No abstract available.
Child* ; Heart Diseases* ; Heart* ; Humans ; Mass Screening*

Over a continuous 4-year period, from January 1989 till December 1992, 7,100 infants were born in Department of Obstetrics and admitted to Nursery or Neonatal Intensive Care Unit of Department of Pediatrics of Seoul National University Children's Hospital. Among them, 126 cases were diagnosed as respiratory distress syndrome (RDS) of newborn. The total incidence of RDS among all the newborns (inborn) was 1.77%. And the incidence of RDS related to birth weight was 81.82% in infants of 500~749 g of birth weight, 68.57% in infants of 750~999 g of birth weight, 55.6% in infants of 1,000~1,249 g of birth weight, 35.71% in infants of 1,250~1,499 g of birth weight, 16.67% in infants of 1,500~1,749 g of birth weight, 9.82% in infants of 1,750~1,999 g of birth weight, 1.00%in infants of 2,000~2,249 g of birth weight, 1.29%in infants of 2,250~2,499 g of birth weight, and 0.08% in infants of more than 2,500 g of birth weight. Cumulative incidence of RDS related to birth weight was 81.82%in infants under 750 g of birth weight, 71.74% in infants under 1,000 g of birth weight, 62.39% in infants under 1,250 g of birth weight, 53.33% in infants under 1,500 g of birth weight, 39.85% in infants under 1,750 g of birth weight, 30.83% in infants under 2,000 g of birth weight, 20.42% in infants under 2,250 g of birth weight, and 13.70% in infants under 2,500 g of birth weight. The incidence of RDS related to gestational age was 83.33%, in infants under 25 weeks of gestation, 78.57% in infants at 25~26 weeks of gestation, 67.31% in infants at 27~28 weeks of gestation, 56.41%in infants at 29~30 weeks of gestation, 16.47% in infants at 31~32 weeks of gestation, 4.74% in infants at 33~34 weeks of gestation, 1.15% in infants at 35~36 weeks of gestation, and 0.05% in infants at more than 37 weeks of gestation. Cumulative incidence of RDS related to gestational age was 83.33% under 25 weeks of gestation, 80.00% under 27 weeks of gestation, 70.83% under 29 weeks of gestation, 63.33% under 31 weeks of gestation, 46.38% under 33 weeks of gestation, 27.76% under 35 weeks of gestation. Perinatal risk factors related to the incidence of RDS were analyzed by the multiple logistic regression statistical method in 595 infants, who were born under 37 weeks of gestation and under 2,500 g of birth weight in Seoul National University Hospital. The risk of RDS rose with decreasing gestational age (odds ratio=1.76, 95% CI=1.57, 1.99), with decreasing 5 minute Apgar score (odds ratio=1.23,95% CI=1.08, 1.40), while prolonged ruptrue of membranes of > 24 hours in the absence of maternal infection was highly protective (odds ratio=0.37, 95% CI=0.20, 0.70).
Apgar Score ; Birth Weight ; Gestational Age ; Humans ; Incidence* ; Infant ; Infant, Newborn* ; Intensive Care, Neonatal ; Logistic Models ; Membranes ; Nurseries ; Obstetrics ; Pediatrics ; Pregnancy ; Risk Factors* ; Seoul

BACKGROUND: The purpose of this study is to evaluate the evidence for the effectiveness of different isolation policies in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in hospital in-patients. METHODS: We prospectively evaluated the effectiveness of an isolation policy on transmission of MRSA in the 745-beds hospital. First period, all patients with MRSA (March - July 2000) were not isolated Second period, strict isolation policies were performed (August 2000 - January 2002). All patients with MRSA were isolated in separated room, hand hygiene using alcohol handrub, gowning and g1oving, apply of MRSA notice sticker, criteria in isolation remove, separated disinfection and wastement. Third period, semi strict isolation policies were performed (February 2002 - August 2005). Some patients with MRSA were isolated in separated room and others were admitted in general ward for bed shortage. Only some practices were performed in hand washing and separated disinfection in general ward. RESULTS: The rates of MRSA nosocomial infection per patients during 1st, 2nd, and 3rd surveillance were reported 0.56, 0.23, and 0.42 (P<0.05). Patient-days rate of MRSA nosocomial infection during 1st, 2nd, and 3rd surveillance were reported 0.62, 0.27, and 0.38 (P<0.05). CONCLUSION: With many different isolation policies, it was possible to reduce nosocomial infection of MRSA. In this study, strict isolation policies (2nd period) were the most effective practices in reducing MRSA infection.
Cross Infection ; Disinfection ; Hand Disinfection ; Hand Hygiene ; Humans ; Incidence ; Infection Control ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Patients' Rooms ; Prospective Studies

No abstract available.
Infection Control* ; National Health Programs*

PURPOSE: Cepharanthin (R) has been reported to improve the symptoms of intractable or steroid-resistant chronic idiopathic thrombocytopenic purpura (ITP). We report the clinical efficacy of oral high dose Cepharanthin (R) in refractory chronic ITP. METHODS: We analyzed eleven patients who were diagnosed as chronic ITP at the Department of Pediatrics, Seoul National University Hospital from January, 2002 to February, 2004. After informed consent patients with platelet count below 20, 000/mm3 were treated with Cepharanthin (R) at the initial dose of 5 gm/day. The doses were increased up to 15 gm/day if there was no response. For the purposes of this study, complete remission was defined as an elevation of the platelet count > or =50, 000/mm3 from the baseline after 4 weeks of treatment. Partial remission was defined as an elevation of the platelet count 20, 000/mm3 and < = or50, 000/mm3 from the baseline. RESULTS: Seven boys and four girls with a median age of 10 were enrolled. Two to four weeks after the initiation of this therapy, 4 patients showed their platelet counts over 50, 000/mm3 1 patients reached partial remission state, 6 patients had no response. Side effects of Cepharanthin (R) were not observed in all patients. CONCLUSION: We suggest that the oral administration of Cepharanthin (R) could be a beneficial and a safe treatment strategy for the refractory chronic ITP patients. Further studies should be performed to elucidate the mechanism of responses.
Administration, Oral ; Child* ; Female ; Humans ; Informed Consent ; Pediatrics ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic* ; Seoul

Abdominal distension is not an uncommon symptom in the neonate; it is indistinguishable from Hirschsprung disease by symptoms and X-ray findings. In three patients, severe abdominal distension was found at early infancy and improved with conservative treatment without relapse. The findings were different from those of Hirschsprung disease. Immaturity or poor coordination of peristaltic movement is postulated as the cause. With maturation such problems can normalize. However the pathogenesis remains unclear and further investigation is needed to improve our understanding.
Hirschsprung Disease ; Humans ; Infant, Newborn* ; Recurrence

Stickler syndrome is an autosomal dominant disorder of connective tissue with a wide range of expressivity and incomplete penetrance which is called hereditary progressive arthro-ophthalmopathy. Affected neohates may present with the Pierre-Robin syndrome, progressive myopia, retinal detachment, flat face, hypertelorism, progressive arthritis. Early recognition of the syndrome is important, not only for genetic counselling but also to offer a more precise prognosis and proper treatment of many serious disorders that may occur in affected children. We experienced a case of Stickler syndrome with large eyeballs in a 3-day-old female baby who showed Pierre-Robin anomaly, flat face, hypertelorism, epicanthal folds, long philtrum, micrognathia, deft palate, high congenital myopia, chorioretinal degeneration, thin habitus and hyperextensible joints.
Arthritis ; Child ; Connective Tissue ; Female ; Humans ; Hypertelorism ; Joints ; Lip ; Myopia ; Myopia, Degenerative ; Palate ; Penetrance ; Pierre Robin Syndrome ; Prognosis ; Retinal Detachment

This study was done to evaluate respiratory syncytial virus (RSV) related readmission (RRR) and risk factors of RRR in preterm infants < 34 weeks gestational age (GA) within 1 yr following discharge from the neonatal intensive care unit (NICU). Infants (n = 1,140) who were born and admitted to the NICUs of 46 hospitals in Korea from April to September 2012, and followed up for > 1 yr after discharge from the NICU, were enrolled. The average GA and birth weight of the infants was 30(+5) +/- 2(+5) weeks and 1,502 +/- 474 g, respectively. The RRR rate of enrolled infants was 8.4% (96/1,140), and RSV accounted for 58.2% of respiratory readmissions of infants who had laboratory tests confirming etiological viruses. Living with elder siblings (odd ratio [OR], 2.68; 95% confidence interval [CI], 1.68-4.28; P < 0.001), and bronchopulmonary dysplasia (BPD) (OR, 2.95; 95% CI, 1.44-6.04; P = 0.003, BPD vs. none) increased the risk of RRR. Palivizumab prophylaxis (OR, 0.06; 95% CI, 0.03-0.13; P < 0.001) decreased the risk of RRR. The risk of RRR of infants of 32-33 weeks' gestation was lower than that of infants < 26 weeks' gestation (OR, 0.11; 95% CI, 0.02-0.53; P = 0.006). This was a nationwide study that evaluated the rate and associated risk factors of RRR in Korean preterm infants. Preterm infants with BPD or living with siblings should be supervised, and administration of palivizumab to prevent RRR should be considered.
Antiviral Agents/therapeutic use ; Birth Weight ; Bronchopulmonary Dysplasia/drug therapy/pathology ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Male ; Odds Ratio ; Palivizumab/therapeutic use ; Patient Discharge ; Patient Readmission ; Republic of Korea ; Respiratory Syncytial Virus Infections/drug therapy/*pathology/virology ; Respiratory Syncytial Viruses/*isolation & purification ; Risk Factors ; Siblings

Purpose: This study compared the subjective and objective sleep quality between subjects with and without thoracic hyper-kyphosis. Methods: Forty participants were divided into a hyper-kyphosis (n = 17) and normal group (n = 17) by thoracic spinal angle measurement. The subjective sleep quality was measured using PSQI, a self-report, and objective sleep quality was measured using an actigraphy that measures time according to sleep patterns. Results: The PSQI scores of subjects with thoracic hyper-kyphosis were significantly higher than those with normal thoracic curvature (p = 0.013). The total sleep time and real sleep time were less in subjects with hyper-kyphosis than in normal subjects (p = 0.006;p = 0.029). The light sleep time was less in subjects with excessive spondylolisthesis than in normal subjects (p = 0.010). Light sleep time was less in those with hyper-kyphosis, but deep sleep time was similar to the subjects with a normal thoracic curvature (p = 0.003;p = 0.140). Conclusion Subjects with thoracic hyper-kyphosis had a decrease in subjective sleep quality, such as sleep discomfort, and objective sleep quality, such as a decrease in sleep time compared to normal subjects.

A 35-years-old man was hospitalized with gene-ralized edema. 6 months ago, the patient was operated by radical subtotal gastrectomy for advanced gastric adenocarcinoma. The patient presented with multiple liver metastasis and the massive proteinuria. The patients renal biopsy revealed minimal change nephrotic syndrome and treated with prednisolone and diuretics. The patient was improved clinical symptome and decreased 24 hours urine protein. In literature reviewed, gastric carcinoma was not associated with minimal change nephrotic syndrome. We experienced advanced gastric carcinoma associated with minimal change nephrotic syndrome, thus we report it.
Adenocarcinoma* ; Biopsy ; Diuretics ; Edema ; Gastrectomy ; Humans ; Liver* ; Neoplasm Metastasis* ; Nephrosis, Lipoid* ; Prednisolone ; Proteinuria