• The Journal of Pediatrics of Korean Medicine
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• v.16 no.2
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• pp.129-141
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• 2002

The Purpose of this study was to investigate infancy patients who had visited Oriental Medicine Hospital, and so to consider a counterplan by oriental medicine. The study was composed of 101 new infancy patients who had visited Dongguk Kyeongju Oriental Medicine Hospital during 1 year from January 2001 to December 2001. The results were as follows : 1. Male children are 65(64.3%), female children are 36(35.6%), male to female ratio is 1.8: 1. 2. In age distribution, 1 month 5.9% ; 2 month 10.9%, 3 month 4.0%, 4 month 11.9%, 5 month 5.9%, 6 month 9.9%, 7 month 10.9%, 8 month 10.9%, 9 month 10.9%, 10 month 14.8%, 11 month 4.0%. 3. According to systematic division of the chief complaint, respiratory diseases are 37.6%, digestive diseases are 25.7%, nervous diseases are 21.8%, urogenital diseases are 1.0%, musculoskeletal diseases are 1.0%, dermatologic diseases are 7.9%, infirmity diseases are 3.0%. 4. In treatment, herb-medication is 86.1%, consultation is 7.9%, acupuncture is 17.8%, moxibution is 2.0%, venesection is 14.8%, aromatherapy is 4.9%, chimsband is 16.8%.

• Journal of Chest Surgery
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• v.56 no.3
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• pp.155-161
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• 2023

Background: Surgical closure of an atrial septal defect (ASD) is infrequently indicated during infancy. We evaluated the clinical characteristics and outcomes of patients who underwent surgical ASD closure during infancy. Methods: A single-center retrospective review was performed for 39 patients (19 males) who underwent surgical ASD closure during infancy between 1993 and 2020. The median body weight percentile at the time of operation was 9.3. Results: During a median follow-up of 60.9 months, 4 late deaths occurred due to chronic respiratory failure. A preoperative history of bronchopulmonary dysplasia (BPD) was the only risk factor for late mortality identified in Cox regression (hazard ratio, 3.54; 95% confidence interval [CI], 1.75-163.04; p=0.015). The 5-year survival rate was significantly lower in patients with preoperative history of BPD (97.0% vs. 50.0%, p<0.001) and preoperative ventilatory support (97.1% vs. 40.4%, p<0.001). There were significant postoperative increases in left ventricular end-diastolic (p=0.017), end-systolic (p=0.014), and stroke volume (p=0.013) indices. A generalized estimated equation model showed significantly better postoperative improvement in body weight percentiles in patients with lower weight percentiles at the time of operation (<10th percentile, p=0.01) and larger indexed ASD diameter (≥45 mm/m², p=0.025). Conclusion: Patients with ASD necessitating surgical closure during infancy are extremely small preoperatively and remain small even after surgical closure. However, postoperative somatic growth was more prominent in smaller patients with larger defects, which may be attributable to an increase in postoperative cardiac output due to changes in ventricular septal configuration. The benefits of ASD closure in patients with BPD are undetermined.

• Journal of Chest Surgery
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• v.27 no.1
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• pp.24-30
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• 1994

Eighteen infants with a large ventricular septal defect[VSD] underwent primary surgical repair from January 1986 to December 1992. Operation was done because of failure to thrive, medically intractable heart failure, recurrent pneumonia, increased pulmonary vascular resistance[PVR]. Four patients[22.2%] died in the early postoperative period. Relief of heart failure and normalization of growth and weight gain was evident in all survivor. There was no late postoperative death. The results of primary surgical repair of VSD in infancy are compared with those of palliative pulmonary artery banding[PAB] and of VSD closure after PAB. Twenty-seven patients with isolated VSD or with VSD associated with atrial septal defect, patent ductus arteriosus, or coarctation of the aorta underwent initial palliative PAB. There were 3 early postoperative deaths[11.1%]. Severe elevation of PVR persisted in two patients. Closure of VSD and pulmonary artery debanding was done in twenty patients, with 2 early postoperative deaths[10.0%]. Placement of the PAB too close to the pulmonary annulus necessitated trasannular patching in one patient, but any problem caused by migration of the band was not developed. It is concluded that primary surgical repair of VSD in infancy is reasonable and that PAB is indicated only for those patients less than 6 months old with a complicated defect or in an emergency situation.

• Journal of Chest Surgery
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• v.48 no.1
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• pp.7-12
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• 2015

Background: Mitral regurgitation is one of the leading causes of cardiovascular morbidity in pediatric patients with Marfan syndrome. The purpose of this study was to contribute to determining the appropriate surgical strategy for these patients. Methods: From January 1992 to May 2013, six patients with Marfan syndrome underwent surgery for mitral regurgitation in infancy or early childhood. Results: The median age at the time of surgery was 47 months (range, 3 to 140 months) and the median follow-up period was 3.6 years (range, 1.3 to 15.5 years). Mitral valve repair was performed in two patients and four patients underwent mitral valve replacement with a mechanical prosthesis. There was one reoperation requiring valve replacement for aggravated mitral regurgitation two months after repair. The four patients who underwent mitral valve replacement did not experience any complications related to the prosthetic valve. One late death occurred due to progressive emphysema and tricuspid regurgitation. Conclusion: Although repair can be an option for some patients, it may not be durable in infantile-onset Marfan syndrome patients who require surgical management during infancy or childhood. Mitral valve replacement is a feasible treatment option for these patients.

• Journal of Chest Surgery
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• v.16 no.3
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• pp.322-330
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• 1983

TAPVC represents 1 to 4% of all congenital cardiac defects. Generally severe and refractory cardiac failure develops in the majority of patients in the early infancy. In a small minority of patient, they are relatively asymptomatic in infancy, but symptoms will develop of necessity In the later life. Our three cases had dyspnea on exertion and cyanosis and had a history of frequent respiratory infections. All 3 cases had the typical showman configuration on roentgenograms of the chest. Current surgical therapy has greatly altered the unfavorable course of these patients after institution of extra-corporeal circulation. We have experienced three cases from June, 1973 to May, 1983, the patients were undergone complete repair with extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery in the Yonsei University. The ages ranged from 12 years to 14 years, all cases were supracardiac type of TAPVC. Only one case died due to bleeding from anastomosis site between LA and pulmonary venous trunk. In the remaining two patients with complete corrections of TAPVC, there was excellent relief of symptoms such as dyspnea and cyanosis. Their postoperative course have been good during follow-up.

• Korean Journal of Bronchoesophagology
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• v.16 no.2
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• pp.115-120
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• 2010

Background: Pediatric deep neck infection can cause critical complications in that they are seldom able to verbalize symptoms or cooperate with physical examination. The objective of this study is to identify the clinical characteristics according to age. Material and Method: A retrospective study was performed on 26 cases with pediatric deep neck infection during 12 years. Patients were classified infancy group (1-7 yr, 19.2%), preschool age group (7-15 yr, 30.8%) and school age group (15 yr-, 50%). We analyzed the age, sex, sites of abscess, predisposing factors, symptoms and compared onset, hospital date, laboratory and outcomes at each group. Results: In pediatric patients with deep neck infection, the age distribution was 18 males (69.2%) and 8 females (30.8%), the mean age was 7.4 years. The most common infection site was the anterior cervical triangle and submandibular space (19.2%). The most commonly known associated preceding disease was upper viral infection (34.6%), but we could not find the preceding diseases in most of cases (50%). Neck swelling (69.2%) was the most frequent symptom. The mean age of patients who performed neck CT was 8.23 years and neck US was 2.75 years. The younger patients were preferred to perform the neck US than the neck CT (p=0.022). The mean time from disease onset to admission was 9 days in the infancy, 5.5 days in the preschool aged and 5 days in the school aged group. The surgical treatment was performed in 30.8% of school aged, 62.5% of preschool aged and 100% of infancy group. Surgical treatment was preferred to younger patients (p=0.026). Conclusion: Abscess sites, size, and antibiotics susceptibility and especially patient age should be carefully considered in treating pediatric deep neck infection.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.3
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• pp.175-179
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• 2015

Purpose: Infants with Alagille syndrome (AGS) are occasionally misdiagnosed as biliary atresia and subsequently undergo Kasai operation. The purpose of this study was to investigate the outcome of patients with AGS who had previously received Kasai operation during infancy. Methods: This retrospective study was conducted at the Department of Pediatrics, Samsung Medical Center. We compared the prognosis and mortality between those who had undergone Kasai operation during infancy (Kasai group) and those who had not (non-Kasai group). Results: Among the 15 children with AGS, five had received Kasai operation, while 10 had not. All subjects in the Kasai group revealed neonatal cholestasis, while 70% of the non-Kasai group showed neonatal cholestasis. Liver transplantation was performed in 100% (5/5) among the Kasai group, and 20.0% (2/10) among the non-Kasai group (p=0.007). Mortality was observed in 60.0% (3/5) among the Kasai group, and 10.0% (1/10) among the non-Kasai group (p=0.077). Conclusion: Although overall mortality rate did not significantly differ between the two groups, the proportion of patients receiving liver transplantation was significantly higher in the non-Kasai group. The relatively worse outcome in AGS patients who had received Kasai operation may be due to the unfavorable influences of Kasai operation on the clinical course of AGS, or maybe due to neonatal cholestasis, irrespective of the Kasai operation.

• Journal of Chest Surgery
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• v.29 no.3
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• pp.271-277
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• 1996

In selected cases, early corrective surgery is indicated in the management of infants having large ventricular septal defects. The risk of any surgical procedure in infancy is acknowledged to be great and should be avoided whenever possible. However this greater surgical risk is justified when the patient presents with intractable congestive heart failure, severe pulmonary hypertension, marked growth retardation, and recurrent prolonged lower respiratory infections. We analyzed 31 patients with ventricular septal defect in infancy who underwent surgical correction from January 1991 through December 1994. Age ranged from 6 months to 12 months with mean age of 9.2 months. Of the thirty-one patients, 23 patients were male and 8 patients were female. Mean body weight was 7. 4kg. The most common type of ventricular septal defect was perimembraneo s (64.5%). Associated cardiac anomalies were found in 17 patients (55.8%). Mitral regurgitation was the most commonly associated cardiac anomaly (16.1 %) and followed by patent ductus arteriosus (12.9%). When cardiac catheterization data were analysed, the most common range of Qp/qs, RpiRs, Pp/ps were 2.1∼ 3.0, 1-0.25, above 0.70 respectively. Among the indications of surgical correction, there were pulmonary hypertension in 20 patients, congestive heart failure in 3 patients, intractable respiratory infection in 10 patients and growth retardation in 14 patients. The most common surgical approach and method for closure of ventricular septal defect .were right atriotomy (58%) and Dacron patch closure (94%). Postoperative complications occurred in 10 cases (32%) and overall mortality was 12.9% (4 cases). All operative deaths in this series occurred in infants under the age of 8 months and weight of 8 kilograms.

• Neonatal Medicine
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• v.15 no.1
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• pp.75-79
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• 2008

Purpose : There are many causes of hematochezia in neonates and during early infancy. Cow's milk allergy is considered to be the most common cause of bloody stools in infants; however, cow's milk allergy is diagnosed in relatively few patients. In a significant proportion of case investigations, the etiology of hematochezia is not determined. The objectives of this study were to evaluate the clinical course and prognosis of patients with hematochezia of unknown etiology. Methods : The patients were <4-month-old infants with hematochezia in whom infectious and surgical etiologies had been excluded. We investigate retrospectively the clinical course and laboratory finding. We also perform 2-years follow-up study and evaluate prognosis of the patients. Results : In all study patients, RAST milk was negative. All patients had self-limited hematochezia. In 2-years of follow-up, the prognosis of patients was good. There were no differences at 2-year regarding allergic tendencies of the patients, as determined by the increase in total eosinophil count. Conclusion : Hematochezia in neonates and during early infancy is generally a benign and self-limiting symptom. Based on 2-years of follow-up, the prognosis of the patients is good.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.15 no.2
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• pp.78-86
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• 2015

Purpose: Homocystinuria (OMIM#236200) is a metabolic disease caused by mutation in the CBS gene. This study was conducted to identify the clinical features and prognosis of homocystinuria as well as to find out the CBS gene mutations of the six homocystinuria patients who were receiving treatment in the Pediatric Department at Soonchunhyang University Hospital. Methods: From January 1992 to March 2015, clinical, biochemical, and genetic analyses were performed retrospectively on the six patients diagnosed with classic homocystinuria at Soonchunhyang University Hospital. Results: A total of six patients were included in this study, including three who were diagnosed with homocystinuria at the mean age of $50{\pm}22.5$ days based on their abnormal newborn screening test results. The other three were diagnosed at the mean age of 7, when they visited the hospital for evaluation of developmental delay and lens dislocation. The group diagnosed at early infancy had normal cognitive function, but the other group had varying degrees of mental retardation. Major complications were found only in the group diagnosed after infancy. CBS gene mutation was found in all the patients, and they were all non-responsive to vitamin B6 treatment. At present, all patients' diets are controlled following a methionine-free formula and they are on medication with folic acid, betaine, pyridoxine, and methylcobalamin. Conclusion: Six homocystinuria patients were monitored for up to 23 years. The group diagnosed at early infancy exhibited no major complications. Therefore, early diagnosis is crucial in the prognosis, and homocystinuria must be included in the newborn screening program.