No abstract available.
Mass Screening*

The levels of pH,pCO,bicarbonate, and base excess in umbillical venous blood were measured at birth of life in 30 normal term infant and 27 high risk infants. The study group was divided into two categories by clinical evaluation: first group of normal term infant without high risk indication and second group of high risk infants. Following results were obiained. 1) The average level of umbilical venous blood pH in normal group was 7.3260.001 and high risk group was 7.3180.002(7.326 versus 7.318,respecitvely,p>0.05) 2) The average Apgar Score in normal group was 9.30.95 and more acidotic high risk group was 7.42.54 3) The average level of pCO in normal group was 43.361.36mmHg and high risk group was 43.952.36mmHg(43.36 respecitively, p>0.05) 4) The average level of pCo in normal group was 21.550.85mmEq/L and high risk group was 20.030.78mEq/L(21.55 versus 20.03mEq/L respectively,p>0.05) 5) The average level of base excess in normal group was -2.610.76mEq/L and high risk group was -3.060.91mEq/L(-2.61 versus -3.06mEq/L respecitively,p?0.05) 6) Relationship between hP and Apgar Score in normal group was False normal (6.7%),False abnormal(10%) and high risk group was False normal (14.8%) False abonromal(7.4%).
Apgar Score ; Humans ; Hydrogen-Ion Concentration* ; Infant* ; Parturition

PURPOSE: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). METHODS: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. RESULTS: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR chi2=44.56, P=0.001; AD chi2=16.23, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (chi2=7.41, P=0.0025). CONCLUSION: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.
Advance Directive Adherence ; Advance Directives ; Caregivers* ; Decision Making ; Employment ; Hospice Care ; Hospitals, General ; Humans ; Medical Staff* ; Personnel, Hospital ; Resuscitation Orders ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to evaluate the accuracy of Tc-99m DTPA diuretic renal scans in children upper urinary tract. MATERIALS AND METHODS: We reviewed diuretic renal scans of 14 pediatric patients (age range: 3 days to 4 years) with unilateral hydronephrosis diagnosed by ultrasonography. Diuretic renal scan was done using Tc-99m DTPA and standardized protocol. In 3 neonates, diuretic renal scans were performed within 1 week and 3-7 months after birth. RESULTS: Six patients required pyeloplasty and eight were managed conservatively. All 6 patients requiring pyeloplasty were diagnosed as having ureteropelvic junction obstruction in the diuretic renal scan. In these 6 patients, post-operative renal scans at 3-12 months after surgery were converted to nonobstructive pattern in 5 and a nonobstructive patterns in 1. In 3 patients who underwent diuretic renal scan within 1 week after birth., nonobstructive patterns of initial scan were coverted to obstructive patterns in the follow-up scan. However, all patients with nonobstructive diuretic renal scans performed after the neonatal period did well on serial ultrasonography and showed favorable clinical outcome without progression to obstruction. CONCLUSION: Tc-99m DTPA diuretic renal scan with standarized protocol is useful in assessing suspected ureteropelvic junction obstruction in children as an initial diagnostic or post-operative follow-up modality. Nonobstructive or indeterminate scan RESULTS in the neonatal period requires follow-up scan to monitor development of the obstructive pattern.
Child* ; Follow-Up Studies ; Humans ; Hydronephrosis ; Infant, Newborn ; Kidney Pelvis ; Parturition ; Pentetic Acid* ; Radioisotope Renography* ; Ultrasonography ; Urinary Tract*

No abstract available.
Eosinophilia*

A 13-year-old boy had a 5-day history of prodromal symptoms of fever and dry cough followed by two episodes of severe anginal chest pain and substantial transient ST-segment elevation. A subsequent evaluation showed that the chest pain was caused by coronary artery vasospasm complicating acute myocarditis. We report a rare case of coronary artery vasospasm in an adolescent with a medical history of Raynaud’s phenomenon who was successfully treated with intravenous immunoglobulin and a calcium channel blocker. This report exemplifies the need for pediatricians to be aware that anginal pain due to coronary artery spasm can, albeit rarely, occur in children as a complication of myocarditis, sometimes as a concomitant feature in patients with Raynaud’s phenomenon; in suspected cases, serial electrocardiography is important to perform.

A 13-year-old boy had a 5-day history of prodromal symptoms of fever and dry cough followed by two episodes of severe anginal chest pain and substantial transient ST-segment elevation. A subsequent evaluation showed that the chest pain was caused by coronary artery vasospasm complicating acute myocarditis. We report a rare case of coronary artery vasospasm in an adolescent with a medical history of Raynaud’s phenomenon who was successfully treated with intravenous immunoglobulin and a calcium channel blocker. This report exemplifies the need for pediatricians to be aware that anginal pain due to coronary artery spasm can, albeit rarely, occur in children as a complication of myocarditis, sometimes as a concomitant feature in patients with Raynaud’s phenomenon; in suspected cases, serial electrocardiography is important to perform.

No abstract available.

We experienced two suspected cases of hereditary cerebellar ataxia of ten years and right years aged boys who brothers. The patients manifested progressive wide base ataxic gait, incordination, intention tremor, impaired balance and dysarthria. A bries review of related literature is also presented.
Cerebellar Ataxia* ; Dysarthria ; Gait ; Humans ; Siblings* ; Tremor

We experienced one suspected case of chondrodystrophic calcificans congenita of 2 days aged newborn infant. The patient manifested short stature, articular contracture on both lower and upper extremities, moderate jaundice and irritabilities. A brief review of related literature is also presented.
Contracture ; Humans ; Infant, Newborn ; Jaundice ; Upper Extremity