A follow up study was made of 59 cases of neonatal hyperbilirubinemia receving blood exchange transfusion at Kwangju Christian Hospital from early 1976 to early 1979, with the following results. 1. 42patients(71.2%) returned for followup: 12 patients(20.3%) did not return; and 5 patients(8.5%) had died. 2. Of those returning, developmental status was studied by D.D.S.T. 38 patients(90.5%) had normal development , 3(7.1%) were retarded, and 1(2.4%) was questionable. 3. There was no retardation among patients exchange-Transfused at the age of 5 days or less, except for one patients with severe dehydration. All the other retarded or dying patients were over 5 days at the time of exchange transfusion. 4. Serum bilirubin level was above 27 mg% in all retarded patients . Of the 5 patients dying, 3 had serum bilirubin levels of over 40mg%, one with S.B. of 25mg% had BET at 10 days of age, and one died of necrotizing enterocolitis without evidence of kernicterus. 5. In patients with normal development, 23 were male, and 15 were female. All females had normal development, whereas all four babies with retardation were male. 6. Because S.B. remained over 25mg%, three patients underwent a second BET, with good results. 7. ABO incompatibility was etiologically responsible in 23 cases (55.9%), followed by idiopathic hyperbilirubinemia in 16 cases (27.4%), Other causes of hyperbilirubinemia were infection, respiratory distress syndrome, immune neonatal thrombocytopenia, enclosed hemorrhage, small-for-date infant, etc. 8. Mean values with standard errors of pre BET serum bilirubin level were as follows. Normal development group: 28.10.69mg% Retarded development group: 30.21.15mg% There was a tendency toward higher S.B. levels in retarded development group. 9. Nine patients who had early signs of kernicterus on admission, developed normally after BET, but those patients , shown later to be retarded, had only transient improvement of early signs of kernicterus at the time of discharge. 10. Thirty-three patients had siblings, among whom 8 also had history of hyperbilirubinemia or mental retardation due to kernicterus, or had undergone blood exchange transfusion. All of the were cases of ABO incompatibility. 11. Motor distrubance was the predominant handicap in all 4 cases of typical cerebral palsy, but no speech disturbance or hearing loss was seen. Choreoathetosis was evident in two patients over 3 years of age, but it was not possible to classify the cerebral palsy in two patients less than 1 1/2years of age.
Bilirubin ; Blood Transfusion* ; Cerebral Palsy ; Dehydration ; Enterocolitis, Necrotizing ; Female ; Follow-Up Studies* ; Gwangju ; Hearing Loss ; Hemorrhage ; Humans ; Hyperbilirubinemia* ; Hyperbilirubinemia, Neonatal ; Infant ; Infant, Newborn* ; Intellectual Disability ; Kernicterus ; Male ; Siblings ; Thrombocytopenia, Neonatal Alloimmune

The various and serious types of disaster occur everyday and everywhere on the earth. There is no doubt that it is very timely to discuss about the effectiveness and preparedness of disaster. The purpose of this study is to develop a curriculum on the disaster management through reviewing disaster concepts and the disaster management system. For the empirical relevance of the study, researchers participated in a couple or more disaster training program, reviewed references, and consulted to the experts working on action parts in the area. As a result, the 'Integrated Disaster Management System Model(IDMSM)' was designed, in which four dimensions were explained. Then the 'Disaster Curriculum Model(DCM)' was explored with its theoretical framework based on the system model. The developed curriculum is composed of four levels ; the introductory course, the fundamental course, the advanced course, and the expert course. From this DCM, basically the course-outlines of two subjects in the introductory course, 18 subjects in the fundamental course(5 of direct services, 13 of indirect services) were developed. Also each course-outline was explored by its course objective, learning objectives, contents, and its length. Finally to make the most of the results, suggestions are proposed. The governmental considerations on the policy should support the systematic and integrated educational program to practice, appointing [Disaster School] or [Disaster Training Center] of relevance and accountabilities. The further study should explore the higher levels of the DCM through interdisciplinary efforts, and develop the text materials. The further study should explore the higher levels of the DCM through interdisciplinary efforts, and develop the text materials.
Curriculum* ; Disasters* ; Education ; Learning

No abstract available.

No abstract available.
Cyclosporine* ; Graft Survival* ; Kidney* ; Transplants*

No abstract available.
Down Syndrome* ; Humans ; Twins, Monozygotic*

Hyperkeratosis of the nipple and areola is a rare condition. We report a case of hyperkeratosis of the nipple and areola occurrinp in man with no underlying endocrirop thy or synthetic estrogenic drug therapy. The patient was not associated with epidermal nevus orichthyosis and so fitted into the nevoid form of hyperkeratosis of the nipple and areola. The clinical appearance and histological findings of the lesion were the same as those reported before. He showed a slight improvement in the color and hyperkeratcsis of the nipple and areola with 6 months use of a topical keratolytic agent and corticosteroid crearn.
Drug Therapy ; Estrogens ; Humans ; Nevus ; Nipples*

No abstract available.
Brain* ; Child* ; Humans

No abstract available.
Hyperaldosteronism* ; Kidney Transplantation*

A clinical study was carried out on patients with tuberculous meningitis who were admitted to the Department of Pediatrics, Kwangju Christian Hospital during a 9 year period from January, 1971 to December, 1979. The following results were obtained. 1) About 3/4 of all cases were under the age of 6, the majority being between the age of one and three. The male-to-female ratio was 1.3:1. 2) Seasonal incidence was in the order of spring, summer, winter and autumn, but no sign ificant differences were noted. 3) A family history of tuberculosis was found in 41.5%, usually in one of the parents. 4) A history of B.C.G. vaccination was found in 16.7% of tuberculous meningitis cases. The tuberculin test was positive in 28.9%. 5) The most frequent symptoms on admission were vomiting, fever, convulsion and headache, in that order. 6) The major neurologic findings were unconsciousness(34.0%), neck stiffness(76.4%), and positive Kernig's sign(63.2%). 7) Leukocytes in the C.S.F. on admission were generally elevated, but below the range of 500/mm3 in 74.5% of cases, and the mean count was 278.7/mm3 with 66.7% lymphocytes. Mean protein level in the C.S.F. was 162.5mg/dl, and 94.3% of all cases were over 50mg/dl. Sugar in the C.S.F. was definitely reduced to less than 120 mEq/L in 78.3%, with the mean level being 112.8mEq/L. 8) Chest X-ray revealed tuberculous lesions in 69.8% and miliary tuberculosis was found in 36.8% of cases. 9) The highest mortality was seen in young infants. Among 26 patients of clinical stage I on admission, 21(80.3%) recovered, and 35(79.5%) of 44 patients of stage II recovered, whereas only 13(36.1%) out of 36 patients of stage III were cured. Over-all mortality rate was 5.7% of those followed.
Fever ; Gwangju ; Headache ; Humans ; Incidence ; Infant ; Leukocytes ; Lymphocytes ; Mortality ; Neck ; Neurologic Manifestations ; Parents ; Pediatrics ; Seasons ; Seizures ; Thorax ; Tuberculin Test ; Tuberculosis ; Tuberculosis, Meningeal* ; Tuberculosis, Miliary ; Vaccination ; Vomiting

The measurement of levator action is most important guide to the diagnosis, management of the blepharoptosis, especially to the choice of operation. Levator action was determined by the Berke's method on 850 normal Koreans(1700 eyes) who were seen in the Severance Hospital from November, 1985 through April, 1986. The results were as follows. 1. The average levator action of 850 normal Korean was 13.3 +/- 0.4mm, but no significant difference of levator action was found neither between right and left eye, nor between male and female. The levator action below 10 or over 60 years old was significantly weaker than the other age groups. 2. The average action of the frontalis muscle was 3.2 +/- 0.4mm, but there was no significant difference of frontalis muscle action in bilaterality or sex. The frontalis muscle action under 10 or beyond 60 years old was significantly weaker than the other age groups. 3. The average height of the palpebral fissure was 8.6 +/- 0.4mm, but the discrepancy of the height was not found neither among sex nor between both eyes. The height of the palpebral fissure becomes higher until 40 years old, whereas it becomes lower after 40 years old. 4. The correlation coefficient was 0.43.
Adult ; Blepharoptosis ; Diagnosis ; Female ; Humans ; Male ; Middle Aged