• Clinical and Experimental Pediatrics
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• 제50권9호
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• pp.855-861
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• 2007

Purpose : The most common causes of acute viral gastroenteritis in newborn period are rotavirus, astrovirus, norovirus and enteric adenovirus. This study was designed to investigate the clinical characteristics, clinical symptoms, isolation rate and distribution of these viruses in full-term neonates during neonatal period. We also studied the influence on the viral isolation rate by postnatal care place and feeding type. Methods : We evaluated 112 healthy full-term neonates who were admitted to Eulji hospital, presenting with symptoms of acute viral gastroenteritis from September 2004 to August 2005. Epidemiologic, clinical and laboratory data were reviewed. Enzyme-linked immunosorbent assay (ELISA) for rotavirus, astrovirus and norovirus and RT-PCR for enteric adenovirus were performed in study subjects.Results : The mean age at the admission was $11.4{\pm}5.4days$, mean weight loss was $5.9{\pm}5.1%$, mean hospitalization duration was $6.3{\pm}3.4days$. Moderate and severe weight loss were expressed in 51.7% and metabolic acidosis was in 13.4%. The percent of living in postnatal care facility (PCF) was 74.1 % and the percent of mixed feeding was 64.3%. Isolation rate of virus was 33%. The most prevalent virus was rotavirus (59.5%), followed by astrovirus (29.7%) and norovirus (10.8%). There was no differences in virus isolation rate by postnatal care place and by feeding type. The rotavirus was main virus in both home group and PCF group. But astrovirus was more detected in PCF and norovirus was more detected in home (P<0.05). According to monthly distribution of virus, acute viral gastroenteritis in newborn period was concentrated in September to December. Conclusion : The isolation rate of 4 type viruses was 33% and rotavirus was the leading cause of acute gastroenteritis during neonatal period. There was no differences in clinical characteristics on each viral groups.

• Clinical and Experimental Pediatrics
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• 제48권10호
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• pp.1116-1120
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• 2005

Purpose : Although the rotavirus-related neonatal death occurred in western part of Kyeonggi Province recently, there were just a few reports about rotavirus gastroentertis in domestic since 2000. We proposed to investigate changes of epidemiology and clinical features of rotavirus gastroenteritis for the last 2 years. Methods : We selected 166 patients diagnosed as gastroenteritis from January, 2002 to July, 2003 and reviewed the admission records retrospectively such as age distribution, sex ratio, seasonal distribution, admission period, laboratory data and dehydration type in the rotavirus group(RVG) and non-RVG. Results : The percentage of patient under 3 years was 77% on RVG. The non-RVG showed even age distribution(P<0.05). In RVG, patients occurred in March frequently and 52% occurred from January to March. In non-RVG, patients occurred highly in February and July(P<0.05). The average of admission period was higher in RVG than non-RVG(P<0.05). The percentage of patient admitted for over 10 days was 8% in the RVG. In dehydration severity, the RVG showed mild(51%), moderate(44%) and severe(5%) respectively, but non-RVG showed only mild dehydration(P<0.05). The laboratory findings' did not have statistic significance between RVG and non-RVG. Conclusion : Compared to the previous studies, seasonal peak prevalence of rotavirus gastroenteritis changed from autumn to spring and patients over 3 years increased. Therefore, we suggest that there are variable serotypes of rotavirus domestically and there is a need for reinvestigation about clinical features and serotypes of rotavirus gastroenteritis.

• Clinical and Experimental Pediatrics
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• 제49권1호
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• pp.29-33
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• 2006

Purpose : The aim of this study was to analyze the results and contributing factors of catch-up growth in very low birth weight infants(VLBWI) at the corrected age of 2 years. In addition, we looked for a relationship between the catch-up growth and the development by the bayley scales of infant development II(BSID II). Methods : A retrospective analysis by evaluating medical records was done for the 76 VLBWI whose follow-up was possible up to a corrected age of 2 years, out of the 114 who had been treated in the neonatal intensive care unit during the January of 2000 to December of 2001 at Samsung Cheil Hospital. Based on the Standard Korean Infant's Growth Curve, the catch-up growth group was defined over the 10th percentile of weight at 2 years as the corrected age and the failed catch-up growth group was defined under the 10th percentile. We investigated the clinical factors and courses of each group and compared the scores of the BSID II. Results : The catch-up growth group of the VLBWI was 51 infants and the failed catch-up growth group was 25 infants. In comparison with maternal clinical factors, use of antenatal steroids was significantly higher in the catch-up growth group. In comparisn with clinical factors and courses of VLBWI, two clinical factors were significantly different between the two groups : birth weight and intrauterine growth retardation(IUGR). Numbers of delayed development were increased in the failed catch-up growth group but statistically significant differences could not be observed. Conclusion : The catch-up growth of the VLBWI was affected by the use of antenatal steroids, birth weight and IUGR. No significant differences regarding neurodevelopmental outcome were observed between the catch-up and failed catch-up growth groups.

• Clinical and Experimental Pediatrics
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• 제49권4호
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• pp.401-409
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• 2006

Purpose : Human metapneumovirus(hMPV) is a respiratory viral pathogen that causes a wide spectrum of illnesses, ranging from asymptomatic infection to severe bronchiolitis. The virus has been identified world widely, but so far it has not been published in Korea. Methods : We obtained clinical samples by nasopharyngeal aspiration from 218 children hospitalized due to acute lower respiratory tract infections at Soonchunhyang University Hospital in Cheonan from October, 2004 to April, 2005. We designed specific primers from conserved region of fusion glycoprotein of hMPV. Total RNA was extracted and RT-PCR was performed, and single specific 423 bp product was obtained. The PCR product was confirmed to be fusion glycoprotein RNA by sequencing. Results : We detected hMPV in 15(6.9 percent) of the 218 hospitalized children. The infected children comprised nine boys and six girls; their mean age was 2.8 years(5 mo-12 yrs) and they were diagnosed with pneumonia(60 percent), bronchiolitis(33.3 percent), croup(6.6 percent). The number of cases of detected hMPV in Korea increased dramatically during the period from March to May 2005. Conclusion : hMPV is circulating in Korean children and is associated with respiratory tract infection. Additional studies are required to define the epidemiology and the extent of diseases in the general population caused by hMPV.

• Clinical and Experimental Pediatrics
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• 제48권10호
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• pp.1096-1101
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• 2005

Purpose : Recently, early surfactant replacement and tidal volume based gentle ventilation has been a fundamental treatment of respiratory distress syndrome(RDS). The aims of this study were to survey the changes in ventilator care duration and rate of complication in RDS groups. Methods : We performed a retrospective study of 255 newborn infants less than 1,500 g admitted to the neonatal intensive care unit(NICU) and discharged from January 1999 to December 2003. 141 of 255 newborn infants were RDS groups that required invasive management, such as endotracheal intubation, surfactant replacement and assisted ventilation. We analyzed epidemiologic data to study the changes in ventilator care duration and outcome of RDS groups. Results : Of 141 RDS groups, 135 were mild to moderate RDS groups and only 6 were severe RDS groups. 24(17.8%) of 135 mild to moderate RDS groups and 3(50%) of 6 severe RDS groups were antenatal no use of maternal dexamethasone. 127(90.1%) of 141 RDS groups underwent replacement of surfactant during 3 hours after birth. 121(85.9%) weaned within 48 hours. Conclusion : Our study shows a decreased frequency of severe RDS by a antenatal use of maternal dexamethasone and decreased duration of ventilator care by early surfactant replacement and gentle ventilation.

• Clinical and Experimental Pediatrics
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• 제48권10호
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• pp.1102-1106
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• 2005

Purpose : The present study examined the etiology, management, and the difference of prognosis according to methodology of treatment in severe hyperbilirubinemia with total serum bilirubin levels of more than 25 mg/dL. Methods : Medical records of severe hyperbilirubiemia in newborns(serum level=25 mg/dL) admitted to the NICU of Samsung Medical Center between October 1994 and June 2004 were reviewed retrospectively. Infants were grouped according to methodology of treatment : Group I(phototherapy only, n=42), Group II(exchange transfusion, n=6). And In addition, we evaluated the etiology and the difference of prognosis. Results : A total of 48 documented cases of severe hyperbilirubinemia were identified. Birth weight was significantly lower in Group 2($2,852{\pm}1,085g$) compared to Group 1($3,137{\pm}437g$)(P<0.05). There were no significant differences in gestational age, sex, mode of delivery, inborn, age at presentation, and age at first examination and admission between the two study groups. Maximal bilirubin level was significantly higher in Group 2($45{\pm}16mg/dL$) compared to Group 1($29{\pm}6mg/dL$) (P<0.05). But there were no significant differences in neurologic outcome. Conclusion : Our study suggests that the present guidelines for managing hyperbilirubinemia in newborns should be effective but follow-up with the first postnatal week would be necessary for each detection and treatment in the newborn infants with high risk of severe hyperbilirubinemia.

• Clinical and Experimental Pediatrics
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• 제46권3호
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• pp.224-229
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• 2003

Purpose : To examine various neonatal outcomes and perinatal factors resulting from assisted reproduction compared to that of spontaneous conception. Methods : This is a retrospective study. The control cases were all twins of spontaneous conception born between periods from January 1995 to June 2000. The study cases were identified from twins conceived by assisted reproduction in the same time peried. A total of 460 sets of twins consisted of 250 twins of spontaneous conception and 156 twins of assisted reproduction were studied. The primary outcomes were neonatal morbidity and mortality and the secondary outcomes were perinatal factors including number, length and cost of hospitalization for the delivery. Results : No differences were seen in various neonatal factors including gestational age, birth weight and incidences of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, hyperbilirubinemia, sepsis, intraventricular hemorrhage and the length of hospitalizations. Lower one minute and five minute Apgar scores and frequently encountered electrolyte abnormalities were observed in neonates of assisted reproduction. In general, the second twin of assisted reproduction had increased incidences of respiratory distress syndrome, sepsis and necrotizing enterocolitis than the first twin. Increased frequencies of preterm labor, hospitalization and elective cesarean section were seen among mothers who underwent artifical conception. However, overall hospital costs in terms of mothers hospitalization for the delivery and neonates hospitalization did not show differences. Conclusion : Assisted reproduction twins had similar neonatal morbidities, mortalities and perinatal morbidities compared to those born by spontaneous conception.

• Clinical and Experimental Pediatrics
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• 제51권4호
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• pp.383-390
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• 2008

Purpose : This study was aimed to analyze the clinical characteristics of patients with acute interstitial pneumonia who had presented similar clinical patterns from March to June, 2006 and to describe our experience of treatment and to identify risk factors associated with prognosis. Methods : The clinical characteristics, radiologic and histopathologic findings and response to steroids of 15 patients (non-survival group [n=7] and survival group [control, n=8]) with acute interstitial pneumonia were investigated through the review of medical records. Results : The mean age of the patients was 26 (range: 3-48) months. Cough, cyanosis and fever were frequent symptoms. The most frequent radiologic findings on admission were pneumomediastium and extensive ground glass opacity. Surgical lung biopsy was performed on 8/15 (53.3%) patients and diffuse alveolar damage was found. Mechanical ventilation was applied for 9/15 (60.0%) patients for 40 (range: 1-99) days. Five patients in survival group received steroid treatment and 7 patients in non-survivial group (P=0.20). One patient in survival group received steroid pulse treatment and 4 patients in non-survival group (P=0.12). Seven patients died all of respiratory failure. The survival rate was 53.4%. Conclusion : The patients with acute interstitial pneumonia which occurred on spring 2006 showed high mortality because of rapidly and extensively progressing pulmonary fibrosis and air leakage. Therefore, we should consider surgical lung biopsy and steroid application earlier. We should recognize this acute interstitial pneumonia occurring on spring in domestics and need to investigate the cause and treatment in large scale.

• Sleep Medicine and Psychophysiology
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• 제7권1호
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• pp.60-66
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• 2000

Objectives: The Psychopathology of schizophrenia was expected to be related with focal dysfunction of brain while schizophrenia is recognized and studied as the brain disease. Authors studied correlation between neuropsychological tests and delusion which is representative symptom of schizophrenia in patients with head trauma and psychiatric patients in order to explore the functional localization of brain in delusional symptom. Methods: Halstead Reitan Neuropsychological Test Battery and Korean Weschler Intelligent Scale and Minnesota Multiphasic Personality Inventory(MMPI) were administered to one hundred ninteen patients consisted of sixty nine psychiatric patients and fifty patients with brain damage. We tested correlation between results of neuropsychological tests and delusional scale made from twenty four items related with delusion in MMPI. T-test between eighteen higher delusion scorers and twenty one lower scorers was examed in psychiatric group. Results: In brain damage group, signigicant correlations were found in the tests related with function of frontal lobe such as category test, trail making AB test, tactual performance test, digit symbol test and fingertip number writing test, and significant correlations were also noted in the tests related with function of left temporal and parietal lobes such as information, comprehension, vocabulary, similarities and speech sound perception test. The tests related with the function of right hemisphere such as tactual performance test location, picture completion and performance, and the tests related with subcortical function such as arithmetic, digit span, attention, digit symbol test, digit symbol and trail making AB test were signigicantly corelated with delusional scale too. In psychiatric group there were significant difference of delusional score in the tests related with function of left hemisphere such as vocabulary, vocable IQ, comprehension and language, and in the tests related with subcortical function such as N 120 voltage, digit symbol and arithmetic. Conclusions: Delusion seems to be related with function of frontal lobe, left hemisphere and subcortex in both groups. Right hemisphere may be also partially related with delusion.

• The Journal of Korean Academy of Prosthodontics
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• 제37권5호
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• pp.581-596
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• 1999

The purpose of this study was to investigate the stress distribution of the abutment and sup-porting tissues according to the slopes and types of the guiding plane of distal extension removable partial dentures. The 3-dimensional finite element method was used and the finite element models were prepared as follows. Model I : Kratochvil type guiding plane with $90^{\circ}$ to residual ridge Model II : Kratochvil type guiding plane with $95^{\circ}$ to residual ridge Model III : Kratochvil type guiding plane with $100^{\circ}$ to residual ridge Model IV : Krol type guiding plane with $90^{\circ}$ to residual ridge Distal extension partial denture which right mandibular first and second molar were lost was used and the second premolar was prepared as primary abutment with RPI type retainer. Then 150N of compressive force was applied to central fossae of the first and second molars and von Mises stress and displacement were measured. The results were as follows 1. Model I and Model IV showed a similar stress distribution pattern and the stress was concentrated on the apex of the root of the abutment. 2. The stress was increased and concentrated on mesial side of the root of the abutment in Model II. The stress was concentrated on buccal and mesiobuccal side of the root of the abutment in Model IV. 3. In Model I, the root of the abutment displaced and twisted a little in clockwise. In Model IV, the root of the abutment displaced to distolingually at apical region of the root and mesiobuccally at cervical region of the root. 4. In Model II, the root of the abutment displaced to mesiolingually at apical region of the root and more displaced and twisted in counterclockwise at cervical region of the root. In Model III, the root of the abutment displaced to mesiobucally at apical region of the root and more displaced and twisted in clockwise at cervical region of the root.