PURPOSE: Recent studies show that chorioamnionitis has an important role in the pathogenesis of bronchopulmonary dysplasia(BPD) and it induces thymic involution. The purpose of this study is to test the usefulness of thymic size at birth as a predictor of BPD. METHODS: This study was conducted on 91 very low birth weight infants of <1, 500 g with mean gestational age of 29.3 weeks and mean birth weight of 1, 161 g who were admitted at NICU of Dong Kang General Hospital for past 4 years of whom 21 infants had BPD. Thymic size was measured on routine chest radiographs taken in the first 3 hours after birth and measured as the ratio between the width of the cardiothymic shadow at the level of the carina and that of the thorax at the costophrenic angles (CT/ T). RESULTS: Correlation of thymic size with gestational age was statistically significant (P=0.003). CT/T of BPD group was smaller than that of non-BPD group (0.27+/-0.06, 0.33+/-0.07, respectively, P<0.01). A significant positive correlation between small thymus at birth and BPD was detected (P=0.003, odds ratio, 21.7), but not in other disease groups. CONCLUSIONS: We concluded that a small thymus at birth on the chest radiograph could be used as an early predictive parameter of the BPD.
Birth Weight ; Bronchopulmonary Dysplasia* ; Chorioamnionitis ; Female ; Gestational Age ; Hospitals, General ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Odds Ratio ; Parturition* ; Pregnancy ; Radiography, Thoracic ; Thorax ; Thymus Gland

Isolated submandibular suppurative sialadenitis occurring in the neonatal period is extremely rare. At present, only 15 cases of isolated submandibular sialadenitis in the neonatal period have been reported in the literature. We report a rare case of multiple deep neck abscess in association with both submandibular suppurative sialadenitis in a term neonate.
Abscess* ; Humans ; Infant, Newborn ; Neck* ; Sialadenitis*

PURPOSE: We analyzed pediatric death patients who visited Dong-Kang Hospital emergency center, in order to minimize unexpected pediatric deaths. METHODS: The authors analyzed retrospectively the medical records of 110 pediatric patients who died before and within 24 hours after admission to the emergency center of Ulsan Dong-Kang General Hospital from January 1997 to December 2002. RESULTS: We classified three categories by the cause of death, accident group(AG) 46 cases(41.8%), disease group(DG) 37 cases(33.6%), unknown cause group(UG) 27 cases(24.6%) respectively. The most common age was between two and five years of age(50.0%) in AG, under one month (40.5%) in DG, between one month and one year(51.9%) in UG respectively. The most common season was summer(37.0%) in AG, winter(51.4%) in DG, spring(37.1%) in UG respectively. The most common time on arrival was from 13:00 to 18:00(37.0%) in AG, from 7:00 to noon(43.2%) in DG, from midnight to 6:00(29.6%) and from 7:00 to noon(29.6%) in UG respectively. The most common type of accident was traffic accident(47.8%). The most common cause of death in DG was respiratory disorder(40.5%). Sudden infant death syndrome was the most common(37.1%) in unknown cause of death. CONCLUSION: Accidental injuries and severe chronic illnesses are the major cause of unexpected pediatric death. Legislation related to accidents and a parents teaching program for emergency situations are necessary to decrease cases of unexpected pediatric death.
Cause of Death ; Chronic Disease ; Emergencies* ; Hospitals, General ; Humans ; Medical Records ; Parents ; Retrospective Studies ; Seasons ; Sudden Infant Death ; Ulsan

PURPOSE: Urachal anomalies are rare but are known to develop several complications, especially infection. Moreover, uniform guidelines for management have not been presented because of the variable clinical characteristics of these anomalies. The purpose of this report is to review our experience with urachal anomalies and attempt to determine the optimal management. METHODS: We retrospectively reviewed the records of fourteen children with a variety of urachal anomalies who had been treated from January 1996 to June 2005 at Dong Kang General Hospital. RESULTS: The age distribution of the patients(mean age; 3.8 years) was six neonates, one infant, five preschool-age and two school-age children. The male to female ratio was 1:1. Six cases of urachal cyst, four cases of patent urachus, two cases of urachal sinus and two cases of urachal diverticulum were found. Three patients with patent urachus and one with urachal cyst had hydronephrosis. Other associated anomalies included an inguinal hernia in one patient with urachal sinus and a vesicoureteral reflux in one patient with urachal diverticulum. As a first-line diagnostic tool, high-resolution ultrasound examination was performed in thirteen cases and computed tomography in one case. Surgical excision was performed in nine patients with urachal anomaly. Five cases out of six neonatal cases experienced spontaneous improvement during a three-month follow up period. Due to frequent infection of the umbilicus, surgical excision was performed on one neonate with urachal sinus. CONCLUSION: All patients with urachal anomalies should undergo investigation for associated anomalies. The neonate with urachal anomalies, especially patent urachus, do not require surgical excision unless the patient has multiple episodes of recurrent infection.
Age Distribution ; Child* ; Diverticulum ; Female ; Follow-Up Studies ; Hernia, Inguinal ; Hospitals, General ; Humans ; Hydronephrosis ; Infant ; Infant, Newborn ; Male ; Retrospective Studies ; Ultrasonography ; Umbilicus ; Urachal Cyst ; Urachus ; Vesico-Ureteral Reflux

Migraine equivalents include cyclic vomiting, acute confusional states, and benign paroxysmal vertigo. Cyclic vomiting is characterized by recurrent, sometimes monthly, boults of severe vomiting that may be so intense dehydration and electrolyte abnormalities occur, particularly in an infact. We experienced a 3-year-old girl who showed manifestations of cyclic vomiting and abdominal pain. We report this case with a review of related literatures.
Abdominal Pain ; Child, Preschool ; Dehydration ; Female ; Humans ; Migraine Disorders* ; Vertigo ; Vomiting

No abstract available.
Cholecystokinin* ; Gallbladder Emptying* ; Gallbladder* ; Meals*

Severe cough may contribute to serous coplications such as pneumothorax, pneumomediastinum, rib fracture, subconjunctival hemorrhage, subdural hemorrhage and cough syncope. However abdominal wall hematoma is a rare complication. Because it usually presents with abdmoianal pain, abdominal wall hematoma needs to be differentiated from the acute surgical abdomen. A 78-year-old woman was admitted with right lower quadrant abdominal pain and a palpable mass for several days. She experienced abdominal pain after violent coughing associated with an upper respiratory tract in fection. Abdominal computed tomography revealed an approximately 7×4 cm sized, ill-defined, soft tissue density lesion in the right lower posterolateral abdominal wall. An abdominal wall hematoma was diagnosed. After admission, she had persistent right lower abdominal pain and an increasing mass. The mass was surgically removed and she was discharged without complications. In summary, when a patient complains of abdmonial pain after severe coughing, an abdominal wall hematomas as a differential diagnosis must be considered.
Abdomen ; Abdomen, Acute ; Abdominal Pain ; Abdominal Wall* ; Aged ; Cough ; Diagnosis, Differential ; Female ; Hematoma* ; Hematoma, Subdural ; Hemorrhage ; Humans ; Mediastinal Emphysema ; Pneumothorax ; Respiratory System ; Rib Fractures ; Syncope

Pulmonary hamartoma is uncommon benign tumor-like malformation, which comprises abnormal mixing of the normal components of the lung i.e., cartilage, fat, smooth muscle or respiratory epithelium. The majority occurs in fourth and fifth decades of life, but extremely rare in the pediatric age. Pulmonary hamartoma is clinically classified to endobronchial and intrapulmonary hamartoma. The majority of the pulmonary hamartomas have no clinical symptoms and are detected incidentally by routine chest roentgenograms. But definite diagnosis should be necessary, because of its difficulty to differentiate from malignant and inflammatory lesions. We report a case of intrapulmonary hamartoma which was detected by routine chest roentgenogram check up and diagnosed by fine needle aspiration biopsy and pathological examination with the review of the literature.
Biopsy ; Biopsy, Fine-Needle ; Cartilage ; Child ; Diagnosis ; Hamartoma* ; Humans ; Lung ; Muscle, Smooth ; Respiratory Mucosa ; Thorax

PURPOSE: The aim of this study is to investigate the usefulness of intestinal ultrasonography (US) and upper gastrointestinal endoscopy in the early diagnosis of Henoch-Schonlein purpura (HSP) with the gastrointestinal (GI) symptoms preceding the emergence of the skin lesion. METHODS: The clinical, intestinal US and upper gastrointestinal endoscopic records of 85 patients (88 cases) with GI symptoms relating to HSP presenting between January 1999 and April 2001 were reviewed. RESULTS: 1) GI symptoms were observed in 52 cases (59%) and skin, joint, renal and scrotal manifestations were observed in 88 (100%), 64 (73%), 15 (17%), 3 cases (3%) respectively. 2) Out of 52 cases with GI symptoms, abdominal pain was observed in all cases (100%). Positive stool occult blood, nausea and vomiting, abdominal tenderness, melena or tarry stool, diarrhea, hematemesis, rebound tenderness and rigidity were observed in 28 (50%), 17 (33%), 17 (33%), 12 (23%), 6 (12%), 4 (8%), 1 (2%) and 1 case (2%) respectively in order of frequency. 3) Intestinal US examination was performed in 27 cases with HSP and GI symptoms (52 cases). Out of 27 sonographic examinations 22 showed abnormal findings. Thickening of the duodeno-jejunal wall was observed in 16 cases (73%). Free peritoneal fluid, enlarged mesenteric lymph node, ileus and abnormal gall bladder were seen in 8 (36%), 8 (36%), 4 (18%) and 1 case (5%) respectively. In three cases of HSP without GI symptoms, those changes were absent. 4) In all of five cases with HSP and GI symptoms, endoscopic study showed mucosal edema and multiple hemorrhagic erosions especially at the second portion of the duodenum. Biopsy specimens from the duodenum of 2 cases out of 5 endoscopic examinations showed acute inflammatory infiltrates in the mucosa with hemorrhage. 5) Both intestinal US and endoscopic studies were performed in 4 cases with HSP and GI symptoms simultaneously. Out of 4 those cases, 3 cases showed the thickened duodeno-jejunal wall on the intestinal US, which suggested erosive hemorrhagic duodenitis by endoscopic findings. CONCLUSION: The typical but nonpathognomonic intestinal US findings including the thickening of the duodeno-jejunal wall and upper gastrointestinal endoscopic findings including hemorrhagicerosive duodenitis, in children with GI symptoms, should be considered a manifestation of HSP, even in the absence of skin lesion.
Abdominal Pain ; Ascitic Fluid ; Biopsy ; Child ; Diarrhea ; Duodenitis ; Duodenum ; Early Diagnosis ; Edema ; Endoscopy ; Endoscopy, Gastrointestinal ; Hematemesis ; Hemorrhage ; Humans ; Ileus ; Joints ; Lymph Nodes ; Melena ; Mucous Membrane ; Nausea ; Occult Blood ; Purpura, Schoenlein-Henoch* ; Skin ; Ultrasonography ; Urinary Bladder ; Vomiting

BACKGROUND: The recent studies shows that LV relaxation abnormalities are the important factors of heart failure in elders. To determine the association between LV diastolic functions and heart failure, we assessed LV diastolic functions in elderly patients with pulmonary congestion and in asymptomatic elders by using pulsed doppler echocardiography. METHODS: In order to assess LV diastolic function, we performed pulsed doppler echocardiography to elderly patients with pulmonary congestion and asymptomatic elders from Mar.2001 to Sep.2001. The following parameters were used as indices of LV diastolic function; Mitral E wave(E), Mitral A wave(A), Deceleration time(DT), Isovolumic relaxation time(IVRT), Systolic pulmonary venous flow(PVs), Diastolic pulmonary venous flow(PVd). RESULTS: In elderly patients groups, there was significant increase in deceleration time compared with asymptomatic elders(255.83+/-54.41 vs 210.80+/-48.53, p<0.05). There was significant increase in isovolumic relaxation time in elderly patient group compared with asymptomatic elders(123.06+/-25.07 vs 98.78+/-15.12, p<0.01). Although there was no significant difference, decreased E/A ratio and increased PVs/PVd were noted in both groups. CONCLUSIONS: The results shows that the impairments of LV diastolic function were noted in both groups. Especially DT and JVRT were significant increase in elderly patient group with pulmonary congestion. Therefore these parameters, such as DT, IVRT, can be helpful as predictive indices of diastolic heart failure in elders.
Aged* ; Deceleration ; Echocardiography, Doppler, Pulsed ; Estrogens, Conjugated (USP)* ; Heart Failure ; Heart Failure, Diastolic ; Humans ; Relaxation