No abstract available.
Hypothermia* ; Hypoxia-Ischemia, Brain*

Respiratory distress syndrome (RDS) of newborn is a disease revealed high morbidity and mortality rate, especially in premature infant. To evaluate the predictive value of Stable Microbubble Rating (SMR) and Shake test on RDS in premature infant, the anthors carried out the gastric aspirates Shake test and SMR test at birth, 3 and 6 hours after birth respectively on 124 premature infants who were born at the department of Pediatrics, Dong-San Hospital, Keimyung University during the period of 6 months form June 1993 to November 1993. The following results were obtained: 1) Among the 124 premature infants, RDS was developed on 23 (18.5%). 2) The birth weight, gestational age and Apgar score were significantly lowered in RDS cases than non-RDS cases (p<0.005). 3) The sensitivity, specificty, positive-and negative-predictive values of Shake test were 87.0% 79. 2% 48.8% and 96.4%, and those of SMR test were 100% 93.1% 76.7% 100% at birth, 95.7% 88.1% 64.7% 98.9% at 3rd-hour of life, and 95.7% 72.3% 44% 98.6% at 6th-hour of life. With the results of this study we concluded that SMR test at 6th-hour of life.
Apgar Score ; Birth Weight ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Microbubbles* ; Mortality ; Parturition ; Pediatrics

PURPOSE: Newborn infants with diarrhea, metabolic acidosis and dehydration may develop methemoglobinemia without exposure to oxidizing agents. This study was undertaken to investigate clinical features in the development of methemoglobinemia in newborn infants with diarrhea. METHOD: This study involved 16 newborn infants with diarrhea who were admitted to NICU at Dong San Medical Center between January 1995 and June 1996. We investigated the age of onset of methemoglobinemia, sex ratio, level of methemoglobin in the blood, feeding methods, clinical manifestations, arterial blood gas findings, the results of culture findings and the response to therapy. RESULT: 1) The age of onset was beyond the second week of life in most cases, no sex predilection was noted and formula feeding was used in all cases. 2) Methemoglobin level in the blood was 10.1-20.0% in 7 cases, 20.1-30.0% in 6 cases, 30.1-40.0% in 2 cases and above 40.1% in one case. 3) Clinical rnanifestations on admission: moderate to severe dehydration developed in all patients with diarrhea along with respiratory distress in 13 cases, cyanosis in 6 cases, fever was noted in 5 cases, vomiting in 5 cases, while 2 cases presented with abdominal distention. Combined diseases included metabolic acidosis in most cases (93.8%), hypokalemia in 6, failure to thrive in 3, chronic diarrhea in 2, hyponatremia in 2, necrotizing enterocolitis in 1 and hepatitis was found in one case. 4) In all cases, there were no pathogenic organisms found in either blood or urine cultures along with similar negative findings in stool cultures, and Rotazyme test results using ELISA method were negative. 5) Rehydration and correction of acidosis with sodium bicarbonate was accomplished in all patients and 11 cases with greater than 15% methemoglobin were treated with methylene blue, 2mg/kg as a 1% solution in normal saline. Response to methylene blue was indicated in 1 to 2 hours in all cases although there was a reoccurrence of methemoglobinemia after an initial response in 2 cases, they both responded favorably with retreatment with methylene blue. CONCLUSION: In all newborn infant with diarrhea, dehydration and metabolic acidosis, screening tests for early diagnosis of methemoglobinemia should be considered with prompt fluid replacement therapy.
Acidosis ; Age of Onset ; Cyanosis ; Dehydration ; Diarrhea* ; Early Diagnosis ; Enterocolitis, Necrotizing ; Enzyme-Linked Immunosorbent Assay ; Failure to Thrive ; Feeding Methods ; Fever ; Fluid Therapy ; Hepatitis ; Humans ; Hypokalemia ; Hyponatremia ; Infant* ; Infant, Newborn* ; Mass Screening ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Oxidants ; Retreatment ; Sex Ratio ; Sodium Bicarbonate ; Vomiting

No abstract available.
Candidiasis* ; Humans ; Infant, Newborn ; Infant, Premature*

Chylothorax is the most common cause of pleural effusion in the neonatal period and is defined as an effusion of lymph in the pleural cavity. We report a case of chylothorax in a 13-day-old male who was admitted due to respiratory difficulty. Chest AP showed pleural effusion of the left lung and milky yellow fluid was aspirated via thoracentesis upon which laboratory and lipoprotein electrophoresis of pleural fluid revealed findings compatible with that of chylothorax. Due to reaccumulation of chyle after daily thoracentesis, chest tube was inserted at the 4th hospital day, and MCT containing diet was given. He was discharged on the 21st hospital day in good health, and revealed no recurrence for 3 months during outpatient follow up visits.
Chest Tubes ; Chyle ; Chylothorax* ; Diet* ; Electrophoresis ; Follow-Up Studies ; Humans ; Infant, Newborn ; Lipoproteins ; Lung ; Male ; Outpatients ; Pleural Cavity ; Pleural Effusion ; Recurrence ; Thoracostomy* ; Thorax ; Triglycerides*

OBJECTIVE: Immune hemolytic jaundice is caused by the destruction of antibody-sensitized erythrocytes and is associated with antibody-dependent cellular cytotoxic effects mediated by Fc receptor-bearing cells of the reticuloendothelial system. Intravenous immune globulin(IVIG) may have exerted its effect through Fc receptor blockade. We studied the effect of high-dose intravenous immune globulin(HDIVIG) in neonatal hemolytic jaundice unresponsive to phototherapy. METHODS: We selected only those with Coombs test(+) immune hemolytic jaundice who had admittcd at the NICU of the Dcpartment of Pediatzics of Dongsan Medical Center, Keimyung University between January 1995 and December 1998. They were unresponsive to phototherapy. Ten newborn infants(9 ABO incomplatibilities, l minor group incompatabillity due to anti-E) received HDIVIG therapy combined with phototherapy. IVIG was given as a dose of lg/kg for 6 hours, and serial hemoglobin, reticulocyte count, and bilirubin levels were evaluated. If the serum bilirubin level went up and reached the level above 22mg/dl, we conducted exchange transfusion for the patient. RESULTS: HDIVIG induced a significant decrease of serum billirubin levels in 8(80%, group I, HDIVIG responsive poup) of 10 cases and only 2 cases(group II, HDIVIG unreponsive group) required exchange tnnsfusions. No side effect was observed after HDIVIG therapy. CONCLUSION: We suggest HDIVIG may be effective in the treatment of phototherapy-resistant hyperbilirubinemia due to blood group incompatibility. More studies are needed to confirm the optimal dosage and therapeutic indication of HDIVIG in the therapy of neonatal immune hemolytic jaundice.
Bilirubin ; Blood Group Incompatibility ; Erythrocytes ; Humans ; Hyperbilirubinemia ; Immunoglobulins, Intravenous ; Infant, Newborn ; Jaundice* ; Mononuclear Phagocyte System ; Phototherapy* ; Receptors, Fc ; Reticulocyte Count

A clinical study was made on 12 cases of neonatal Group B beta-hemolytic streptococcal (=GBS) meningitis, who were admitted to the department of pediatrics, Dong-San Hospital, Keimyung University during the period of 3 years from Aug 1989 to Jul 1992. The following results were obtained: 1) GBS was cultured in 12 cases (57.1%) among 21 neonatal meningitis admitted during the same period. 2) Male and female ratio was 1.4:1, and 4 cases had early-onset and 8 cases had late-onset. 3) In 6 (50%) out of 12 cases, obstetric factors were noted, including premature rupture of membrane (2 caes), premature delivery(1 case), asphyxia (1 case), cesarean section (1 case) and maternal toxemia (1case). 4) The clinical manifestations were fever (91.7%), lethargy and poor feeding (83.3%),vomiting and irritability (50%), convulsion and bulging fontanel in order. 5) Associated diseases were GBS sepsis (8 cases), pneumonia (2 cases), hyperbilirubinemia (2 cases), etc. 6) Cerebrospinal fluid findings were increased cells(250-12600/mm3), decreased sugar (1-11), increased protim (220-678mg%) and the CBC differential ratio was less than 1.0 in all cases. 7) Overall survival rate was 83.3% with 75% in early-onset disease, and 87.5% in late-onsetdisease. 8) The acute neurologic complications were noted in 5 cases (45.5%) including subdural hemorrhage, brain swelling and cerebral infarction.
Asphyxia ; Brain Edema ; Cerebral Infarction ; Cerebrospinal Fluid ; Cesarean Section ; Female ; Fever ; Hematoma, Subdural ; Humans ; Hyperbilirubinemia ; Infant, Newborn ; Lethargy ; Male ; Membranes ; Meningitis* ; Pediatrics ; Pneumonia ; Pregnancy ; Rupture ; Seizures ; Sepsis ; Survival Rate ; Toxemia

To characterize the sympathetic nervous system response to congestive heart failure in infants and children, plasma norepinephrine levels were measured in 29 patients aged 4 months to 15 years undergoing routine cardiac catheterization at Dong San Hospital, Keimyung University during the period of 4 months from November 1990 to February 1991. Plasma norepinephrine levels were significantly higher in patients with heart disease and congestive heart failure than in those without congestive heart failure(P<0.001). A significant association was found between the level of plasma norepinephrine and severity of the symptoms of congestive heart failure. Plasma norepinephrine levels correlated well with size of the shunt (Qp/Qs)(gamma=0.75), degree of pulmonary arterial pressure (gamma=0.79) and degree of right ventricular pressure (gamma=0.82).
Arterial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Estrogens, Conjugated (USP)* ; Heart ; Heart Diseases ; Heart Failure* ; Humans ; Infant* ; Norepinephrine* ; Plasma* ; Sympathetic Nervous System ; Ventricular Pressure

We encountered the danger of the bleeding the vertex and posterior fossa epidural hematoma(EDH) operation which were related with large sinuses. Traumatic vertex EDH and posterior fossa EDH were usually accompanied by the fractures of coronal, sagittal suture or occipital bone. And frequently, sources of the bleeding were venous sinuses or fracture site. The patients who had vertex EDH were paraparetic soon after injury and the patients who had posterior fossa EDH were dangerous due to brain stem compression. We treated successfully the 13 patients who had vertex EDH(7 patients) and posterior fossa EDH(6 patients) by the method of one or two burr holes and urokinase irrigation. The authors represented this method may occasionally be preferable to craniotomy for these lesions. Advantages of the methods were : 1) More simple, cosmatic procedure and no need of cranioplasty. 2) Reduced operation time and morbidity. 3) Enable to operate under local anesthesia. 4) Reduced rate of delayed intracranial hematoma due to acute decompression of epidural hematoma. 5) Reduced the date of admission. 6) Possibly, prevention of rebleeding and air embolism.
Anesthesia, Local ; Brain Stem ; Craniotomy ; Decompression ; Embolism, Air ; Hematoma* ; Hemorrhage ; Humans ; Occipital Bone ; Sutures ; Urokinase-Type Plasminogen Activator*

No abstract available.
Aneurysm* ; Angiography* ; Circle of Willis*