No abstract available.
Humans ; Infant, Newborn*

Neonatology in pediatrics became a part of medical school curricula in Korea in 1954-1959. Specific treatments and procedures in the neonatal field were adopted around this period, for example, antibiotics, oxygen therapy, and the exchange transfusion procedure were established in 1950-1960. Usage of an infant incubator was implemented along with the establishment in 1960. The trend of separation between a premature infant care unit and newborn nursery room enabled the specialized treatment of high-risk infants in the 1970s. Assisted ventilation with continuous positive airway pressure and phototherapy was initiated in 1978. The recent concept of a neonatal intensive care unit was established in 1980, and it made so-called neonatal intensive care such as mechanical ventilation and intensive monitoring available. The Korean Society of Neonatology was founded in 1993. The usage of pulmonary surfactant in the 1990s, accelerated the improvement of respiratory distress syndrome survival, and it resulted in the nationwide opening of neonatal intensive care unit in hospitals. The high frequency ventilator and inhaled nitric oxide were introduced in the 2000s. The Korean Neonatal Network was commenced as a nationwide systemic database for very low birth weight infant registry in 2010. Accordingly, the history of Korean neonatology can be summarized as 50 years in total, and 35 years in a narrow sense. During this era, neonatal care in Korea has improved remarkably and has achieved a great survival rate for high-risk neonates, preterm infants, and micro-premies. In this review, we intend to provide an overview of the history, efforts, and outcomes of Korean neonatology activity that have led to these achievements.
Anti-Bacterial Agents ; Continuous Positive Airway Pressure ; Curriculum ; Humans ; Incubators, Infant ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Korea* ; Neonatology* ; Nitric Oxide ; Nurseries ; Oxygen ; Pediatrics ; Phototherapy ; Pulmonary Surfactants ; Respiration, Artificial ; Schools, Medical ; Survival Rate ; Ventilation ; Ventilators, Mechanical

No abstract available.
Neonatology

We report a case of primary cardiac angiosarcoma in a 35 year-old woman. She presented with dyspnea, facial edema and neck vein distension during 1 month. The oval round large mass(8x4 cm) filling the right atrium infiltrated into the entire thickness of the lateral wall and extended to the vena cava and ventricle. The interatrial septum and pericardium seemed to be intact. Despite the surgical excision and adjuvant chemo-and radiotherapy, the patient died 8 months later due to tumor recurrence. The histologic findings of tumor varied from benign looking capillary proliferation mimicking granulation tissue to sarcoma composed of spindle cells. But anastomosing vascular channels lined by anaplastic polygonal cells and intracytoplasmic lumen containing red blood cells were characteristic findings. These tumor cells showed positive reaction to endothelial cell antigen and factor VIII-related antigen. The intercellular junctional complex and vascular channels formed by cytoplasmic process of tumor cells were identified by the ultrastructural study.
Female ; Humans

We have experienced a patient (4-year-old female) with a granular cell tumor (GCT), Examination of patients skin showed a bean sized asymtomatic firm nodule on the left baek. Exciaional biopsy and histopathologic examination were perforrned under the impression of angiolipoma. The specirnen revealed a distinctive picture of GCT.
Angiolipoma ; Biopsy ; Granular Cell Tumor* ; Humans ; Skin

Authors came acoss a case of Behcet's syndrome involving cecum. The patient was a 33-year-old female. Her chief complaint was right lower quadrant pain, Colonoscopy revealed several ulcerations the base of which was covered by thick whitish coat, They were surrounded by mulitiple nodular masses. Endoscopic biopsy showed noaspecific ulceration. The patient had a history of aphthous ulceration of mouth and external genitalia. So she was diagnosed to have Behcets syndrome. She underwent right hemicolectomy with tetminal ilectomy. We report this case with literiature review.
Adult ; Behcet Syndrome* ; Biopsy ; Cecum* ; Colonoscopy ; Female ; Genitalia ; Humans ; Mouth ; Stomatitis, Aphthous ; Ulcer

The superficial lymph nodes may be enlarged in consequence of biologic or non-biologic antigenic stimuli, lymphoreticular maligna ntneoplasm, metastatic tumor or infiltrative disorders such as histiocytosis-X, and biopsy of the enlarged superficial lymph node is a time-honored diagnostic, therapeutic and follow-up tool. At present it is performed with ease and wideness. But in Korea there is no comprehensive studies about the diseases involving superficial ly-mph nodes of pediatric ages based on clinical and histopathological aspects. The present study is an sttempt to research for the histopathological aspects. The present study is an attempt to research for the histopathological findings of the superficial lymphadenopathy in correlation with the clinical characteristics. The histopathological findings of enlarged superficial lymph nodes, biopsied in Yonsei Univ-ersity Hospital for a 5year-period from 1976 to 1980, were reviewed. All patients were under 15year-old age, whose chief complaints were palpable lymph node with or without other sympt-oms. The results were as follows; 1. Of the 150 enlarged superficial lymph nodes, the male to female ratio was 1.68:1. Most of the biopsies were performed after the preschool age group and only 8 were of neonate or inf-ancy. 2. Of the 150 enlarged superficial lymph nodes, 79(52.7%) showed reactive hyperplasia, and inflammatory and malignant lymphadenopathies were 37.3% and 10.0% respectively. 3. Nonspecific reactive hyperplasia was the most common cause of the superfical lymphad-enopathy in pediatric ages, being 52.1% of total. Tuberculous lymphadenitis comprised 26.7%, being the 2nd most common cause, and of the 15 malignant lymphadenopathy 11 were primary lymphoreticular and 6 of the latter were histiocytic medullary reticulosis. 4. Ten percent of the patients with tuberculous lymphadenitis were of infancy, but none of those with both primary and metastatic malignant lymphadenopathy was of that age group. 5. The clinical symptoms and signs observed were fever, hepatosplenomegaly, gastrointest-inal symptoms and signs, rash, upper respiratory infection and others, irrespective of the histol-ogical classification. 6. The duration of superficial lymphadenopathy was less than 6 months in most cases of fu-ngal, acute and subacute nonspecific inflammatory and malignant origin, whereas it was more than 6 months in 38.5% of tyberculous lymphadentis and 41.7% of nonspecific reactive. 7. Superficial lymph node enlargement was most frequently found at cervical area which was followed by inguinal and axillary areas. 8. The superficial lymphadenopathy involved a single node in 63.9% of tuberculous origin but it tended to involve multiple ondes of one or more anatomical sites in nonspecific inflamm-ation, fungal infection, nonspecific reactive hyperplasia and malignancy. 9. The enlarged superficial lymph noded tendes to be soft and nontender in tuberculosis and nonspecific reactive hyperplasia, in contrast to the acute and subacute lymphadenitis and mali-gnant lymphadenopathy where they were more commonly hard with variable tenderness.
Biopsy ; Classification ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; Humans ; Hyperplasia ; Infant, Newborn ; Korea ; Lymph Nodes ; Lymphadenitis ; Lymphatic Diseases* ; Male ; Tuberculosis ; Tuberculosis, Lymph Node

PURPOSE: Peak expiratory flow rate (PEFR) monitoring plays an important role in the diagnosis of airway obstruction and management of patients with bronchial asthma. This study compared the PEFR taken by a Microplus pocket spirometer and mini-Wright peak flow meter by assessing the extent of agreement between the instruments and the repeatability of measurements with each instrument. METHODS: Eighty healthy children (age 11-12 years, 43 females, 37 males) performed three PEFR maneuvers on the Microplus pocket spirometer and on the mini-Wright peak flow meter in a random order. Agreement and reproducibility between the two instruments were assessed by the statistical methods proposed by Bland and Altman. RESULTS: Seventy six (95%) of the PEFR taken by the mini-Wright peak flow meter were higher than that of Microplus pocket spirometer. The 95% limits of agreements (mean difference+/-2SD) between each instrument were very wide (2.7 to 144.3 L/min). The repeatability coefficient for the mini-Wright peak flow meter was 27 L/min and for the Microplus pocket spirometer was 33.5 L/min. Analysis by sex and order of usage did not show any significant differences. CONCLUSION: The limit of agreement between the Microplus pocket spirometers and the mini-Wright peak flow meter was too wide to use interchangeably.
Airway Obstruction ; Asthma ; Child ; Diagnosis ; Female ; Humans ; Peak Expiratory Flow Rate*

We describe a case of successful extracorporeal membrane oxygenation(ECMO) in a small infant with cardiopulmonary resuscitation(CPR) failure after an open heart surgery. A 35-day-old male infant weighing 4.4 kg who had congestive heart failure and pulmonary hypertension underwent patch closure of ventricular septal defect without any intraoperative event. Postoperative course was unremarkable in the intensive care uint for about 5 hours before the junctional ectopic tachycardia developed. Sudden cardiac decompensation with bradycardia occurred about 50 minutes after the development of junctional ectopic tachycardia. He was put on ECMO by arterial cannulation at the ascending aorta and by venous cannulation at the right atrial appendage after 4 hours' CPR. The hemodynamics were stable with enough urine output during ECMO. He was weaned from ECMO 38.5 hours after initiation. Delayed sternal closure was attempted. He was extubated on postoperative day 7 and discharged home on postoperative day 21 without any neurologic sequelae.
Aorta ; Atrial Appendage ; Bradycardia ; Cardiopulmonary Resuscitation* ; Catheterization ; Extracorporeal Membrane Oxygenation* ; Heart Failure ; Heart Septal Defects, Ventricular ; Heart* ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Infant ; Critical Care ; Male ; Membranes ; Tachycardia, Ectopic Junctional ; Thoracic Surgery*

PURPOSE: The score for neonatal acute physiology (SNAP) based on physiologic derangements, is applied to variable fields including morbidity as well as mortality estimate. We evaluate the clinical usefulness of SNAP and SNAP variants for neonatal acute severity and mortality. METHODS: Twenty-one neonates were evaluated the SNAP, SNAP-PE, SNAP-II, and SNAPPE-II, who survived more than 24 hours in Neonatal Intensive Care Unit in Department of Pediatrics, Kyunghee University from July 2003 to December 2004. A study group included 21 neonates as death group and a control group matched for gestational age and birth weight. We analyzed the differences of clinical usefulness of SNAP and SNAP variants indices between the two groups. RESULTS: 1) SNAP:The scores were ranged 2-18 (median 6.5) in survival group and 9-31 (median 13.0) in death group. 2) SNAP-PE:The scores were ranged 2-48 (median 16.5) in survival group and 23-75 (median 32.0) in death group. 3) SNAP-II:The scores were ranged 0-16 (median 10.5) in survival group and 10-62 (median 21.0) in death group. 4) SNAPPE-II:The scores were ranged 0-45 (median 24.5) in survival group and 35-109 (median 44.0) in death group. The median values were higher in those who were died:SNAP<0.05 (P-value), SNAP-PE<0.01, SNAP-II<0.01, SNAPPE-II<0.01 showing the significant differences. CONCLUSION: The study shows that SNAP and SNAP variables are useful for the evaluation of acute severity and excellent predictors of neonatal survival. They would help the management of neonatal intensive care unit.
Birth Weight ; Gestational Age ; Humans ; Infant, Newborn* ; Intensive Care, Neonatal ; Mortality ; Pediatrics ; Physiology