A review of all 919 perinatal deaths occurring in II Sin Christian Hospital From 1985 to 1989 was carried out. The results of clinical analysis were as follows: 1) The overall perinatal mortality rate was 26.30 per 1,000 birth. 2) The perinatal mortality rate was lowest in the gestation group between 37~41 week and in the weight group between 2,501~4,000 gm. 3) The perinatal mortality rate was high in the age group under 20 and 40 and more. 4) The perinatal mortality rate was increased with an increasing number of parity. 5) The majority of neonatal deaths occurred within 24 hours of life, and the most common cause of death was prematurity. 6) The most common congesital anomaly was multiple anomaly, and the most common single anomaly was anencephaly. 7) In pregnancy, the most common maternal complication was anemia.
Anemia ; Anencephaly ; Cause of Death ; Female ; Humans ; Infant ; Infant Mortality* ; Parity ; Parturition ; Perinatal Mortality ; Pregnancy

A clinical observation was performed on the 80 cases of neonates born from diabetic mothers among the total of 34,936 neonates delivered at II Sin Christian Hospital from January 1985 to December 1989. The results were as follows: 1) The incidence of infants of diabetic mothers was 0.23%, among whom gestational diabetic mothers were 63 cases (78.7%) and overt diabetic mothers were 17 cases (21.3%). 2) Among the complications of pregnancy and delivery, preeclampsia was most frequent as 33.8%, following by urinary tract infection (13.8%), polyhydramnios (1.3%), diabetic ketoacidosis (1.3%). 3) According to the gestational age, prematurity was 11.3%, full term 78.7% and post term 10%. And according to the growth state, small for date infants were 11.3%, appropriate for date infants 53.7% and large for date infants 35%. 4) The incidnece of giant babies (over 4,000 gm) was 30.0% and sex ratio of male to female was 1.1:1 in infants of diabetic mothers. 5) The most frequent clinical manifestation was tachypnea (45.3%), following by poor feeding (20.0%), cyanosis (18.7%). 6) According to the laboratory findings, 53.7% showed hypoglycemia, 36.3% hyperbilirubinemia, 25% hypocalcemia, 15% polycythemia. 7) On the chest X-ray, there were pulmonary infiltration and hyaline membrane disease in 3.2% each other and pulmonary congestion and wet lung in 1.6% each other. 8) The incidence of congenital anomaly was 13.8% in 80 cases of infants of diabetic mothers, and congenital heart disease was most frequent as 3 cases.
Cyanosis ; Diabetic Ketoacidosis ; Estrogens, Conjugated (USP) ; Female ; Gestational Age ; Heart Defects, Congenital ; Humans ; Hyaline Membrane Disease ; Hyperbilirubinemia ; Hypocalcemia ; Hypoglycemia ; Incidence ; Infant* ; Infant, Newborn ; Male ; Mothers* ; Polycythemia ; Polyhydramnios ; Pre-Eclampsia ; Pregnancy ; Pulmonary Edema ; Sex Ratio ; Tachypnea ; Thorax ; Urinary Tract Infections

BACKGROUND: To access the accuracy and clinical usefulness of microplate identification (ID) system for the identification of Enterobacteriaceae, we compared microplate ID system with API 20E(bioMerieux, Etoile, France). METHODS: Ninety-two cultures of Enterobacteriaceae and one isolate of Aeromonas species were simultaneously identified by microplate ID system and the API 20E. Twenty biochemical tests used in microplate ID system were lactose, sucrose, and H2S in Kligler's iron agar media; indole, sucrose, raffinose, arabinose, trehalose, adonitol, dulcitol, sorbitol, cellibiose, methy-red, phenylalanine deaminase, ornithine decarboxylase, lysine decarboxylase, arginine dihydrolase, urease, and citrate in microplate; and oxidase test. The identification was obtained by considering percent likelihood(% ID), modal frequency and ID score method. RESULTS: Among the 92 cultures of Enterobacteriaceae and one isolate of Aeromonas species, agreement rate of identification according to the % ID between microplate ID system and API 20E were 90.3% to the species level and 97.8% to the genus level. CONCLUSIONS: For the identification of clinical Enterobacteriaceae isolates, the microplate ID system compares favorably with API 20E in identification accuracy and have the advantage of costsaving and easy to use.
Aeromonas ; Agar ; Arabinose ; Arginine ; Citric Acid ; Enterobacteriaceae* ; Galactitol ; Iron ; Lactose ; Lysine ; Ornithine Decarboxylase ; Oxidoreductases ; Phenylalanine ; Raffinose ; Ribitol ; Sorbitol ; Sucrose ; Trehalose ; Urease

A male baby with intrauterine growth retardation had a short neck, small hands and feet, hypospadia, both grade I hydronephrosis, type II atrial septal defect, and moderate valvular pulmonary stenosis. The routine chromosome and banding analyses revealed a 46,XY,rec(8)del(8)(p21)dup(8) (q24.1)inv(8)(p21q24.1)pat chromosome constitution. His mother has normal chromosomes, but the father had 46,XY,inv(8)(p21q24.1). Also his uncle had an inv(8) chromosome constitution. We used lymphocytes and examined 40 mitotic cells. All mitotic cells showed deletion of 8p21-->pter and duplication of 8q24.1-->qter. Because 8p21 involves secretion of macrophage and lymphocyte against cancer cells, long-term follow-up for cancer will be needed.
Chromosome Deletion ; Chromosomes, Human, Pair 8 ; Constitution and Bylaws ; Fathers ; Female ; Fetal Growth Retardation ; Foot ; Hand ; Heart Septal Defects, Atrial ; Humans ; Hydronephrosis ; Hypospadias ; Lymphocytes ; Macrophages ; Male ; Mothers ; Neck ; Pulmonary Valve Stenosis ; Trisomy

Neuronal migrational disorders of the brain represent abnormalities in the formation of the neocortex caused by faulty migration of the subependymal neuroblasts. The neuroblasts normally migrate between the sixth and 15th gestational week and in doing so form the six-layered neocortex. When the migration does not occur in a normal fashion the resultant brain anomalies include lissencephaly, pachygyria, schizencephaly, hemimegalencephaly, heterotopia, and polymicrogyria. Neuronal heterotopia is a collection of nerve cells in abnormal locations as a result of arrest of their radial migration, improper formation, or destruction of the radial glial fiber. We reported a case of neuronal heterotopia with brief review of related literatures.
Agenesis of Corpus Callosum ; Brain ; Lissencephaly ; Malformations of Cortical Development ; Neocortex ; Neuronal Migration Disorders ; Neurons*

PURPOSE: This study aimed to investigate visual prognosis and postoperative complications of vitrectomies for macular heterotopia, and compare it with that of tractional macular detachment. METHODS: Medical records of 10 eyes which had undergone pars plana vitrectomy for diabetic macular heterotopia and 21 eyes which for diabetic tractional macular detachment in the 202 patients who had been diagnosed as proliferative diabetic retinopathy at Pusan Paik hospital from January, 1995 to december, 1998 were reviewed to study their clinical features, complications, visual outcome. RESULTS: Final postoperative improved visual acuity was documented in 70% of patients with macular heterotopia and 38% of patients with tractional macular detachment (P>0.05). Postoperative vitreous hemorrhage and cataract developed in 20% and 10% of patients with macular heterotopia and 19% and 10% of patients with tractinal macular detachment. Patients with macular heterotopia experienced retinal detachment and macular hole. Patients with tractional macular detachment experienced increased IOP, neovascular glaucoma and phthisis. CONCLUSIONS: Although we could not revealed statistical significance, the surgical results of vitrectomy for diabetic macular heterotopia was better than that of diabetic tractional macular detachment and in the view of vision and complications, diabetic macular heterotopia was more favorable.
Busan ; Cataract ; Diabetic Retinopathy ; Glaucoma, Neovascular ; Humans ; Medical Records ; Postoperative Complications ; Prognosis ; Retinal Detachment ; Retinal Perforations ; Traction ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

Incontinentia pigmenti is characterized by irregular linear blisters with erythematous lesions which are developed from birth or later, verrucous papules on the extremities which are noted after a few weeks or months, and the appearnace of streaks, spots and swirls of hyperpigmentation. This disorder is known as a systemic disorder caused by a defect at the developmental stage of organs originated from ectoderm or mesoderm. We experienced an incontinentia pigmenti in a male newborn infant who did not have any family history and had cutaneous lesions, which were in bullous and verucous stages, ophthalmic problems, and neurologic abnormalities.
Blister ; Ectoderm ; Extremities ; Humans ; Hyperpigmentation ; Incontinentia Pigmenti* ; Infant, Newborn* ; Male* ; Mesoderm ; Parturition

PURPOSE: The respiratory tract infections including pneumonia have been the major contributing factor for bronchial asthma, and are frequently involved in hospitalization due to asthma attack. We studied clinical characteristics of hospitalized cases due to asthma attack with and without pneumonic infiltrates. METHODS: Over 5 years between January 1993 and December 1997, 628 patients were hospitalized due to asthma attack. 315 of them had pneumonic infiltrates on chest X-ray (defined as pneumonia group) and 197 patients had no pneumonic infiltrates (uncomplicated group). The clinical characteristics of both groups were reviewed retrospectively. RESULTS: The age on admission and first attack in pneumonia group were significantly younger than those of uncomplicated group (P<0.05). The incidence of male was higher than that of female in both groups. The interval from attack to admission and duration of hospitalization were much longer in pneumonia group (P<0.05). The bronchial asthma attack was most frequently occurred between September and November. The atopy-perennial type was predominant in the both groups, and the incidence of non-atopy type was higher in the pneumonia group. The mild asthma attack was predominant in the pneumonia group and moderate one was predominant in the uncomplicated group. The incidence of fever and inflammatory reaction (peripheral blood WBC count, serum CRP level) were higher in the pneumonia group (P<0.05). There was no significant difference in the serum IgE level between two groups. CONCLUSION: Frequency and duration of hospitalization due to asthma attack might be lessened by prevention against respiratory tract infection.
Asthma* ; Female ; Fever ; Hospitalization ; Humans ; Immunoglobulin E ; Incidence ; Male ; Pneumonia ; Respiratory Tract Infections ; Retrospective Studies ; Thorax

PURPOSE: The reasons for breast feeding failure within the first month of birth were related to inappropriate handling of problems in breast feeding. We investigated common reasons for the failure during the neonatal period and assessed medical personnels' attempts to solve them. METHODS: We conducted a survey with a prepared questionnaire on one-hundred-twenty mothers who failed in breast feeding within the first month after delivery. They were selected among those who brought their infants to local private clinics or general hospitals in Taegu from July to August 1999. RESULTS: The breast feeding rate at the starting time of feeding after delivery was significantly higher in the infants who were born at local clinics than general hospitals(52.7% vs 31.8%, P< 0.05), and higher with rooming-in service than routine nursery care(62.1% vs 31.8%, P<0.05). Most with routine nursery care(79.7%) had to feed breast milk at the appointed time. As a consequence, hospital policy was inconvenient for breast feeding. 51.7 per cent of the responders did not even try breast feeding until discharge from hospitals. Information about breast feeding were obtained mainly from their mothers' advice(39.3%). And it was only 7.7 per cent of the responders who obtained information from physicians. The common reasons for breast feeding failure within the first month were insufficient secretion of milk(36.7%), looser stool(16.7%), and inverted nipple(15%), which could have been solved with adequate support and advice from medical personnel. CONCLUSION: To increase the breast feeding rate, medical personnel should actively recommend breast feeding as early as possible after delivery, should educate mothers on the problems that may arise during breast feeding, and should make the hospital environment more convenient for breast feeding.
Breast Feeding* ; Breast* ; Daegu ; Hospitals, General ; Humans ; Infant ; Milk, Human ; Mothers ; Nurseries ; Parturition ; Surveys and Questionnaires

PURPOSE: Conventional indomethacin therapy(0.2mg/kg every 12 hours for three doses) has been used for closure of PDA. The effect of prolonged low dose of indomethacin therapy(0.1mg/kg daily for six days)had been reported in foreign country but, nothing had been reported in our country. So we attempted this study to examine effects of these two methods. METHODS: Forty one infants with PDA of prematurity from January 1992 to July 1995 who were admitted in NICU of Il Sin Christian Hospital were included. 27 of these infants received conventional dose of indomethacin therapy and 14 received prolonged low dose of indomethacin therapy, and we examined with closure rate and complication etc. RESULTS: 1) Closure of PDA was observed in 15(55.6%) and relapse was 3(11.1%) in conventional dose therapy group. In prolonged low dose therapy group, closure was 8(57.1%) and relapse was none. 2) Intraventricular hemorrhage was observed in 20(74.1%), 6(42.9%) and gastrointestinal tract bleeding was 6(22.2%), 13(92.2%) in each group. There was statistically significant between the two groups(p<0.05). 3) The rise of serum BUN, creatinine was observed in 9(33.3%), 6(46.2%), bleeding tendency was 9(33.3%), 8(57.1%), necrotizing enterocolitis was 2(7.4%), 0 and retinopathy of prematurity was 8(29.6%), 3(21.4%) in each group.But there was not statistically significant correlation between the two groups. 4) The development of sepsis and broncopulmonary dysplasia was slightly more in prolonged low dose therapy group. 5) The reduction of urine output was observed in 11(40.7%), 2(14.3%) in each group but, absolute oliguria was not observed in both groups. CONCLUSIONS: Though the closure rate of PDA was similar in both groups, prolonged low dose indomethacin therapy can be recommanded with its effectiveness on preventing the relapse of PDA and the accurrence of necrotizing enterocolitis.
Creatinine ; Enterocolitis, Necrotizing ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Indomethacin* ; Infant ; Oliguria ; Recurrence ; Retinopathy of Prematurity ; Sepsis