Ultrasonic evaluation of the pylorus was performed in a group of 22 infants clinically suspected of having Congenital Hypertrophic Pyloric Stenosis (CHPS), from march 1990 to July 1991. In every case the diagnosis of CHPS was confirmed by surgery. Ten normal babies served as the control group. 1) In CHPS group, the mean age on admission was 36.7 +/- 16.4 days, and male to female ratio was 19.3. In control group, the mean age was 33.7 +/- 18.7 days, with the sex ratio of 8 : 2, male predominating. 2) In CHPS group, the mean age of symptom onset was 18.6 +/- 12.7 days, the majority occurring between 2 to 3 weeks (13 cases : 59%). 3) The ultrasonographic measurements showed that the pyloric muscle thickness of CHPS group was 4.94 +/- 1.35 mm (mean+/-S.D), nearly four times greater than that of the control group with 1.30 +/- 0.17mm, whereas the pyloric canal length of CHPS group (18.03 +/- 1.84mm) was increased significantly, but only by 50%, compared with the control group (11.54 +/- 1.70). 4) In CHPS group, operative measurements of pyloric muscle thickness was 5.20+/-1.23mm, not significantly differing from the sonographic measurement, while pyloric canal length measured 22.13 +/- 3.45mm, significantly larger than ultrasonographic measurement. This indicates that the pyloric muscle thickness measured on preoperative ultrasonogram may provide more significant diagnostic value than the pyloric canal length. 5) If the diagnostic criteria for CHPS were taken as pyloric muscle thickness above 4mm and pyloric canal length above 16mm, 21 out of 22 cases (99.4%) were diagnosed correctly.
Diagnosis* ; Female ; Humans ; Infant ; Male ; Pyloric Stenosis, Hypertrophic* ; Pylorus ; Sex Ratio ; Ultrasonics ; Ultrasonography

BACKGROUND: The aim of this study is to evaluate the therapeutic effect of splenectomy in children with chronic idiopathic thrombocytopenic purpura(ITP) who do not respond to corticosteroids and intravenous immunoglobulin(IVIG). METHODS: Fifteen patients(7 boys and 8 girls) who were admitted to St. Mary's Hospital under the diagnosis of ITP from December 1990 to February 1997 were enrolled In this study. All had chronic forms(more than 6 months after diagnosis) and were refractory to corticosteroids(prednisolone 1~2mg/kg) and IVIG(400mg/kg for 5 days or 1 g/kg for 2 days). We you-finely employ pneumococcal vaccine in 13 patients before splenectomy slnce 1992. Antiplatelet antibody was examed in 10 patients. We measured platelet count at preoperative time, postoperative 1 day, 1 month, and 3 months or more. Hematologic results were analyzed according to Berchtold and McMillan's criteria (1) complete response(CR) >120 x 10(9)/l; (2) partial response(PR) >50 x 10(9)/l (3) no response(NR) < 50 x 10(9)/l. RESULTS: The median age at operation was 10 yr(6~16). The median time interval between diagnosis and splenectomy was 2 yr 2 mo(6 mo~5 yr 5 mo). Antiplatelet antibody was positive in 2 cases of 10 cases(20%). Of 15 cases, 12 cases were corticosteroid resistant and 3 cases were corticosteroid dependent. The postsplenectomy platelet count(median 407 x 10(9)/l of 1 day; 254 x 10(9)/l of 1 month; 227 x 10(9)/l of 3 months or more) was significantly higher than presplenectomy platelet count(median 9 x 10(9)/l)(P<0.05). All patients showed complete or parial response throughout the follow up period. Accessory spleen was found in 1 case and removed during operation. There were no serious complications following splenectomy except mild fever in 2 cases(14%). CONCLUSION: Splenectomy appears to be an effective and relatively safe treatment for patients with chronic ITP who have had inadequate response to conventional therapies.
Adrenal Cortex Hormones ; Blood Platelets ; Child ; Diagnosis ; Fever ; Follow-Up Studies ; Humans ; Platelet Count ; Purpura, Thrombocytopenic* ; Spleen ; Splenectomy*

An objective evaluation of the degree of respiratory impairment in children depends on the establishment of standards of normal function. In addition to sex and growth, various factors such as race and geography have been shown to be important determinants of lung function. The purposes of this paper are to report the result of lung function tests performed on a group of healthy children, to define the range of normal values, to provide a prediction formula of each parameter, and to compare the data with those of other investigators. Pulmonary function tests were performed on 198 healthy normal children in Kwangju between the ages of 5 and 15 years. The following variables were measured: vital capacity, forced vital capacity, one-second forced expiratory volume, peak expiratory flow, and maximal expiratory flow at 25%, 50% of expiratory vital capacity. Simple and complex prediction formulas for variables of PFT are presented according to sex, age, height, weight, and body surface area. 1) With increasing age, height and weight development increased in both sexes and their mean values in each age groups were more higer than those of Korean standard for children. 2) The correlation coefficients were 0.8 or more more in VC, FVC, FEV1 & more higher than that of PEFR, V25, V50. 3) Of the parameters examined, height had the heighest correlation coefficient in all pulmonary function test items. 4) The correlation coefficients by age, weight, body surface area were similar, but according to sex each parameters of PFT varied slightly. 5) Among complex prediction formulas, the correlation coefficients by 3 variables (age, height, and weight) and 2 variables (height and weight) were more higher than others. But disregarding age and weight, the correlation coefficients of height resembled that of simple regression equation. 6) Predicted values of pulmonary function test and correlation coefficients to the parameters were generally higher in boys than those of girls.
Body Surface Area ; Body Weight ; Child* ; Continental Population Groups ; Female ; Forced Expiratory Volume ; Geography ; Gwangju ; Humans ; Lung ; Peak Expiratory Flow Rate ; Reference Values ; Research Personnel ; Respiratory Function Tests* ; Vital Capacity

In 1,146 term neonates without perinatal problems who were born in Kwangju Christian Hospital, blood TSH levels were measured by immunoradiometric assay. In 397 term neonates among them, blood T4 levels were measured by radioimmunoassay in same specimens. 1) In normal neonates aged 3~5 days, 6~10 days, 11~20 days and 21~28 days, the TSH levels were 8.88+/-5.21(mean+/-SD), 9.44+/-5.16, 9.69+/-4.98, 11.96+/-3.75 IU/ml and the T4 levels were 11.41+/-2.79, 11.37+/-2.82, 11.19+/-2.63, 10.51+/-2.99 g/dl respectively. 2) No significant sex difference in TSH level was found in each age group, and TSH level did not correlate with birth weight. In neonates delivered by Cesarean section, TSH levels were lower than those of the normally delivered. 3) T4 levels did not differ between both sexes, and between types of delivery in each age group, and nor did it correlate with birth wweight 4) If the recall rate should be set at 0.2% of the total, TSH levels above 26.9 IU/ml would be required to recall for serum sampling. TSH level above 2 SD was 19.7 IU/ml. Cutoff points of T4 levels at 1.5 SD and 2 SD were 5.8 and 7.2 g/dl respetively, and the lowest 10th percentile was 7.4 g/dl.
Birth Weight ; Cesarean Section ; Female ; Gwangju ; Humans ; Immunoradiometric Assay ; Infant, Newborn* ; Mass Screening* ; Parturition ; Pregnancy ; Radioimmunoassay ; Sex Characteristics

The mineral content and width of bone can be determined noninvasively by “bone densitometer”, which measures the absorption by bone of a monoenergetic photon beam that originates in a radioactive source(Iodine-125 at 27.3 Kev). The intensity of the beam transmitted by the bone is measured by a scintillation detector. The bone mineral density is obtained from dividing the bone mineral content by bone width. Since Cameron and Sorenson, in 1963, first described the photon absorptiometry, many investigators have studied this method and applied it clinically. In order to determine the bone density of normal koreans, and compare it with that of fracture risk group, we measured the bone density of the distal one third of the nondominant radius in 152 normal persons(55 male, 97 female), and 54 patients(23 male, 31 female) having the risk of spontaneous fracture from the third to seventh decades. This data were also compared with those of normal Caucasians. The results were as follows. 1. The average bone densities(gm/cm2) of normal men from the third to the seventh decades were 0.773 ±0.055, 0.749 ±0.070, 0.770 ±0.060, 0.797 ±0.053, 0.664 ±0.126, respectively and those of normal women were 0.680 ±0.058, 0.680 ±0.036, 0.674 ±0.052, 0.608 ±0.084, 0.523 ±0.093, respectively. 2. The average bone densitied(gm/cm2) of fracture risk men from the third to seventh decades were 0.647 ±0.072, 0.719 ±0.050, 0.729 ±0.085, 0.699 ±0.064, 0.562 ±0.049, respectively and those of fracture risk women were 0.603 ±0.049, 0.061 ±0.021, 0.326 ±0.034, 0.494 ±0.045, 0.430 ±0.035, respectively. 3. There were statistically significantly differences in the bone densities between the normal population group and the fracture risk group. 4. The average bone densities(gm/cm2) of normal koreans were lower than those of normal Caucasians by 0.115 ±0.023 in male, and 0.091 ±0.005 in female. 5. We belive that bone densitometer is an effective tool in early detection and treatment in metabolic bone deseass including osteoporosis.
Absorptiometry, Photon ; Absorption ; Bone Density ; Female ; Fractures, Spontaneous ; Humans ; Male ; Methods ; Miners ; Osteoporosis ; Population Groups ; Radius ; Research Personnel

This study intended to calculate the cephalometric norms of Korean adult and to compare those with norms of the North American Caucasian by Moyers. Cephalometric headplates of 41 males and 31 females ranged in age from eighteen to twenty-six with normal occlusion and pleasing face were employed for this investigation. The tracings of the standard lateral cephalograms were analyzed by Moyers' method. As a result of this study, the following conclusion can be made. 1. Norms of Korean adult male and female were calculated. 2. There was no significant sexual difference in the basic craniofacial morphology. 3. The size of craniofacial skeleton was larger in male than in female. 4. The Korean male showed lower value of mandibular plane angle to craial base than that of the Caucasian male. 5. There was no significant difference in the anterior total facial height, however, in the posterior facial height the Korean male was larger than the Caucasian male, which manifested that the Korean male held more square-shaped profile. 6. The anteroposterior length of anterior and posterior cranial base, maxillary and mandibular skeletal and dentoalveolar effective length of the Korean male were shorter than those of the Caucasian male, and this suggested that the craniofacial profile depth of the Korean male was shorter than that of the Caucasian male.
Adult* ; Female ; Humans ; Male ; Skeleton ; Skull Base

Acute focal bacterial nephritis (AFBN), synonymous with acute lobar nephronia (ALN) or focal pyelonephritis, is an inflammatory mass without liquefaction caused by severe acute bacterial infection of kidney. Unless treated effectively, progression to a renal abscees may ensue. Clinically, AFBN presents as acute pyelonephritis, and radiologically, as focal swelling or mass. The distinction between AFBN and renal abceess or even tumor may be confusing and difficult. Ultrasonography and computerized tomography(CT) aid in establishing the correct diagnosis. However, the appearance of AFBN on sonography and CT is by no means pathognomonic. Benign or malignant renal tumors may have a similar appearance. With the clinical history, a high index of suspicion, and follow-up studies after institution of medical treatment may further aid in the differentiation. Herein we report 2 cases of AFBN, which were presented as renal masses.
Bacterial Infections ; Diagnosis ; Kidney ; Nephritis* ; Pyelonephritis ; Ultrasonography

To predict the mydriatic status of the cataract patients preoperatively, we performed maximal mydriasis test with stepwise instillations of 1% tropicamide and 2.5% phenylephrine or 10% phenylephrine to the out-patients who was scheduled to have cataract operation. Among 210 eyes of 113 patients, the pupillary size of 167 eyes was dilated to 8mm or more and the other 43 eyes were insufficiently dilated to less than 8mm diameter. In the insufficiently dilated group, we have observed the presumable causes of insufficient mydriasis as follows: posterior synechiae, diabetic autonomic pupillopathy, age-related miosis and unknown. By this test, we could predict the mydriatic status of the cataract patient preoperatively and could prepare the appropriate operative method and equipment effectively.
Cataract* ; Humans ; Miosis ; Mydriasis* ; Outpatients ; Phenylephrine ; Tropicamide

BACKGROUND AND OBJECTIVES: We report our initial experience with percutaneous transvenous closure of atrial septal defects (ASD). MATERIALS AND METHOD: Between September 1997 and May 2000, we attempted transcatheter closure of ASD in 18 patients using CardioSEALTM (8), STARFlexTM (4) and Amplatzer septal occluder (6). The ages of patients ranged from 4.5-64.8 (mean 32.8) years, body weight ranging from 16-76 (mean 51) kg, Qp/Qs ratio from 1.3-3.4 (mean 2.2). RESULTS: Embolization of device occurred in two patients; right pulmonary artery in one and left atrium in the other. In one patient, the device slipped into the right atrium before detachment. After retrieval of the device, the defect seemed too large for transcatheter closure. There were no other complications apart from a transient aggravation of pre-existing atrial premature beats in two patients. There was no significant size difference between the data measured by transthoracic and transesophageal echocardiography. The stretched ASD diameter was larger (5.1 3.2 mm) than the size measured by transesophageal echocardiography. In the remaining 15 patients, complete closure of defects was confirmed by transthoracic echocardiography on the 1 day or 1 month follow-up. During the same period, transcatheter closure of patent foramen ovale(PFO) was also attempted in 7 patients with stroke. The guidewire could not be passed in 2 of the patients. In the other 5 patients, transcatheter closure was successfully performed without any problems. Though the follow-up period may have been short, no patients were found with further stroke attack. CONCLUSION: Transcatheter closure of ASD can be performed with high efficiency and safety if patient selection is adequate. The indication for ASD closure can be extended to patients with larger defects. Transcatheter closure of PFO is an easy and safe procedure, but the indications of PFO closure in patients with stroke is still unclear. Further evaluation is necessary for long-term results.
Body Weight ; Cardiac Complexes, Premature ; Echocardiography ; Echocardiography, Transesophageal ; Follow-Up Studies ; Heart Atria ; Heart Septal Defects, Atrial* ; Humans ; Patient Selection ; Pulmonary Artery ; Septal Occluder Device ; Stroke

Sacrococcygeal teratoma is a rare tumor, it occurs once in every 40,000 live births. Most of the reported cases appear in female infant (M:F=1:4). They deserve clinical attention because they are potentially malignant and are curable if diagnosed and treated early. The patients may have associated congenital anomalies. This patient has spina bifida cystica in lower sacrum. Brief review of related literature is included in the report.
Female ; Humans ; Infant ; Infant, Newborn* ; Live Birth ; Sacrum ; Spina Bifida Cystica* ; Spinal Dysraphism* ; Teratoma*