PURPOSE: We tried to compare normal term infants with low-birth-weight infants discharged from NICU by evaluating morbidity. So we studied rates of rehospitalization, reasons for rehospitalization and neonatal risk factors that affect rehospitalization of normal term infants and low-birth-weight infants discharged from NICU. METHODS: This study was performed on 217 low-birth-weight infants discharged from NICU and 126 normal term infants born in Presbyterian Medical Center from January 1992 to December 1994. RESULTS: Low-birth-weight infants discharged from NICU had higher rates of rehospitalization than normal term infants. Twenty-nine percent of low-birth-weight infants discharged from NICU were rehospitalized, compared with 12.7% of normal term infants(P<0.001). Rates of rehospitalization by birth weight was 45.5% in infants of 1500g or less and 31.2% in infants of 1500-1999g of birth weight. The rates of rehospitalization increased as birth weight decreased (P<0.001), but there was no significant difference between 16.4% in infants of 2000-2500g of birth weight and 12.7% of normal term infants(P=0.442). Reasons for rehospitalization of low bith weight infants were respiratory problem(63.1%), congenital/developmental problem(10.8%), surgical problem(9.2%), G-I problem(7.7%), ophthalmic problem(3.1%), and cardiac problem(1.5%). Neonatal risk factors related to rehospitalization of low birth weight infants were mechanical ventilation, duration of mechanical ventilation, bronchopulmonary dysplasia and duration of hospitalization(P<0.01). CONCLUSION: Rates of rehospitalization increased accordingly to decreasing birth weight. The most common cause of rehospitalization was respirartory problem. Neonatal risk factors related to rehospitalization were mechanical ventilation, bronchopulmonary dysplasia and duration of hospitalization. The data suggest that high risk infants of rehospitalization require close follow up.
Birth Weight ; Bronchopulmonary Dysplasia ; Hospitalization ; Humans ; Infant ; Infant, Low Birth Weight* ; Infant, Newborn ; Protestantism ; Respiration, Artificial ; Risk Factors

We present a case of autoimmune chronic pancreatitis in a previously healthy child without any history of autoimmune disease. A 12-year-old boy was admitted to the hospital with abdominal pain. The serum amylase, lipase, and IgG levels were elevated and autoantibodies (antinuclear antibody, antineutrophil antibody) were detected. An abdominal CT (computed tomographic) scan revealed diffuse enlargement of the pancreas. ERCP (endoscopic retrograde cholangiopancreaticography) demonstrated an irregular stricture of the main pancreatic duct in the pancreas tail. After two years of oral steroid and immunosuppressive drug therapy, the clinical, laboratory and radiological findings were improved. The patient has been symptom-free for 18 months after the discontinuation of medication.
Abdominal Pain ; Amylases ; Autoantibodies ; Autoimmune Diseases ; Child* ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic ; Drug Therapy ; Humans ; Immunoglobulin G ; Lipase ; Male ; Pancreas ; Pancreatic Ducts ; Pancreatitis, Chronic* ; Tomography, X-Ray Computed

BACKGROUND AND PURPOSE: Stroke is a leading cause of death in Korea. Early measurement to prevent stroke are extremely important since it has no cure. Korean might have different risk factors since their dietary habit and socio-economical status differ from most western countries. However, the risk factors for stroke in Korea have not yet been identified. Moreover, the lifestyle of health Korean adults has not been investigated. In this study we investigate the life of health adults living in Seoul and rural areas and compare the life style of the two. METHODS: One hundred seventy one subjects were studies. Among the subjects studied, 128 were from Seoul, the other 43 were from the country area. The age of the subjects was limited to over 40 years. Blood pressure, fast blood sugar, and cholesterol were measured. The subjects' height, weight, body mass index total body fat, skinfolds thickness of triceps, subscapular and abdomen were measured to determine obesity. Using a structured interview, we assessed : sodium intake, physical activity and exercise, consumption of vegetables, fat, fish and fruits. The results of the two groups were compared. RESULTS: There were no statistical differences in age and education between the two groups of subjects. The mean age of the subjects were 66 years old. The subjects residing in rural areas had a higher intake of sodium(p<0.05), lower physical active(P<0.05), and higher BMI and body fat(p<0.05) as compared to the subjects in Seoul. Subjects with hypertension were between 24% and 33% and the prevalence of hypertension was the highest was the highest when compared to the prevalence of DM, or hypercholesterolemia. However, the prevalence of hypertension, DM, hypercholesterolemia, were not significantly different in these areas. CONCLUSION: our results show that subjects living in rural areas eat more salty food, exercise less and tend to be obese. The finding of this study lead to speculation that Korean living in rural areas have less information about the effects diet of diet on health than city dwellers do. General health and nutrition education programs aimed at the prevention of stoke and other such conditions for rural area Korean may close the risk factor gap between rural and urban dwellers.
Abdomen ; Adipose Tissue ; Adult ; Aged ; Blood Glucose ; Blood Pressure ; Body Weight ; Cause of Death ; Cholesterol ; Diet ; Education ; Food Habits ; Fruit ; Humans ; Hypercholesterolemia ; Hypertension ; Korea* ; Life Style* ; Motor Activity ; Obesity ; Prevalence ; Risk Factors ; Seoul ; Sodium ; Stroke* ; Vegetables

Esophageal candidiasis is an opportunistic infection, often reported in patients who have acquired immune deficiency syndrome (AIDS), a neoplastic disease, or undergoing protracted antibiotic therapy. Impaired cell mediated immunity was often considered as the major predisposing factor in patients of esophageal mucosal colonization of Candida spp. However, it is increasingly reported that the occurrence of esophageal candidiasis with no underlying disease or immune suppression. We have experienced a case of esophageal candidiasis in a 15-year-old girl who was immunologically normal and have no underlying disease and whose main symptoms were epigastric and retrosternal pain with dysphagia. This case suggests the possibilities of candidal infections in children without predisposing factors such as immune compromised conditions, so it will be needed to differentiate the esophageal candidiasis among healthy children with symptoms of odynophagia and dysphagia.
Acquired Immunodeficiency Syndrome ; Adolescent ; Candida ; Candida albicans ; Candidiasis* ; Causality ; Child* ; Colon ; Deglutition Disorders ; Female ; Humans ; Immunity, Cellular ; Opportunistic Infections

Herpes simplex esophagitis can occur in those with normal immune function, but is more often seen in those who are immunocompromised. In one series, 5 percent of post-kidney transplant recipients had herpes esophagitis. We experienced a case of herpes simplex esophagitis, following renal transplantation in a 9 year old male. He complained of epigastric pain, nausea and blood-tinged vomiting. Endoscopic examination showed volcano ulcer, mucosal friability and multiple confluent ulcers covered by whitish exudates on elevated margin in the middle and lower esophagus. Microscopic findings revealed multinucleated giant cells, margination of chromatin, intense nonspecific inflammation and strong positive for herpes simplex virus immunohistochemical staining. Esophageal lesions and symptoms improved after acyclovir therapy.
Acyclovir ; Child* ; Chromatin ; Esophagitis ; Esophagus ; Exudates and Transudates ; Giant Cells ; Herpes Simplex* ; Humans ; Inflammation ; Kidney Transplantation ; Male ; Nausea ; Simplexvirus* ; Transplantation ; Ulcer ; Vomiting

PURPOSE: Rotavirus is one of the most important causes of nosocomial infections among children. The aim of this study is to determine the risk of nosocomial rotavirus infections and to evaluate the effectiveness of breast-feeding and probiotics in the prevention of nosocomial rotavirus infections. METHODS: This study was carried out on admitted children without diarrhea between March 1, 2003 and February 29, 2004. Three hundred ninety patients aged 4 days to 13 years during this study were available. We examined the feces of all children for rotavirus by latex agglutination on admission, during hospital, and after discharge, to see whether they developed diarrhea or not. RESULTS: Nosocomial rotavirus infections was significantly increased with children under 12 months of age(P=0.008). The monthly attack rate was great between December and March(P=0.046). Prolonged hospital stay was associated with an increased attack rate of nosocomial rotavirus infections (P=0.003). The risk of nosocomial rotavirus infections was not associated with the number of roommates and whether or not they were breast-fed or fed on probiotics. CONCLUSION: Nosocomial rotavirus infections are significantly more likely to occur in children under 12 months of age, admitted between December and March, and with prolonged hospital stays. Prompt identification and isolation of children with nosocomial rotavirus infections, even without diarrhea, may decrease rates of nosocomial rotavirus infections.
Agglutination ; Child* ; Cross Infection ; Diarrhea ; Feces ; Humans ; Latex ; Length of Stay ; Probiotics ; Risk Factors* ; Rotavirus Infections* ; Rotavirus*

PURPOSE: This study investigated the breast-feeding period, the milk bottle-using period, the age of cow's milk, introduced and the amount of cow's milk consumed in relation to anemia. METHODS: Over the course of three years, 930 children(12 months to 36 months) who went to the Presbyterian Medical Center, Chonju, Korea were tested for anemia and their parents were surveyed for a history of their children's milk consumption. RESULTS: Anemia appeared more likely between 30 months and 36 months, however, iron-deficiency anemia appeared more likely between 18 months and 23 months. Anemia, low serum ferritin levels and iron-deficiency anemia appeared more likely in children breast fed less than 6 months and greater than 12 months. Although there were survey reports of side effects with cow's milk, including constipation, diarrhea and skin rash, the milk bottle-using period, age of cow's milk introduced and amount of cow's milk consumed had no connection with anemia, serum ferritin levels and iron-deficiency anemia. CONCLUSION: The data showed no correlation between the cow's milk, milk bottle-using period and iron deficiency. But the data revealed that iron deficiency anemia is more likely in children who are breast fed for less than 6 months and over 12 months, so we suggest careful attention during this period to prevent iron deficiency anemia.
Anemia ; Anemia, Iron-Deficiency ; Breast ; Child ; Constipation ; Diarrhea ; Exanthema ; Ferritins ; Humans ; Iron* ; Jeollabuk-do ; Korea ; Milk* ; Nursing* ; Parents ; Protestantism

Mesenchymal hamartoma is an uncommon benign tumor usually found in childhood, especially during the first two years of life. The tumor consists of a solid component and multiple cyst. Without treatment, these lesions can grow to an enormous size. We experienced a case of mesenchymal hamartoma which was found incidentally, in a 8 month old girl who had ascending cholangitis after Kasai operation due to biliary atresia. On abdominal ultrasonography and CT, there was a well-defined homogeneous small echogenic mass in the right lobe of the liver with cirrhosis. Five months later, she underwent liver transplantation. Gross picture of the resected liver showed a dark greenish pigmented solid mass in the right lobe of the cirrhotic liver. Microscopic findings showed reactive mesenchyma and epithelial overgrowth.
Biliary Atresia* ; Cholangitis ; Female ; Fibrosis ; Hamartoma* ; Humans ; Infant ; Liver ; Liver Transplantation ; Mesoderm ; Ultrasonography

Solid and papillary epithelial neoplasm (SPEN) of the pancreas is an uncommon tumor and is found predominantly in young females. The most common clinical presentation is an abdominal mass. The tumor has a low grade malignant potential and complete removal is the treatment of choice. We report a case of SPEN in a 13-year-old girl who presented with abdominal pain and increasing size of an abdominal mass after abdominal trauma. CT and sonographic findings showed a well-demarcated mass in the pancreas tail with solid and cystic portion. She got a distal pancreatectomy and pathologic finding was SPEN of pancreas.
Abdominal Pain ; Adolescent* ; Child ; Female ; Humans ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Pancreatectomy ; Ultrasonography

PURPOSE: Laparoscopic totally extraperitoneal (TEP) herniorrhaphy is an effective surgical technique for recurrent inguinal hernia. The recent introduction of various types of prosthetic mesh and the technical improvements in laparoscopic herniorrhaphy have allowed this modality to be used for various types of recurrent inguinal hernias, although careful selection of surgical techniques is required according to the patient's condition and the type of previous surgery. METHODS: One thousand and thirty cases were scheduled to undergo laparoscopic TEP herniorrhaphies from December of 2000 to August of 2008. We retrospectively collected and analyzed the data on the patient characteristics, the types of hernia, the number of previous recurrences, the operating technique, the operating time, the postoperative hospital stay and the postoperative complications. RESULTS: A total of 86 herniorrhaphies were performed in 83 patients with recurrent inguinal hernias. The mean patient age was 50.4 years. The total number of recurrences among the 83 patients was 118 cases and the number of recurrences was as follows: 1st in 65 patients, 2nd in 12 patients, 3rd in 7 patients and 4th in 2 patients. Eighty one laparoscopic TEP herniorrhaphies were performed, and 5 cases were performed by laparoscopic transabdominal preperitoneal repair or laparoscopic intraperitoneal onlay mesh repair. The mean operative time was 29.9 minutes, and there was no statistical correlation between the type of prior herniorrhaphy and the operative time. The mean postoperative hospital stay was 0.9 days and no major complications occurred. CONCLUSION: Selecting the type of surgery to perform for treating recurrent inguinal hernia has become complicated due to many recent diversified techniques of herniorrhaphy. Although laparoscopic TEP herniorhaphy is effective for treating recurrent inguinal hernia, a meticulous approach and various surgical techniques are required when prosthetic mesh has been previously placed on the preperitoneal space.
Hernia ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Inlays ; Length of Stay ; Operative Time ; Postoperative Complications ; Pyrazines ; Recurrence ; Retrospective Studies