• Clinical and Experimental Pediatrics
• /
• v.46 no.11
• /
• pp.1073-1079
• /
• 2003

Purpose : Recently there has been a decrease in ventilator care rate and duration of very low birth weight infants(VLBWI) in Fatima Hospital. The aims of this study were to survey the frequency and duration of ventilation in VLBWI and to develop a non-invasive neonatal intensive care unit (NICU) policy. Methods : We performed a retrospective study of 284 newborn of infants less than 1,500 gm admitted to NICU and discharged from January 1998 to December 2001. Patients were intubated or applied continuous positive airway pressure(CPAP) via nasal prong immediately after presenting signs of respiratory distress. We analyzed epidemiologic data to study the changes in ventilator care rate, duration and outcome of ventilator care groups. Results : Of 284 newborn infants, 146 required invasive management, such as endotracheal intubation and assisted ventilation. The characteristics, the severity of clinical symptoms and laboratory findings in ventilator care groups at birth showed no significant differences. The annual proportion of infants requiring assisted ventilation decreased according to increasing gestational age. The median duration of ventilation decreased markedly from 6.0 days in 1998 to 2.7 days in 2001. Final complications and outcomes in ventilator care groups showed no significant differences. Conclusion : Our study shows a significant reduction in the invasiveness of the treatment of VLBW infants, which was not associated with an increased mortality or morbidity. A non-invasive strategy for the VLBW infant with minimal to moderate respiratory distress after birth in NICU is better than immediate invasive management. Non-invasive nasal CPAP is a simpler and safer method than invasive assisted ventilation.

• Pediatric Infection and Vaccine
• /
• v.5 no.1
• /
• pp.79-87
• /
• 1998

Purpose : The P1 protein of Mycoplasma pneumoniae mediates the attachment of the pathogen to its host cell and elicits a strong humoral immune response during infection with this organism. Mycoplasma pneumoniae strains can be classified into two groups(I and II) by PCR method of P1 cytadhesin gene. In this study, we evaluated the prevalence, epidemiological and clinical characteristics of each group. Methods : From 155 patients with Mycoplasma pneumoniae, who admitted to the Department of Pediatrics, Sung-Ae and Kwangmyung Sung-Ae Hospital between November 1996 and October 1997, we collected their throat swabs or nasopharyngeal aspirates for DNA extraction and serum for indirect hemagglutination test of Mycoplasma pneumoniae. The group specific PCR amplification were performed using specific oligonucleotide primers designed for P1 gene genotyping. Results : Group I(137 patients, 88.4%) occurred frequently than group II(18 patients, 11.6%). In both group, the most prevalent season was winter in 1996(Nov. to Dec.) and fall in 1997(Aug. to Oct.) The prevalent age was four to six years old. The number of male was more than female in both group; Group 1(1.2:1), Goup 2(1.6:1). No significant relationship were found between two groups in duration of fever and hospital days(P>0.05). The rate of high antibody titers(>1:5120) was lower in group I(6/137, 4.4%) than group II(2/18, 11.1%). Conclusion : Group I was much more prevalent than group II during 1996~1997 in Korea. There was no difference between two groups in epidemiological and clinical parameters except the rate of high antibody titers. Further follow-up survey will be needed for the epidemiologic and clinical studies of Mycoplasma pneumoniae in Korea.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.2 no.1
• /
• pp.21-29
• /
• 1999

Purpose: The aims of this study are to examine clinical characteristics, patterns of medical care utilization, and factors which determine medical care utilization of elementary school children with recurrent abdominal pain (RAP), to find posssible factors influencing the onset and the course of the disorder. Method: We performed questionnaires in Kwangju on children from two primary schools from June,1 1998 to June 30 and carried out statistical analysis. Result: 1) Total number of questionnaires were 1417. 715 were male and 702 were female and the ratio of male to female was 1.02:1. Average age was 10.3 years. 2) 268 children had RAP (18.9%), boys 132 (18.4%), girls136 (19.2%). 3) The duration of the pain within 10 minutes was 68.5%. 178 children with RAP (66.3%) visited the doctor. The utilization pattern of medical facilities of the pupils with RAP; the most frequently utilized medical facility was pediatrics (35.2%) and the order ran as internal medicine (31.5%), and pharmacy (29.25). The utilization pattern of medical facilities for the older students; the utilization rate of pediatrics decreased, but internal medicine increased. The major factors affecting the selection of the medical facility were geographic accessibility, kindness of the personnel, good results and traffic convenience. 4) Symptoms which were accompanied with abdominal pain were headache (44.5%), chest pain (28.2%), dizziness (26.6%), vomiting (9%), and 119 children (44.5%) had no accompanied symptoms. 5) In 95 children (35.3%) abdominal pain, occured at postprandial time, in 55 children (20.5%) before meal and in 39 children (14.7%) at school. The highest incidence rate of RAP was observed on Monday (21.4%), and the lowest on Saturday (8.7%). 6) The most frequent involved part of the abdomen was periumbrical area (38%) and the order ran as epigastrium and suprapubic area. The most frequent characteristics of abdominal pain were burning pain (36.9%) and the order ran as dull, cramping and colicky pain. Conclusion: RAP is a frequent disease entitiy in children. Too many times children with RAP are treated by other departments instead of Pediatrics. A child has a peculiar growth and development which is different to those from an adult with advancing years. So, it is necessary to choose special medical care and an adequate medical facility.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.4
• /
• pp.465-473
• /
• 1995

Background: The prevalence of pulmonary tuberculosis has decreased progressively after the control of the tuberculosis began as national control. But as diabetes, malignancy, immunodeficiency disease recently tend to be increased, the tuberculosis become to the important national health problem. So, this study was designed to observe the state and the change of the prevalence and the clinical status of pulmonary tuberculosis for recent 10 years at one women's university. Method: We retrospectively investigated the epidemiology and the clinical status of 612 patients who were registered at the Ewha Womans University Health Center by analyzing records from 1983 to 1992. Results: 1) The prevalence rate had been steadily decreased from 0.63% in 1983 to 0.11 % in 1992. The prevalence of freshman and the incidence rate according to the entrance year while in the university significantly decreased since 1989. 2) In classifying by registered source, 45.6% of students were detected by annual periodical health examination, 34.5% by entrance physical examination, 12.0% by hospital, 5.4% by health center clinic, 2.5% by reentrance physical examination, sequentially. 3) The students with past history of tuberculosis were 70(11.4%) and 61(10%) suffered from pulmonary tuberculosis. The patients with family history of tuberculosis were 142(23.3%). 4) There were 530(86.6%) with minimal disease, 79(12.9%) with moderate and only 3(0.5%) with far advanced, when classified by the severity of disease. 5) The initial symptoms were mild breathing difficulty in 30.1%, sweating in 14.9%, fatigue in 14.3%, febrile sense in 11.7%, hemoptysis in 8.2%, sequentially. 6) The duration of treatment was $10.6{\pm}3.6$ months in mild group, $14.9{\pm}5.2$ months in the moderate group(P<0.05). 7) The side reactions of the drug were GI trouble in 7.2%, hepatitis in 1.8%, skin rash in 0.8% and streptomycin side in used patients in 9.1%. Conclusion: The prevalence of pulmonary tuberculosis among the students in one women's university was significantly lower than that of university students and 20-24 year-old age group announced in tuberculosis survey on a national scale, and significantly decreased since 1989. The treatment effect was desirable in student's group managed by university health center.