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No abstract available.
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Neuroblastoma stage IV-S patients have frequent spontaneous remission and high survival rate. Many investigators have recommended minimal or no therapeutic intervention ; however, some patient do experience progressive disease and ultimately die of neuroblastoma. We experienced a case of stage IVS neuroblastoma with N-myc amplification and coagulopathy. This patient has treated with combination chemotherapy and radiation therapy, then remained disease free for 1 year on the follow up till March, 1997.
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Humanos , Quimioterapia Combinada , Estudios de Seguimiento , Neuroblastoma , Remisión Espontánea , Investigadores , Tasa de SupervivenciaRESUMEN
Rupture of the sinuses of Valsalva is not common in childhood. It is frequently associated with other heart disease, most commonly with VSD. It is classified into four types, anatomically. The symptoms are differentiated as acute, gradual progression, and unruptured aneurysm. We experienced 2 cases of rupture of the sinuses of Valsala, which were corrected completely after operation. The patients were 14 year old boy with his chief complaint of dyspnea and chest pain, and an 11 year old girl with chief complaint of exertional dyspnea.
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Adolescente , Niño , Femenino , Humanos , Masculino , Aneurisma , Dolor en el Pecho , Disnea , Cardiopatías , RoturaRESUMEN
PURPOSE: This study was undertaken to assess the change of the serum cholesterol level according to the duration of fever in children. METHODS: A retrospective study presents data on fasting serum cholesterol assessed 346 children aged from 3 to 14 years, admitted to National Medical Center from Jan. 1992 to Jun. 1994 due to febrile disease. These patients were divided into three groups according to the duration of fever at the time of cholesterol measurement. Group 1 comprised children in whom cholesterol was evaluated on the first 2day of fever, group 2 children in whom cholesterol was assessed on day 3 to 5 and group 3 subjects evaluated 6 to 20 days after the onset of fever. 200 healthy children without fever were also enrolled in this study. The fasting serum cholesterol levels were also measured in both febrile period and afebrile convalescent period in 34 children with febrile diseases during the 7months period of Apr. to Oct. 1994. RESULTS: As the retrospective study, the fasting serum cholesterol levels of group 1, 2 and 3 were lower than those of the controls. And the difference of the serum cholesterol levels between group 1 and group 3 was significant. The prospective study was significantly associated with a decrease of serum cholesterol in the febrile period compared with that in the convalescent period. CONCLUSIONS: Timing of blood collection for screening test and diagnostic measurement of serum cholesterol level should be carefully defined taking into account that febrile illnesses are biologic variables that may significantly affect serum cholesterol.
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Niño , Humanos , Colesterol , Ayuno , Fiebre , Tamizaje Masivo , Estudios Prospectivos , Estudios RetrospectivosRESUMEN
A study was carried out to see the knowledge, attitude and practice of mothers in regard to infant and child health through enquete. The questionnaires were filled up by 350 mothers who registered at Well Baby Clinic, National Medical Center, during two months period from March, 1980 to April, 1980. The survey intended to look into maternal knowledge and attitude toward pregnancy, prenatal care, nutritional care, vaccination and health care. The following conclusions were obtained. 1. Among the mothers enrolled in this study, the age group in 25~29 constituted the largest proportion(58.3%) and the mean age was 28.0 years. 2. High school graduates occupied the largest proportion(48.1%) of the respondents. 3. The most frequent age of the first delivery was in 25~29(63.7%) years. 4. Concerning the knowledge on pregnancy, delivery and child rearing, the majority of the primary school graduates learned from their parents in law, the middle & high school graduates acquired through reading books or magazines and the college graduates learned by school education. 5. Regular prenatal cares were taken in 70% of the respondents. 6. Regarding the knowledge about the influences on fetus of the diseases during pregnancy, there noted the difference among the respondents by education, and most of them notified ventral diseases and tuberculosis as the diseases most concerned. 7. Breast feeding only was done in 50% of the respondents until the 3 months of age of the infants, and bottle feedings supplemented by solid foods or other was the most common type of feeding after 3 months of age to 15 months of age followed by adult type diet afterwards. 8. Relation between the educational level of mothers and the method of infant feeding disclosed that the higher the education level, the higher the bottle feeding. 9. About 71% of the mothers replied that they know the significance or the necessity of the weaning. The ideal starting period of weaning was thought 4~6 months in 58.6% of the respondents. 10. The most common initial weaning food was fruits and vegetables(50.4%) followed by cereals(18.7%) and commercial weaning food products(17.4%) 11. Regarding the most important nutrient in infants and children, they notified vitamins most commonly(46.9%) and more than half of them supplied the vitamins to their infants. 12. About 42% of all mothers know the beginning period of primary vaccinations as 2 months of age, 69.7% of them recognized the next vaccinations and 77.1% of them immunized their infants as schedule. 13. Most of the mothers(96.6%) realized the necessity and importance of the vaccination. A few mothers, however, had knowledge on the side effects of DPT vaccination. 14. The most concerned problem with regard to health care was the illness(42.9%). In more than half, health care was provided only on well baby clinic visits.
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Adulto , Niño , Niño , Humanos , Lactante , Embarazo , Atención Ambulatoria , Citas y Horarios , Alimentación con Biberón , Lactancia Materna , Crianza del Niño , Salud Infantil , Encuestas y Cuestionarios , Atención a la Salud , Dieta , Educación , Feto , Frutas , Jurisprudencia , Madres , Padres , Publicaciones Periódicas como Asunto , Atención Prenatal , Tuberculosis , Vacunación , Vitaminas , DesteteRESUMEN
The clinical study was made on 38 cases of the congenital megacolon who had been admitted to Dept. of Pediatrics and General surgery, National Medical Center from Jan., 1869 to Dec., 1977 We obtained the following results. 1. The sex ratio was 4.4 : 1, of male preponderance. 2. The onset of symptoms was within 1 week after birth in majority of the cases. 3. All patients were delivered at fullterm and the familial occurrence was not observed. The associated anomalies were a case of mongolism with congenital heart disease and of congenital hypertrophic pyloric stenosis. 4. In about half of the cases, the definitive diagnosis was made before the age of 6months 5. The clinical symptomes were abdominal distension, constipation, vomiting, diarrhea, visible peristalsis and weight loss in order of frequency. 6. Meconium passage was spontaneous in 41.2% and after digital examination or enema in 58.8%. 7. The majority of the cases(79%) were so called short segment type. One male patient was proved to be total aganglionic colon. 8. The definitive operation was performed in 18 cases, in which 14 cases(77.7%) received Swenson's procedure. The early complications were wound infection, leakage, fistula, pelvic abscess and the late complications were stricture, intestinal obstruction, enterocolitis, fecal impaction, malnutrition in order of frequency. 9. The total mortality rate was 23.7% and the operation mortality was 16.7%. 10. The results of one stage operation was somewhat better than two stage operation. 11. The follow up results were good in 83.3% of operated cases.
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Humanos , Masculino , Absceso , Colon , Estreñimiento , Constricción Patológica , Diagnóstico , Diarrea , Síndrome de Down , Enema , Enterocolitis , Impactación Fecal , Fístula , Estudios de Seguimiento , Cardiopatías Congénitas , Enfermedad de Hirschsprung , Obstrucción Intestinal , Desnutrición , Meconio , Mortalidad , Parto , Pediatría , Peristaltismo , Estenosis Hipertrófica del Piloro , Razón de Masculinidad , Vómitos , Pérdida de Peso , Infección de HeridasRESUMEN
A clinical & statistical analysis was made on 325 cases of premature & low birth weight infants, admitted to the department of Pediatrics, National Medical Center, during the period. Of September, 1968 to august, 1976. The results obtained were as follows. 1. Sex ratio was 1.1 :1 between male & female. 2. Monthly distribution showed higher incidence in cold season than in warm season. 3. In regard to the place of delivery, there showed increasing tendency of hospital delivery. 4. Important predisposing factors disclosed toxemia of pregnancy, inappropriate pelvic condition, acute infection & twin delivery in order of frequency. Among them toxemia of pregnancy was the most important. 5. Overall incidence of premature delivery was 5.0% in 1968 and 3.1% in 1975 and revealed. Decreasing tendency. 6. Concerning the order of pregnancy, the highest incidence was among the 1st pregnancy. (33.2%). 7. In low birth weight infants, Apgar score was higher weight group. 8. The mortality rate was higher in males and in the group of out side delivery. The highest mortality rate was noted in the birth weight group of 1001-1250 gm. The larger the gestational period the lower the mortality rate was also noted. 9. Most of the deaths occurred during the first 48 hours and sharp decrease after the 3rd day of life. Main causes of death were idiopathic respiratory distress syndrome and pneumonia. 10. Initial weight loss was marked between the 7 th and 11 th day of life and about 10% of birth weight. The lower weight group showed the greater loss. 11. Regain as well as true weight gain during the 1 st month of life was slower in low birth weight group.
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Femenino , Humanos , Lactante , Recién Nacido , Masculino , Embarazo , Puntaje de Apgar , Peso al Nacer , Causalidad , Causas de Muerte , Incidencia , Recién Nacido de Bajo Peso , Mortalidad , Pediatría , Neumonía , Preeclampsia , Estaciones del Año , Razón de Masculinidad , Aumento de Peso , Pérdida de PesoRESUMEN
No abstract available.
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Humanos , Urgencias Médicas , Servicio de Urgencia en Hospital , Estadística como AsuntoRESUMEN
No abstract available.
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Estudios de Seguimiento , Infecciones Urinarias , Sistema Urinario , Reflujo VesicoureteralRESUMEN
Ninety two cases of culture proved neonatal sepsis who had been admitted to pediatric department, National medical Center, during 7 years from Jan. 1984 to Dec. 1990 were reviewed clinically and the following results were obtained. 1) The frequency of neonatal sepsis was 3.1% and male to female sex ratio was 1.9:1, Sepsis was more prevalent in premature infants (9.9%) than in full term infants (1.9%). 2) The seasonal incidence was more prevalent in summer (32.6%). 3) The weight distribution showed 50 cases with the weight less than 2500 gram and 42 cases more than 2500 gram. 4) In 76 cases the onset was before 7 days old and in 16 cases were developed after 7 days old. 5) The major associated perinatal conditions in neonatal sepsis were institutional baby (23.9%), premature rupture of membranes (11.9%) and placenta previa (4.3%) in the order of frequency. The clinical manifestations on admission were jaundice (50.0%), poor activity (46.7%), respiratory difficulty (35.9%), poor feeding (22.8%), cyanosis (22.7%), gastrointestional symptoms (21.5%), fever (15.2%) and convulsion (13.0%) in the order of frequency. 6) The associated diseases were urinary tract infection (31.5%), hyaline membrane disease (19.6%), congenital disorder (18.5%), pneumonia (15.2%), anemia (13.0%), meningitis (9.8%), omphalitis (7.6%), DIC (6.5%), necrotizing enterocolitis (5.4%) and intracranial hemorrhage (5.4%) in the order of frequency. 7) Causative organisms were gram positive organisms in 27 cases (25.7%) and gram negative organisms in 79 cases (74.3%). The main organisms were Serratia marcescens (18.5%). Enterobacter spp (17.4%), Klebsiella pneumoniae (12.0%), Staphylococcus aureus (10.9%), Acinetobactor calcoaceticus (8.7%), Coagulase (-) staphylococcus (8.7%), E. coli (8.7%), Enterococcus (6.5%), Group B beta-hemolytic streptococcus (5.4%) and Pseudomonas (5.4%) in the order of frequency. The sensitivity to antibiotics were: Serratia marcescens: 70.6% sensitive to Amikacin 58. 9% sensitive to Cefotaxime 59. Enterobacter spp: 87.5% sensitive to Amikacin 68.8% sensitive to Cefotaxime Klebsiella pneumoniae: 100% sensitive to Amikacin 91. 0% sensitive to Cefotaxime Staphylococcus aureus: 100% sensitive to Cefazolin 90. 0% sensitive to Cefotaxime Acinetobacter calcoaceticus: 88.9% sensitive to Amikacin Coagulase (-) Staphylococcus: 100% sensitive to Amikacin 87. 5% sensitive to Cefotaxime E. coli: 100% sensitive to Amikacin, Cefotaxime Enterococcus: 50% sensitive to Gentamicin, Ampicillin, Amikacin Group B beta-hemolytie Streptococcus: 100% sensitive to Ampicillin, Penicillin Pseudomonas: 100% sensitive to Amikacin, Gentamicin, Tobarmycin 8) Mortality cases were 32 cases (34.8%).
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Femenino , Humanos , Lactante , Recién Nacido , Masculino , Acinetobacter calcoaceticus , Amicacina , Ampicilina , Anemia , Antibacterianos , Cefazolina , Cefotaxima , Coagulasa , Enfermedades y Anomalías Neonatales Congénitas y Hereditarias , Cianosis , Dacarbazina , Enterobacter , Enterococcus , Enterocolitis Necrotizante , Fiebre , Gentamicinas , Enfermedad de la Membrana Hialina , Incidencia , Recien Nacido Prematuro , Hemorragias Intracraneales , Ictericia , Klebsiella pneumoniae , Membranas , Meningitis , Mortalidad , Penicilinas , Placenta Previa , Neumonía , Pseudomonas , Rotura , Estaciones del Año , Convulsiones , Sepsis , Serratia marcescens , Razón de Masculinidad , Staphylococcus , Staphylococcus aureus , Streptococcus , Infecciones UrinariasRESUMEN
High matemal hemoglobin levels have been associated with intrauterine growth retardation and preterm delivery. We used it to examine the relationship between the lowest hemoglobin concentration in pregnancy, birth weight of newborns and preterm delivery. The study included 2586 pregnancies. The result as follows. A group with higher hemoglobin(above 14.5 g/dL) levels during pregnancy has higher incidence of low birth weight and preterm delivery than norrnal or low maternal hemoglobin levels.
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Humanos , Recién Nacido , Embarazo , Peso al Nacer , Retardo del Crecimiento Fetal , Incidencia , Recién Nacido de Bajo Peso , PartoRESUMEN
Hypodipsic hypernatremia is characterized by chronic or recurrent episodes of severe hypernatermia associated with dehydration and a lack of thirst. This constellation of deficits suggests that the syndrome is due to hypodipsia of destruction of the hypothalamic osmoreceptors that regulate thirst and ADH secretion. We report a child with abnormalities of the central nervous system who had hypernatremia and a lack of thirst without detectable abnormalities in the osmoregulation of ADH secretion. The patient was a 11 month old female and her chief complaints were poor oral intake and weight gain. There were recurrent hypernatremia with hyperosmosis and normal level of plasma ADH. With intravenous rehydratin, oral intake was improved and plasma sodium level decreased.
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Niño , Femenino , Humanos , Lactante , Sistema Nervioso Central , Deshidratación , Hipernatremia , Osmorregulación , Plasma , Sodio , Sed , Aumento de PesoRESUMEN
The symmetrical peripheral gangrene syndrome consists of sudden onset of symmetrical gangrene of the fingers, toes and more raely, the nose, upper lip, ear lobes, or genitalia. There is no evidence of occulusion of large vessels or vasculitis. We experienced a case of symmetrical peripheral gangrene developed in fingers and toes with disseminated intravascular coagulation in 20 day-old permature infant with sepsis by Enterobacter aerogenes. Thereafter, we presented a case with a brief review of the related literatures.