No abstract available.
Humans ; Infant, Newborn*

No abstract available.
Neonatology

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

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

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

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

PURPOSE: To evaluate the various nationwide statistical data for 2002 in Korea and to compare it to statistical data obtained in 1996. METHODS: Questionaires were distributed to 104 hospitals to obtain vital statistics for live-births, their gestational age and birth weight, incidence of preterm infants, low birth weight infants (LBWI), very LBWI (VLBWI), and neonatal mortality for year 2002. RESULTS: Based on 53, 831 inborn and 11, 151 outborn population, from 64 responded hospitals, the incidence of preterm, term, and postterm were 17.5%, 81.4%, and 1.1%, respectively among inborn group. The incidence of preterm among outborn group was lower than that of inborn. The incidences of LBWI, normal birth weight (2.5-4.0 kg) infants, and large birth weight (>4.0 kg) infants were 15.3%, 80.6%, and 4.2%, respectively among inborn group. The incidence of LBWI was lower in outborn group as compared with the inborn group. Overall neonatal mortality rates of preterm, term, and postterm were 5.5%, 0.3%, and 0% and those of LBWI, normal birth weight (2.5-4.0 kg) infants, and large birth weight (>4.0 kg) infants were 6.1%, 0.2%, and 0.1%, respectively. Neonatal mortality rates of VLBWI and extremely LBWI (ELBWI) were 22.5% and 43.9%, respectively. CONCLUSION: Based on statistical data obtained for 2002 from 64 hospitals, the incidence of preterm and LBWI increased, however, the neonatal mortality rates of LBWI and VLBWI declined in 2002 compared to 1996 in Korea. Further continuation of efforts need to be given to improve standarized neonatal care in Korea.
Birth Weight ; Gestational Age ; Humans ; Incidence ; Infant ; Infant Mortality* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Korea* ; Vital Statistics

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

PURPOSE: Pulmonary surfactants for preterm infants contain mostly animal-derived surfactant proteins (SPs), which are essential for lowering surface tension. We prepared artificial pulmonary surfactants using synthetic human SP analogs and performed in vitro and in vivo experiments. MATERIALS AND METHODS: We synthesized peptide analogues that resemble human SP-B (RMLPQLVCRLVLRCSMD) and SP-C (CPVHLKRLLLLLLLLLLLLLLLL). Dipalmitoylphosphatidylcholine (DPPC), phosphatidylglycerol (PG), and palmitic acid (PA) were added and mixed in lyophilized to render powdered surfactant. Synsurf-1 was composed of DPPC:PG:PA:SP-B (75:25:10:3, w/w); Synsurf-2 was composed of DPPC:PG:PA:SP-C (75:25:10:3, w/w); and Synsurf-3 was composed of DPPC:PG:PA:SP-B:SP-C (75:25:10:3:3, w/w). We performed in vitro study to compare the physical characteristics using pulsating bubble surfactometer and modified Wilhelmy balance test. Surface spreading and adsorption test of the surfactant preparations were measured. In vivo test was performed using term and preterm rabbit pups. Pressure-volume curves were generated during the deflation phase. Histologic findings were examined. RESULTS: Pulsating bubble surfactometer readings revealed following minimum and maximum surface tension (mN/m) at 5 minutes: Surfacten® (5.5±0.4, 32.8±1.6), Synsurf-1 (16.7±0.6, 28.7±1.5), Synsurf-2 (7.9±1.0, 33.1±1.6), and Synsurf-3 (7.1±0.8, 34.5±1.0). Surface spreading rates were as follows: Surfacten® (27 mN/m), Synsurf-1 (43 mN/m), Synsurf-2 (27 mN/m), and Synsurf-3 (27 mN/m). Surface adsorption rate results were as follows: Surfacten® (28 mN/m), Synsurf-1 (35 mN/m), Synsurf-2 (29 mN/m), and Synsurf-3 (27 mN/m). The deflation curves were best for Synsurf-3; those for Synsurf-2 were better than those for Surfacten®. Synsurf-1 was the worst surfactant preparation. Microscopic examination showed the largest aerated area of the alveoli in the Synsurf-3 group, followed by Synsurf-1 and Surfacten®; Synsurf-2 was the smallest. CONCLUSION: Synsurf-3 containing both SP-B and SP-C synthetic analogs showed comparable and better efficacy than commercially used Surfacten® in lowering surface tension, pressure-volume curves, and tissue aerated area of the alveoli.
1,2-Dipalmitoylphosphatidylcholine ; Adsorption ; Animal Experimentation* ; Animals* ; Humans ; In Vitro Techniques* ; Infant, Newborn ; Infant, Premature ; Palmitic Acid ; Pulmonary Surfactant-Associated Proteins ; Pulmonary Surfactants ; Reading ; Surface Tension