• Neonatal Medicine
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• v.17 no.1
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• pp.109-115
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• 2010

Persistent pulmonary hypertension in newborns (PPHN) is a disorder of the vascular transition from fetal to neonatal circulation. It results in cyanosis due to right-to-left shunting of the blood through the ductus arteriosus and/or foramen ovale manifesting as hypoxemic respiratory failure. We managed two cases of PPHN after meconium aspiration with high frequency oscillating ventilators and inhaled nitric oxide. They did not respond to conventional management. Veno-venous extracorporeal membrane oxygenation (ECMO) was provided, and ECMO weaning was possible resulting survivals in two cases. We report two PPHN cases, which were treated successfully with veno-venous ECMO for the first time in Korea.

• Proceedings of the Korean Society of Veterinary Pathology Conference
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• 2002.11a
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• pp.134-134
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• 2002

A stillborn bovine male fetus with abdominal distention, arthrogryposis and atresia ani was presented for diagnostic evaluation. At necropsy, this fetus had a large amount of ascites, urachal obstruction and marked bladder distention. The ventral surface of the bladder had ruptured and attached to the abdominal wall by fibrinous adhesions. There was bilateral hydronephrosis with moderate pelvic dilatation and cortical attenuation. The rectum was filled with meconium but the anus was imperforate. The right forelimb was contracted. The cause(s) of these abnormalities could not be determined; however, we believe that developmental abnormalities during embryogenesis may be the result of chromosomal abnormalities. This report is the first to report congenital urachal obstruction in this species.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.103-105
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• 2003

Scrotal swelling may be acute or chronic, painful or painless. Common causes of scrotal swelling in newborns are hydrocele, inguinal hernia, testicular torsion, testicular tumor, scrotal hematoma, meconium peritonitis and epididymitis. Abrupt onset of a painful scrotal swelling necessitates prompt evaluation. Testicular torsion and incarcerated inguinal hernia require urgent surgical management. We report a case of scrotal swelling caused by a tunica vaginalis abscess in a 20-days-old boy. He was admitted to the hospital due to fever, irritability and left scrotal swelling with local heat, tenderness and redness. Exploratory laparotomy was performed to rule out testicular torsion. On the operative field, congestive erythematous inflammation on the left tunica vaginalis was noted and it was filled with a pus like discharge. The cultured organism was Streptococcus agalactiae(group B). He recovered quickly after debridement and administration of empirical antibiotics.

• Journal of Yeungnam Medical Science
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• v.38 no.3
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• pp.240-244
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• 2021

Imperforate anus is an anomaly caused by a defect in the development of the hindgut during early pregnancy. It is a relatively common congenital malformation and is more common in males. Although there are cases of a solitary imperforate anus, the condition is more commonly found as a part of a wider spectrum of other congenital anomalies. Although urgent reconstructive anorectal surgery is not necessary, immediate evaluation is important and urgent decompressive surgery may be required. Moreover, as there are often other anomalies that can affect management, prenatal diagnosis can help in optimizing perinatal care and prepare parents through prenatal counseling. In the past, imperforate anus was diagnosed by prenatal ultrasonography based on indirect signs such as bowel dilatation or intraluminal calcified meconium. Currently, it is diagnosed by directly checking the perineum with prenatal ultrasonography. Despite advances in ultrasound technology, accurate prenatal diagnosis is impossible in most cases and imperforate anus is detected after birth. Here, we present two cases of imperforate anus in female fetuses that were not diagnosed prenatally.

• Clinical and Experimental Pediatrics
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• v.51 no.1
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• pp.89-92
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• 2008

A subcapsular liver hematoma (SLH) is a relatively common lesion in fetuses and neonates. Although an SLH ruptures rarely, it may be life threatening. We report on a term neonate with a delayed rupture of an SLH that occurred on day 7 of life. The infant had been resuscitated with intubation, positive pressure ventilation, and chest compression at birth because of meconium-associated perinatal depression. The SLH was diagnosed by abdominal ultrasonography and paracentesis, and the ruptured SLH was treated operatively. After intensive medical and surgical management, the infant was discharged healthy on day 27 of life. A newborn infant presenting with the sudden onset of extreme shock and pallor associated with abdominal distension should undergo differential diagnosis for SLH and a clinical evaluation concurrent with fluid resuscitation and timely surgery.

• The Journal of Pediatrics of Korean Medicine
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• v.29 no.4
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• pp.97-107
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• 2015

Objectives Hataedock is the treatment that dispels toxic heat and meconium gathered at the fetus for the new born baby by orally administered herbal extracts. The purpose of this study was to evaluate whether Hataedock alleviate inflammatory skin damages in AD-induced NC/Nga mice through regulating of skin barrier maintain and Th2 differentiation. Methods We established an AD model in the 3-week-old NC/Nga mice through the repeated application of DNFB (dinitrochlorobenzene) on days 28, 35, 42 after Hataedock treatment which was orally administered. We identified the changes of skin barrier and Th2 differentiation through the histological and immunohistochemical changes of protein kinase C (PKC), interleukin (IL)-4, degranulated mast cell, Substance P and MMP-9. Results Our results suggested that Hataedock treatment significantly down-regulated levels of PKC by 82% (p < 0.001), as well as IL-4 by 56% (p < 0.001). Hataedock also suppressed mast cell infiltration, ear edema formation. and Substance P in the tissue of NC/Nga mice were decreased by 57% (p < 0.001), and MMP-9 by 55% (p < 0.001). Conclusions These results suggest that Hataedock alleviates AD through the down-regulation of PKC and Th2 cytokines, which are involved in the initial steps of AD development. Hataedock have potential application for the treatment of AD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.4
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• pp.257-262
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• 2014

Severe combined immunodeficiency (SCID) is a life-threatening syndrome of recurrent infections and gastro-intestinal alterations due to severe compromise of T cells and B cells. Clinically, most patients present symptoms before the age of 3 months and without intervention SCID usually results in severe infections and death by the age of 2 years. Its association with intestinal anomalies as multiple intestinal atresias (MIA) is rare and worsens the prognosis, resulting lethal. We describe the case of a four year-old boy with SCID-MIA. He presented at birth with meconium peritonitis, multiple ileal atresias and underwent several intestinal resections. A targeted Sanger sequencing revealed a homozygous 4-bp deletion ($c.313{\Delta}TATC$; p.Y105fs) in tetratricopeptide repeat domain 7A (TTC7A). He experienced surgical procedures including resection and stricturoplasty. Despite parenteral nutrition-associated liver disease, the patient is surviving at the time of writing the report. Precocious immune system assessment, scrutiny of TTC7A mutations and prompt surgical procedures are crucial in the management.

• The Journal of Pediatrics of Korean Medicine
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• v.31 no.3
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• pp.37-45
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• 2017

Objectives Hataedock is an orally-administered herbal extract that used to treat toxic heat and help excrete meconium accumulates in the fetus from pregnancy. This study compared the effects of Hataedock using the extract of Douchi and omega-3 to control inflammation in the colonic mucosa. Methods NC/Nga mice were divided into three groups; Control group (no treatment), FGT group (given the extract of Douchi), and O3T group (given omega-3). The 3-week-old mouse from each group were given the extract of Douchi and omega-3. After 2 weeks, the colonic mucosa tissues of the mice were observed via Immunohistochemical staining for IL-4, IL-13, CD40, $Fc{\varepsilon}RI$, $p-I{\kappa}B$, EGF in the intestinal mucosa. Results In both FGT and O3T group, IL-4, IL-13, STAT-6 levels and CD40-positive reactions were decreased. However, EGF-positive responses were increased. FGT group showed 35% decrease in IL-4, 45% decrease in IL-13, 48% decrease in CD40, 50% decrease in $Fc{\varepsilon}RI$, 54% decrease in $p-I{\kappa}B$, 52% increase in EGF compared to the control group. O3T group also showed 14% decrease in IL-4, 23% decrease in IL-13, 22% decrease in CD40, 29% decrease in $Fc{\varepsilon}RI$, 41% decrease in $p-I{\kappa}B$, 39% increase in EGF compared to the control group. Conclusions Both early administration of Douchi extract and omega-3 were effective in regulating Th2, relieving inflammation and developing colonic mucosal tissues. Hataedock with Douchi extract may be more effective in modulating immune system in colonic mucosa than omega-3.

• Advances in pediatric surgery
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• v.5 no.2
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• pp.103-110
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• 1999

To estimate the normal anal canal pressure in neonates, anal manometry was performed in 46 normal babies less than 6 days of age. Twenty-eight of the subjects were boys and 18 girls. All the subjects passed meconium within 24 hours after birth. Birth weights were above 2.4 kg. There were no sexual differences in birth weight, birth height, gestational age, postnatal age, or Apgar score (p<0.05). The mean manometry values were; anal sphincter length $18.6{\pm}3.9$ mm, high pressure zone (HPZ) $9.2{\pm}3.6$ mm, vector volume $2027.2{\pm}2440.7$ mmHg2cm, maximum pressure $42.3{\pm}17.4$ mmHg, and position of the maximum pressure $6.0{\pm}22.4$ mm. Only the HPZ of boys was longer than those of girls (p=0.005). In squeezing state, HPZ and the position of maximun pressure were not changed from resting state. HPZ, vector volume, and maximum pressure in boys were higher than those in girls. As the birth weight increased, the anal sphincter length (p=0.001) and the HPZ increased (p=0.047). The resting pressures of the anal canal were evaluated in three portions; /23 upper portion, $12.8{\pm}8.6$ mmHg, middle portion, $20.3{\pm}10.8$ mmHg, and lower portion, $26.1{\pm}12.9$ mmHg. These normal values may serve as guidelines for the evaluation, diagnosis and treatment of neonatal anal diseases.

• Advances in pediatric surgery
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• v.13 no.1
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• pp.61-65
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• 2007

Conventional treatment of Hirschsprung's disease consists of initial colostomy followed by pull-through operation. But, the treatment of Hirschsprung's disease has been changed along with the development of new surgical technique. Since 1995, endo-GIA has been available at our hospital and one stage Duhamel operation has been performed for neonatal Hirschsprung's disease. Between May 1995 and April 2006, 26 neonates have been treated with one stage pull-through operation by one pediatric surgeon at HanYang University Hospital. The sex ratio was 4.2:1 with male predominance. Clinical findings included abdominal distension (96.2 %), vomiting (50.0 %), delayed passage of meconium (46.2 %), constipation (23.1 %), and enterocolitis (15.4 %). Twenty two cases (84.6 %) were short-segment and 4 cases (15.4 %) were long-segment disease, of which 2 cases were total colon aganglionosis. One of the two patients with total colonic aganglionosis had double transition zones - distal ileum and hepatic flexure of the colon. The average age at operation was $14.56{\pm}8.77$ days and the average weight at operation was $3.26{\pm}0.66kg$. Primary Duhamel operations were performed in 25 patients and Soave-Boley operations was performed in one patient. The endo-GIA 35 (Ethicon, USA) was used from 1995 until 1997, and after that endo-GIA 60 (USSC, USA) was used. The average Duhamel operation time was $88.57{\pm}22.80$ minutes. Wound abscess (n = 2) and septum formation (n =1) occurred after Duhamel operation. Bowel function was normalized in 59 % within 3 months and in 95% within 1 year after operation. There was no mortality after one stage pull-through operation in neonate.