A wedge shape compensating filter composed of aluminium was made to equalise the density of lung and mediastinum. Total 68 patients were taken chest tomograph with compensating filter and the radiographic findings were correlated with the pathologic, bacteriologic prove or the clinical course. This simple device was turned out to be very useful in certain disease categories, especially central type of bronchogenic carcinoma.
Carcinoma, Bronchogenic ; Humans ; Lung ; Mediastinum ; Thorax

Over a continuous 4-year period, from January 1989 till December 1992, 7,100 infants were born in Department of Obstetrics and admitted to Nursery or Neonatal Intensive Care Unit of Department of Pediatrics of Seoul National University Children's Hospital. Among them, 126 cases were diagnosed as respiratory distress syndrome (RDS) of newborn. The total incidence of RDS among all the newborns (inborn) was 1.77%. And the incidence of RDS related to birth weight was 81.82% in infants of 500~749 g of birth weight, 68.57% in infants of 750~999 g of birth weight, 55.6% in infants of 1,000~1,249 g of birth weight, 35.71% in infants of 1,250~1,499 g of birth weight, 16.67% in infants of 1,500~1,749 g of birth weight, 9.82% in infants of 1,750~1,999 g of birth weight, 1.00%in infants of 2,000~2,249 g of birth weight, 1.29%in infants of 2,250~2,499 g of birth weight, and 0.08% in infants of more than 2,500 g of birth weight. Cumulative incidence of RDS related to birth weight was 81.82%in infants under 750 g of birth weight, 71.74% in infants under 1,000 g of birth weight, 62.39% in infants under 1,250 g of birth weight, 53.33% in infants under 1,500 g of birth weight, 39.85% in infants under 1,750 g of birth weight, 30.83% in infants under 2,000 g of birth weight, 20.42% in infants under 2,250 g of birth weight, and 13.70% in infants under 2,500 g of birth weight. The incidence of RDS related to gestational age was 83.33%, in infants under 25 weeks of gestation, 78.57% in infants at 25~26 weeks of gestation, 67.31% in infants at 27~28 weeks of gestation, 56.41%in infants at 29~30 weeks of gestation, 16.47% in infants at 31~32 weeks of gestation, 4.74% in infants at 33~34 weeks of gestation, 1.15% in infants at 35~36 weeks of gestation, and 0.05% in infants at more than 37 weeks of gestation. Cumulative incidence of RDS related to gestational age was 83.33% under 25 weeks of gestation, 80.00% under 27 weeks of gestation, 70.83% under 29 weeks of gestation, 63.33% under 31 weeks of gestation, 46.38% under 33 weeks of gestation, 27.76% under 35 weeks of gestation. Perinatal risk factors related to the incidence of RDS were analyzed by the multiple logistic regression statistical method in 595 infants, who were born under 37 weeks of gestation and under 2,500 g of birth weight in Seoul National University Hospital. The risk of RDS rose with decreasing gestational age (odds ratio=1.76, 95% CI=1.57, 1.99), with decreasing 5 minute Apgar score (odds ratio=1.23,95% CI=1.08, 1.40), while prolonged ruptrue of membranes of > 24 hours in the absence of maternal infection was highly protective (odds ratio=0.37, 95% CI=0.20, 0.70).
Apgar Score ; Birth Weight ; Gestational Age ; Humans ; Incidence* ; Infant ; Infant, Newborn* ; Intensive Care, Neonatal ; Logistic Models ; Membranes ; Nurseries ; Obstetrics ; Pediatrics ; Pregnancy ; Risk Factors* ; Seoul

No abstract available.
Cerebral Palsy*

In the current era of low-birth rate in Korea, it is important to improve our neonatal intensive care and to establish an integrative system including a regional care network adequate for both high-risk pregnancies and high-risk newborn infants. Therefore, official discussion for nation-wide augmentation, proper leveling, networking, and regionalization of neonatal and perinatal care is urgently needed. In this report, I describe the status of neonatal intensive care in Korea, as well as nationwide flow of transfer of high-risk newborn infants and pregnant women, and present a short review of the regionalization of neonatal and perinatal care in the Unites States and Japan. It is necessary not only to increase the number of neonatal intensive care unit (NICU) beds, medical resources and manpower, but also to create a strong network system with appropriate leveling of NICUs and regionalization. A systematic approach toward perinatal care, that includes both high-risk pregnancies and newborns with continuous support from the government, is also needed, which can be spearheaded through the establishment of an integrative advisory board to propel systematic care forward.
Female ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Japan ; Korea ; Perinatal Care ; Pregnancy, High-Risk ; Pregnant Women

In the early postnatal period, prematurely born infants, especially those born at the earliest limits of viability, face a nutritional crisis. A lack of essential nutrients may result in substantial developmental morbidity. In particular, because this period is crucial to proper neurodevelopment, a central concern must be providing essential nutrition for proper neurodevelopment, and the prevention of long-term neuro-deficits. Therefore, providing appropriate nutrition for growth and development is one of the most essential concerns in the care of preterm infants. The optimal goal for providing nutrition in the preterm infant is to achieve a postnatal growth rate approximating that of the normal fetus at the same gestational age. However, extra-uterine growth restriction develops during the course of care for most very low birth weight infants admitted to the neonatal intensive care unit. Herein, the optimal nutrient requirements and most recently recommended total parenteral and enteral feeding strategies are reviewed to provide neonatal clinicians with current guidelines for nutritional care that can improve neurodevelopmental outcomes in preterm infants during and after treatment in the neonatal intensive care unit.
Enteral Nutrition ; Feeding Methods ; Fetus ; Gestational Age ; Growth and Development ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Nutritional Status ; Nutritional Support

Nosocomial sepsis or late onset sepsis is among the leading causes of mortality and morbidity in extremely low birth weight infants hospitalized to neonatal intensive care units (NICU). Prevention of nosocomial sepsis is based on strategies that aim to limit susceptibility to infections by enhancing functional maturities, and ameliorating extrinsic risk factors by limiting transmission of organisms and by promoting the judicious use of antimicrobials. Several clinical strategies which are available include; hand hygiene practices; prevention of central venous catheter-related septicemia; judicious use of therapeutic or prophylactic antimicrobials; proper skin care; and early trophic enteral feeding with human milk. The implementation of these proper clinical strategies and maintaining of surveillance system in individual NICU for prevention of nosocomial infection is quite effective and important to reduce the incidence of noscomial sepsis of extremely premature infants and ultimately to improve their survival and quality of life.
Cross Infection ; Enteral Nutrition ; Hand Hygiene ; Humans ; Incidence ; Infant ; Infant, Extremely Premature ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care Units, Neonatal ; Milk, Human ; Quality of Life ; Risk Factors ; Sepsis ; Skin

No abstract available.
Humans ; *Infant Health ; Infant, Low Birth Weight ; Infant, Newborn ; Republic of Korea ; Societies, Medical/*organization & administration

Throughout the past several decades in Korea, the field of neonatology has developed enormously along with the advancement of modern neonatal intensive care units, which has resulted in significant improvement of treatment effectiveness for high-risk newborn and premature infants. Since the deaths of newborn infants are closely related to the infant death rate - one of the most important indicators of national health - neonatal intensive care is significant as a major element of the basic infrastructure of the national healthcare system. In Korea, where a noteworthy decrease in birth rates and an aging population has serious consequences for the future, interest at the national level and policy support for neonatal intensive care as well as for the effective continuous and systematic organization of perinatal care is strongly needed. Important topics for future exploration in the field of neonatology in Korea include the establishment of regionalization and organization of an effective perinatal care system, active quality improvement in neonatal care, and the improvement of evidence-based neonatal medicine through active multicenter clinical trials and the development of new research subjects for unresolved problems in the neonatal field. In addition, suggestions for multidisciplinary treatment and interest in family-oriented and developmental care for newborn infants as well as long-term follow-up research after discharge from the neonatal intensive care unit will also be discussed.
Aging ; Birth Rate ; Critical Care ; Delivery of Health Care ; Follow-Up Studies ; Forecasting ; Humans ; Infant Death ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Korea* ; Neonatology* ; Perinatal Care ; Quality Improvement ; Research Subjects ; Treatment Outcome

No abstract available.
Korea* ; Neonatology*

This study was aimed to provide data on the use of medical resources by preterm infants following discharge from the neonatal intensive care unit (NICU). The cohort included preterm infants (n=2,351) born at 22-32 weeks' gestation who were discharged from the NICUs of 44 Korean hospitals between April 2009 to March 2010. Mean duration of post-discharge follow-up was 425+/-237 days. After discharge from the NICU, 94.5% of total infants visited a pediatric outpatient clinic (11.5+/-9.8 mean visits), 42.9% visited a pediatric clinic for respiratory problems irregularly (4.9+/-6.6 mean visits), and 31.1% utilized emergency center at least once. Among all visits to the emergency center, 24.7% resulted in readmission and 50.8% of those visits were due to respiratory problems. At least one episode of readmission was required by 33.6% (788/2,346) of total infants, and 18.4% (431/2,346) of total infants were readmitted with respiratory problems at least once. Among all infants readmitted for respiratory problems, 16.2% (70/341) were diagnosed with respiratory syncytial virus infection which accounted for 30.3% of viral etiologies confirmed by laboratory testing. Infants born at <30 weeks' gestation had more frequent total readmission and respiratory readmission than those > or =30 weeks' gestation (2+/-1.7 vs. 1.7+/-1.2, P=0.009, 1.8+/-1.2 vs. 1.5+/-1.1, 0.027, respectively). Overall, use of medical resources is common, and respiratory problems are the leading cause of use of medical resources. Total readmissions and respiratory readmissions are more frequent in more immature infants.
Cohort Studies ; Databases, Factual ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases/*pathology ; Intensive Care Units, Neonatal ; Male ; Patient Readmission ; Republic of Korea ; Respiratory Distress Syndrome, Newborn/*pathology ; Retrospective Studies