CT and three-dimensional image reconstruction. Spiral CT with three-dimensional reconstruction is non-invasive method of visualizing the vascular system and in some instances can replace conventional angiography in pediatric patients.
Angiography ; Humans ; Imaging, Three-Dimensional* ; Scimitar Syndrome ; Tomography, Spiral Computed ; Vena Cava, Superior

No abstract available.
Multiple Myeloma* ; Osteosclerosis*

Doppler echocardiography was performed to evaluate the tricuspid regurgitation in 786 infants and children with heart disease. 3 Doppler methods were used. : The duration of systolic turbulence of tricuspid regurgitation in thr right atrium was evaluated by continuous wave Doppler method, the distance of systolic turbulence within right atrium from the tricuspid plane, by pulsed Doppler method and the retrograde systolic hepatic vein regurgitation, by color Doppler method. The following results were obtained. 1) Incidence of pan systolic tricuspid regurgitation in each disease were as follows. 68% of ECD, 66% of Ebstein's anomaly, 54% of pulmonary atresia, 50% of arrhythmia, 45% of ASD, 38% of TAPVR, 15% of VSD, 26% of TOF, 12% of PDA, 13% of normal children. 2) In about 90% of children with tricuspid regurgitation, hepatic vein regurgitation was detected by color Doppler echocardiography.
Arrhythmias, Cardiac ; Child* ; Ebstein Anomaly ; Echocardiography, Doppler ; Echocardiography, Doppler, Color ; Heart Atria ; Heart Diseases* ; Heart* ; Hepatic Veins ; Humans ; Incidence ; Infant* ; Pulmonary Atresia ; Scimitar Syndrome ; Tricuspid Valve Insufficiency*

Neonatal infective endocarditis is fatal and rare disease but recently there is a trend of an increase in incidence even without congenital heart disease when there are high risk as prematurity, central vein catheterization and neonatal cardiopulmonary resuscitation. Symchych reported that in about 3% of autopsy cases of an year, the findings of infective endocarditis were noted. In Korea, there was a case report but it was case of a premature infant who had umbilical vein catheterization and respiratory ventilator treatment. We experienced a case of neonatal infective endocarditis in a female infant who was delivered at 34 weeks gestational age without receiving central vein catheterization or neonatal cardiopulmonary resuscitation. Although she received intensive antibiotic therapy for staphylococcus cultured in blood, she died necessarily. We reported a case of neonatal infective endocarditis without cardiac anomaly with brief review of related literature.
Autopsy ; Cardiopulmonary Resuscitation ; Catheterization ; Catheters ; Endocarditis* ; Female ; Gestational Age ; Heart Defects, Congenital ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Korea ; Rare Diseases ; Staphylococcus ; Staphylococcus aureus ; Umbilical Veins ; Veins ; Ventilators, Mechanical

No abstract available.
Blood Platelets* ; Fetal Growth Retardation* ; Platelet Count* ; Pregnancy*

Many laparoscopic techniques have been developed to repair inguinal hernia in children using either an intraperitoneal or extraperitoneal approach. Percutaneous internal ring suturing (PIRS) is one of the extracorporeal suture techniques. It could be performed with comparable surgical complication or recurrence rates and excellent cosmetic results. To minimize the perioperative complications, surgical procedures of PIRS can be performed carefully with technical refinements for inguinal hernia repair in children.

No abstract available.
Child* ; Epidemiologic Studies* ; Gastroenteritis* ; Humans ; Rotavirus*

Adenosquamous carcinoma originating in the stomach is relatively rare, and the occurrence of such tumor is interesting with respect to its histogenesis. We describe three cases of gastric adenosquamous carcinoma in a 39-year-old man, a 58-year-old woman and a 52-year-old man. They were grossly classified as Borrmann type III or II, revealing no difference from usual advanced gastric adenocarcinomas. Microscopically three cases showed well or moderately differentiated squamous cell carcinoma component occupying large areas of the tumors. Areas of transition from glandular to squamous epithelium were frequently observed. Metastatic foci in the regional lymph nodes also were consisted of two elements. On immunohistochemical study, CEA immunoreactivity was found not only in adenocarcinoma component but also in squamous cell components, in comparison to cytokeratin which was detected only in squamous areas. The immunohistochemical findings of CEA reactivity in both components, and the presence of microscopic transitional zones support the hypothesis of squamous metaplasia occurring in an already existing adenocarcinoma in the development of adenosquamous carcinoma of the stomach.
Female ; Male ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

The purpose of this study were to assess main management components that can lead to successful university foodservice operations. Specifically, it was intended to develop the tool which assesses the service quality, management, to assess the difference between customer importance from and perceptions of service quality, to compare management perceptions of customer importances with actual service delivery, and to identify internal problems which affect service quality with the use of gap model. Three types of questionnaires were developed and implemented for customers, foodservice personals and foodservice manager. Assessment tools were developed based on the literature review, SERVQUAL, GAP model, and the pilot study. Through the validity and reliability test, the questionnaires were revised. Questionnaires were distributed to 900 university students, 207 foodservice personnels, and 54 foodservice manager respectively. 831 university students, 177 foodservice personnels, and 48 foodservice manager were responded with a response rate of 92.3%, 85.5%, and 88.8% respectively. Statistical data analysis was completed using the SPSS programs for descriptive analysis, ANOVA. and SNK test. The results of this study can be summarized as follows : 1. In quality service management components, 31 quality service attributes were categorized and named into primary quality, secondary quality, hygiene, empathy, tangibles, reliability, responsiveness, and price by the factor analysis. 2. Importance mean score of customers was 4.02 out of 5, but perception mean score of customers was 2.55. So there was a relative big gap(1.47) between importance and perception scores, especially in three dimensions of responsiveness, primary quality, and hygiene. 3. It showed that customers' mean scores of perceived service quality by dimensions were the following order : price > reliability > secondary quality > hygiene > tangibles > primary quality > responsiveness > empathy. And the perception mean score of rented(2.59) or contracted(2.58) management was significantly higher than that of self-operated(2.48). 4. Customers' importances mean score which internal customers recognize was 4.23 out of 5, but service delivery mean score was 3.85. So there was a little gap(0.39) between management perceptions of customer importances and actual service delivery. 5. In gap model, SERVQUAL score showed -1.47, Gap 1 positive 0.15, gap 2 negative 0.61, and gap 3 was positive 0.19. 6. The internal problems were as follows ; (1) The managers of University foodservice perceived well enough the customers' expectation value but their management competency was lacked in terms of responding customer needs, (2) The foodservice staff perceived service performance more highly than service quality specifications.
Data Interpretation, Statistical ; Empathy ; Humans ; Hygiene ; Pilot Projects ; Surveys and Questionnaires ; Reproducibility of Results