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A Criteria for Calculation of Hospital Rate for the Health Insurance (47).

Chong Kil LEE

Journal of the Korean Pediatric Society.1990;33(3):431-.

No abstract available.
Insurance, Health*

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A Case of Septic Pulmonary Embolism in Neonate.

Sang Hee LEE ; In Hoon LEE ; Jin Kuk KIM ; Byung Do NAM ; Ju Seok LEE ; Jae Hong PARK

Journal of the Korean Pediatric Society.1998;41(9):1304-1308.

Septic pulmonary embolization is an uncommon condition in which the clot or fibrin matrix, contaminated with micro-organisms, lodge in the pulmonary arterial tree, leading to infarction, suppuration and other complications. The septic emboli reach the lung from a variety of sources, including acute suppurative pelvic thrombophlebitis, infective endocarditis involving tricuspid and pulmonary valve, osteomyelitis, suppurative lesions of the neck, infected venous catheters or pacemaker wires and sepsis. Early clinical detection, along with prompt administration of broad- spectrum antibiotics, is an important factor in the prognosis of patients, but the initial clinical diagnosis is often difficult because of nonspecific findings in clinical and laboratory data. Recently, the characteristic appearance of septic emboli by chest computed tomography (CT) has been described, and chest CT is an important modality for confirming the presence of septic pulmonary emboli. We experienced a case of septic pulmonary embolism in a 14-day-old neonate with cough, fever dyspnea. Initial conventional chest radiogaphs revealed bilateral infilterate, but chest CT revealed the presence of multiple peripheral nodules, cavitation of nodules and a distinct vessel leading to a pulmonary nodule which is referred to as a feeding vessel sign, which diagnosis suggests. Coagulase negative staphylococcus was cultured in the blood stream and clinical and radiologic improvement was achieved after adminstration of antibiotics.
Anti-Bacterial Agents ; Catheters ; Coagulase ; Cough ; Diagnosis ; Dyspnea ; Endocarditis ; Fever ; Fibrin ; Humans ; Infant, Newborn* ; Infarction ; Lung ; Neck ; Osteomyelitis ; Prognosis ; Pulmonary Embolism* ; Pulmonary Valve ; Rivers ; Sepsis ; Staphylococcus ; Suppuration ; Thorax ; Thrombophlebitis ; Tomography, X-Ray Computed

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A Case of Polyglandular Autoimmune Syndrome.

Kyung Ah CHOI ; Ji Yeoun KANG ; Chul Hoe KOO ; Wha Mo LEE ; Young Suk JEON

Journal of the Korean Pediatric Society.1998;41(9):1299-1223.

When dysfunction of two or more endocrine glands occurs in association with circulating organ specific antibodies directed against the involved glands, the term polyglandular autoimmune (PGA) syndrome is applied. This syndrome is usually classified into three groups. The autoimmune nature of this disease has been based on the presence of lymphocytic infiltration of the affected glands, organ specific autoantibody in serum, cellular immune defects and association with HLA DR/DQ genes. A 12-year-old girl developed PGA syndrome, type III manifesting Grave's disease and insulin-dependent diabetes mellitus. The thyroid microsomal Ab, TSH receptor Ab and pancreatic islet cell Ab were positive. She should be observed for the possible development of adrenal insufficiency and/or other autoimmune disease.
Adrenal Insufficiency ; Antibodies ; Autoimmune Diseases ; Child ; Diabetes Mellitus, Type 1 ; Endocrine Glands ; Female ; Humans ; Islets of Langerhans ; Receptors, Thyrotropin ; Thyroid Gland

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A Case of Nutcracker Esophagus Combined with Hypertensive Lower Esophageal Sphincter.

Seong Hun KIM ; Ju Suk LEE ; Su Eun PARK ; Sang Ook NAM ; Jae Hong PARK

Journal of the Korean Pediatric Society.1998;41(9):1288-1292.

Nutcracker esophagus and hypertensive lower esophageal sphincter (LES) are primary esophageal motility disorders. Nutcracker esophagus have demonstrated distal esophageal contraction amplitude that exceeds the normal range (>160mmHg), without association abnormalities of the esophageal contraction wave, or lower esophageal sphinter relaxation. The criteria for diagnosing hypertensive LES take the mean LES pressure >45mmHg, LES relaxation >75% and normal peristalsis, which is a poorly characterized motility disorder associated with chest pain and dysphagia. We experienced a case of nutcracker esophagus combined with hypertensive LES in a 3-year- old girl who presented with projectile vomiting immediately after eating solid foods. After she had taken barium esophagography and esophageal endoscopy, we suspected she had esophageal motor disorder. Esophageal manometric findings show abnormal high pressure of LES (mean LES pressure, 52.9 mmHg), abnormal high amplitude of lower esophagus more than 320 mmHg, normal esophageal perisaltic movement and normal LES relaxation. After pneumatic dilatation, now she can eat semisolid foods. This case may be the first case of nutcracker esophagus combined with hypertemsive LES in children.
Barium ; Chest Pain ; Child ; Deglutition Disorders ; Dilatation ; Eating ; Endoscopy ; Esophageal Motility Disorders* ; Esophageal Sphincter, Lower* ; Esophagus ; Female ; Humans ; Peristalsis ; Reference Values ; Relaxation ; Vomiting

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A Case of Congenital Tuberculosis Misdiagnosed as Fungal Pneumonia.

Hye Kyung LEE ; Young Chang KIM ; Young Tong KIM

Journal of the Korean Pediatric Society.1998;41(9):1283-1287.

Congenital tuberculosis is a rare disease and it is difficult to diagnose because of the nonspecific nature of the presenting symptoms, signs and the fatal outcome in the absence of early therapy. We experienced a case of congenital tuberculosis in a newborn infant, who was born prematurely to a mother who had a miliary pulmonary tuberculosis confirmed on the 34th postpartum days. At the age of 32 days, chest X-ray revealed total hazziness of the right lung and the infant required intubation and mechanical ventilation. At that time a significant number of fungi were found in the urine culture. Amphotericin B therapy was started with the impression of fungal pneumonia. DIC developed despite of intensive therapy. Based on the medical history of the mother, laboratory tests were done on the infant for the isolation of M. tuberculosis at the age of 34 days. Acid-fast bacilli were seen in the gastric aspirates and sputum by staining and antituberculosis therapy with isoniazid, rifampin, pyrazinamide and prednisolone was started. Significant clinical improvement occurred 2 weeks after therapy began.
Amphotericin B ; Dacarbazine ; Fatal Outcome ; Fungi ; Humans ; Infant ; Infant, Newborn ; Intubation ; Isoniazid ; Lung ; Mothers ; Pneumonia* ; Postpartum Period ; Prednisolone ; Pyrazinamide ; Rare Diseases ; Respiration, Artificial ; Rifampin ; Secondary Prevention ; Sputum ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary

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The Significance of Family History, Immunoglobulin E, Total Eosinophils and Eosinophil Cationic Protein as a Predictor of Allergic Diseases.

Dong Su PARK ; Hyun Hee KIM ; Joon Sung LEE

Journal of the Korean Pediatric Society.1998;41(9):1273-1282.

PURPOSE: Family history of allergy and cord blood immunoglobulin E concentration have been proven to be predictors of the development of allergic diseases in children. The purpose of this study is to evaluate whether maternal, cord and baby's blood total eosinophils or eosinophil cationic protein (ECP) in addition to the above two predictors could be a predictor of subsequent allergic diseases later in life. METHODS: Fifty pregnant women and their newborns with positive family history of allergic disease and fifty other pregnant women and their newborns with no family history were investigated and a clinical follow-up study was conducted in thirty-two infants for two years. Immunoglobulin E level, total eosinophils and ECP level were measured in maternal, cord and baby's blood. RESULTS: The group who developed allergic disease showed significantly high cord immunoglobulin E concentration than the group who did not develop allergic disease (P<0.01). There were no significant differences of immunoglobulin E level, total eosinophils, ECP level in maternal, cord, baby's blood between the group with positive family history of allergic disease and the group with no family history. The incidence of allergic disease was significantly higher in the group which had both positive family history and high cord blood immunoglobulin E concentration than the group which had no family history and low cord blood immunoglobulin E concentration (P<0.01). CONCLUSION: Family history of allergy and high-cord blood immunoglobulin E concentration are the best predictors of allergic diseases later in life.
Child ; Eosinophil Cationic Protein* ; Eosinophils* ; Female ; Fetal Blood ; Follow-Up Studies ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Immunoglobulins* ; Incidence ; Infant ; Infant, Newborn ; Pregnant Women

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Thymopentin Therapy in Atopic Dermatitis.

Geun Woong NOH ; Ki Young LEE

Journal of the Korean Pediatric Society.1998;41(9):1268-1272.

PURPOSE: Atopic dermatitis is a chronic relapsing inflammatory skin disease that results from allergic reaction. Steroid therapy has become a major therapeutic modality for treatment of atopic dermatitis. Several immunomodulatory therapies have been tried for atopic dermatitis. In this study thymopentin therapy was performed and its clinical effects and laboratory results were evaluated. METHODS: Atopic dermatitis with typical clinical symptoms were included in this study. Twelve patients were treated with subcutaneous injection of thymopentin ( (Imupentin ) at a dose of 1 mg/kg, three times per week for eight weeks. Clinical scores were measured by Hanifin scoring system before and at the end of the treatment. General hematologic laboratory tests such as hemoglobin, hematocrit, WBC count, neutrophil percentage, lymphocytes percentage and eosinophil percentage as well as blood IgE level were conducted at the same time. RESULTS: The clinical severity of atopic dermatitis patients was markedly improved by thymopentin therapy. The clinical severity score improved by 85.5%. Three patients showed complete remission of clinical status at the end of thymopentin therapy. Hemoglobin, hematocrit, WBC counts, neutrophil percentage, and lymphocyte percentage were not affected by the thymopentin therapy. Eosinophil percentage and blood IgE level were significantly reduced statistically. CONCLUSION: Thymopentin therapy is an effective immunomodulatory therapeutic modality in atopic dermatitis. Thymopentin decreased eosinophil percentage and blood IgE levels without other hematologic changes.
Dermatitis, Atopic* ; Eosinophils ; Hematocrit ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunomodulation ; Injections, Subcutaneous ; Lymphocytes ; Neutrophils ; Skin Diseases ; Thymopentin*

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The Clinical Significance of Serum Sodium Concentration in Febrile Convulsion.

So Young PARK ; Seung Joo LEE

Journal of the Korean Pediatric Society.1998;41(9):1262-1267.

PURPOSE: Recently hyponatremia was reported to be common in febrile convulsion and related to the probability of a repeated convulsion. It was documented that hyponatremia lowers the threshold for convulsion in experiment animals. We therefore studied the relationship between hyponatremia and febrile convulsion. METHODS: Serum sodium concentration was measured in 82 children with febrile convulsions and 66 age-matched febrile controls without convulsion from January 1995 to September 1996 at Ewha Womans University Hospital. The relationship between hyponatremia and febrile convulsion, including the repeat or recurrency was examined in 17 children with repeated convulsions during the same febrile period and 36 children with recurrent convulsions during the other febrile illness. RESULTS: Serum sodium concentration in febrile convulsions was 134.9 +/- 2.3mEq/L which was significantly lower than 138.2 +/- 2.4mEq/L in febrile controls (P<0.01) and that in repeated and recurrent febrile convulsions was significantly lower compared to non-repeated and non- recurrent febrile convulsions. The incidence of hyponatremia in febrile convulsions was 36 of 82 children (44%) which was significantly higher than the incidence in febrile controls (3%) (P<0.01) and that in repeated febrile convulsions (59%) and recurrent convulsions (56%) had significantly higher incidence than that in non-repeated (31%) and non-recurrent febrile convulsions (37%) (P<0.05). The increase in probability of a repeated and recurrent convulsion when serum sodium level decreases, was significant (P<0.05). Conclusion : Serum sodium concentration in children with febrile convulsions was significantly lower than febrile children without convulsions and the lower the serum sodium concentration, the higher the probability of a repeated and recurrent febrile convulsion.
Animals ; Child ; Female ; Humans ; Hyponatremia ; Incidence ; Seizures ; Seizures, Febrile* ; Sodium*

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Short Term Effect of Recombinant Human Growth Hormone Therapy in Children with Chronic Renal Failure.

Si Whan KOH ; Dong Kyu JIN

Journal of the Korean Pediatric Society.1998;41(9):1256-1261.

PURPOSE: Growth retardation is one of the major side effects of chronic renal failure. In this study, the short-term growth promoting effect, effect on the chemical parameters, and probable side effects of growth hormone treatment to child patients with chronic renal failure were examined. METHODS: The research sample was 5 child patients diagnosed with chronic renal failure and receiving growth hormone treatement for more than 6 months. Data were gathered on the height standard deviation scores, IGF-I, fasting blood sugar, general chemistry changes, and changes in blood pressure. Collected data was processed as the statistics by SAS (ver 6.12) program. RESULTS: After six months of growth hormone treatment, three of 5 subjects showed clinical increase in height SDS. The rest two, who were older than 10, also showed steady growth, but significant differences didn't appear in the process of statistical analysis (P=0.0625). All of those three done IGF-I has shown clinical increases, but significant differences didn't appear in the process of statistical analysis (P=0.1079). Presumably, it was because of the small number of the subjects and the short period of observation. One of the five patients showed increased blood pressure after the treatment. However, even after stopping the treatment, the blood pressure didn't return to the normal level. CONCLUSION: Growth hormone treatment to child patients with low height caused by chronic renal failure induced growth effect in the clinical setting without pernicious side-effects or significant changes in the biochemical tests.
Blood Glucose ; Blood Pressure ; Chemistry ; Child* ; Fasting ; Growth Hormone ; Human Growth Hormone* ; Humans* ; Insulin-Like Growth Factor I ; Kidney Failure, Chronic*

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Thyroid Function Studies in Patients Who Underwent Open Heart Surgery.

Hyung Joo SOHN ; Yu In PARK ; Chang Sung SON ; Joo Won LEE ; Young Chang TOCKGO

Journal of the Korean Pediatric Society.1998;41(9):1250-1255.

PURPOSE: Alteration in the serum level of thyroid hormone can occur following open heart surgery due to major stress and hemodilution after extracorporeal circulation but these changes have been ignored. The purpose of this study is to evaluate the changes of thyroid hormone level after open heart surgery and if these changes influence the prognosis. METHODS: We evaluated 26 children who had undergone open heart surgery from Sept. 1994 to Jun. 1996 at Korea University Hospital. Five ml of blood were collected before surgery, immediately after surgery and 24 hours after surgery. The blood was centrifused and the serum stored at -40degrees C until examinations were made. Serum T3, T4, reverse T3 were measured by sensitive and specific radioimmunoassay. RESULTS: The mean T3 level was 1.49 +/- 0.50ng/ml (normal 0.08-2.0ng/ml) at pre op, 0.75 +/- 0.40ng/ ml immediately after surgery and 0.69 +/- 0.50ng/ml 24 hours after surgery. The mean T4 level was 10.73 +/- 4.40ug/dl (normal 6.1-11.8 microgram/dl) at pre op, 5.80 +/- 1.90ug/dl immediately after surgery and 5.60 +/- 2.10ug/dl 24 hours after surgery. The mean TSH level was 1.69 +/- 1.13uIU/ml (normal 0.25-4.0 uIU/ml) at pre op, 1.37 +/- 0.80uIU/ml immediately after surgery and 1.61 +/- 1.00uIU/ml 24 hours after surgery. Serum T3 and T4 levels in cardiac surgical patients were significantly reduced (P<0.01), and serum reverse T3 levels were significantly increased (P<0.05), and serum TSH levels were not significantly different in comparison with the preoperative state. CONCLUSION: We conclued that patients with congenital heart disease who underwent open heart surgery show euthyroid sick states like other severely ill patients. It is likely that reduction in T3 and T4 without increased TSH represents an adaptive response by the body to minimize catabolism when undergoing major stress.
Child ; Extracorporeal Circulation ; Heart Defects, Congenital ; Heart* ; Hemodilution ; Humans ; Korea ; Metabolism ; Prognosis ; Radioimmunoassay ; Thoracic Surgery* ; Thyroid Gland*

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