Journal of Yeungnam Medical Science

Original article

Incidence of congenital hypothyroidism by gestational age: a retrospective observational study: Ha Young Jo, Eun Hye Yang, Young Mi Kim, Soo-Han Choi, Kyung Hee Park, Hye Won Yoo, Su Jeong Park, Min Jung Kwak; J Yeungnam Med Sci. 2023;40(1):30-36. Published online April 12, 2022; DOI: https://doi.org/10.12701/jyms.2022.00059

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Background
Congenital hypothyroidism (CH) is the leading cause of preventable physical and intellectual disabilities. This study aimed to assess the incidence and clinical characteristics of CH in newborns.
Methods
We retrospectively reviewed the medical records of all newborns delivered at the Pusan National University Hospital between January 2011 and March 2021. The incidence of CH was compared according to gestational age, birth weight, and small for gestational age (SGA). The patients aged ≥3 years who could not maintain normal thyroid function and required levothyroxine treatment were diagnosed with permanent CH. Logistic regression analysis was performed to compare CH risks.
Results
Of 3,722 newborns, 40 were diagnosed with CH (1.07%). Gestational age and birth weight were significantly associated with CH incidence. The odds ratios (ORs) of CH in infants delivered at 32–37, 28–31, and <28 weeks were 2.568 (95% confidence interval [CI], 1.141–5.778), 5.917 (95% CI, 2.264–15.464), and 7.441 (95% CI, 2.617–21.159) times higher, respectively, than those delivered at term. The ORs of CH in infants weighing 1,500–2,499 g, 1,000–1,499 g, and <1,000 g were 4.664 (95% CI, 1.928–11.279), 11.076 (95% CI, 4.089–29.999), and 12.544 (95% CI, 4.350–36.176) times greater, respectively, than those in infants weighing ≥2,500 g. The OR of CH was 6.795 (95% CI, 3.553–13.692) times greater in SGA than in non-SGA infants.
Conclusion
The CH incidence in South Korea has increased significantly compared with that in the past. Gestational age, birth weight, and SGA were significantly associated with CH incidence.

Citations

Citations to this article as recorded by

History of Neonatal Screening of Congenital Hypothyroidism in Portugal
Maria José Costeira, Patrício Costa, Susana Roque, Ivone Carvalho, Laura Vilarinho, Joana Almeida Palha
International Journal of Neonatal Screening.2024; 10(1): 16. CrossRef
The prevalence of hypothyroxinemia in premature newborns
Renata Stawerska, Marzena Nowak-Bednarek, Tomasz Talar, Marzena Kolasa-Kicińska, Anna Łupińska, Maciej Hilczer, Ewa Gulczyńska, Andrzej Lewiński
Frontiers in Endocrinology.2022;[Epub] CrossRef

Case report

Scrotal pyocele secondary to gastrointestinal perforation in infants: a case series: Soo-Hong Kim, Yong-Hoon Cho, Hae-Young Kim, Narae Lee, Young Mi Han, Shin Yun Byun; J Yeungnam Med Sci. 2023;40(1):86-90. Published online December 15, 2021; DOI: https://doi.org/10.12701/yujm.2021.01508

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Abstract PDF

Pyocele in infants is rarely described in the literature, but it is an emergent condition that requires rapid recognition and treatment to prevent testicular loss. If peritonitis due to gastrointestinal perforation occurs, abdominal contamination may spread through a patent processus vaginalis in an infant, which may lead to pyocele. We report the cases of three infants with scrotal pyocele due to the spread of infection or inflammatory material from the intraperitoneal cavity through a patent processus vaginalis. Two infants were surgically treated, while the other was treated with percutaneous aspiration and intravenous antibiotic administration. Although rare, pyocele should be considered in the differential diagnosis of acute scrotum in infants, especially in infants who previously had peritonitis due to gastrointestinal perforation.

Citations

Citations to this article as recorded by

Neonatal pyocele originating from a urinary tract infection: a case report
Zahra Jamali, Mohammad Shafie’ei, Najmeh Soltani Nejad
Journal of Medical Case Reports.2024;[Epub] CrossRef

Original article

Predictive value of C-reactive protein for the diagnosis of meningitis in febrile infants under 3 months of age in the emergency department: Tae Gyoung Lee, Seung Taek Yu, Cheol Hwan So; Yeungnam Univ J Med. 2020;37(2):106-111. Published online January 8, 2020; DOI: https://doi.org/10.12701/yujm.2019.00402

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Abstract PDF

Background
Fever is a common cause of pediatric consultation in the emergency department. However, identifying the source of infection in many febrile infants is challenging because of insufficient presentation of signs and symptoms. Meningitis is a critical cause of fever in infants, and its diagnosis is confirmed invasively by lumbar puncture. This study aimed to evaluate potential laboratory markers for meningitis in febrile infants.
Methods
We retrospectively analyzed infants aged <3 months who visited the emergency department of our hospital between May 2012 and May 2017 because of fever of unknown etiology. Clinical information and laboratory data were evaluated. Receiver operating characteristic (ROC) curves were constructed.
Results
In total, 145 febrile infants aged <3 months who underwent lumbar punctures were evaluated retrospectively. The mean C-reactive protein (CRP) level was significantly higher in the meningitis group than in the non-meningitis group, whereas the mean white blood cell count or absolute neutrophil count (ANC) did not significantly differ between groups. The area under the ROC curve (AUC) for CRP was 0.779 (95% confidence interval [CI], 0.701–0.858). The AUC for the leukocyte count was 0.455 (95% CI, 0.360–0.550) and that for ANC was 0.453 (95% CI, 0.359–0.547). The CRP cut-off value of 10 mg/L was optimal for identifying possible meningitis.
Conclusion
CRP has an intrinsic predictive value for meningitis in febrile infants aged <3 months. Despite its invasiveness, a lumbar puncture may be recommended to diagnose meningitis in young, febrile infants with a CRP level >10 mg/L.

Citations

Citations to this article as recorded by

Fever without a source under 3 months of age: any predictive factors of Serious Bacterial Infection?
Rita Calejo Pereira Machado Ribeiro, Joana Raquel Pinto de Carvalho Queiros, Ana Ines Rodrigues Paiva Ferreira, Ines Isabel Aires Martins, Fabio David Monteiro Barroso
Pediatric Oncall.2024;[Epub] CrossRef
Immunologic biomarkers for bacterial meningitis
Mina Yekani, Mohammad Yousef Memar
Clinica Chimica Acta.2023; 548: 117470. CrossRef
Febrile infants: written guidelines to reduce non-essential hospitalizations
Ji Yoon Oh, Soo-Young Lee
World Journal of Pediatrics.2021; 17(5): 555. CrossRef

Case Reports

A Case of Granulation Tissue of the Tongue in Infant.: Hee Jung Lee, Eun Sil Yun, Joon Hyuk Choi, Kwang Hae Choi; Yeungnam Univ J Med. 2005;22(2):247-252. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.247

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Abstract PDF: Tongue tumors of pediatric patients are the most common soft tissue tumor of pediatric oral and maxillofacial tumors. There are many kind of pediatric tongue lesions such as hemangioma, lymphangioma, papilloma, and cyst. Most of these lesions are benign, but malignant tumors of tongue may be occurred. Therefore, malignancy should be ruled out. Sometimes, tongue lesions are present with dyspnea, dysphagia, dysarthria, bleeding, or cosmetic problem. We experienced a case of chronic inflammatory mass on posterior 1/3 of the tongue in 4 month old female patient. Swallowing difficulty and respiratory distress symptom occurred because of tongue mass effect. The tongue mass was confirmed as granulation tissue by microscopic examination. After excision of tongue mass, she had no problem with swallowing and breathing.

A Case of Bilateral Testicular Teratoma Found in Infant.: Un Gi Baek, Seok Young Chung, Woo Seok Choi, Phil Hyun Song, Chul Kyu Cho, Ki Hak Moon, Dong Sug Kim; Yeungnam Univ J Med. 2003;20(1):92-98. Published online June 30, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.1.92

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Abstract PDF: Testicular teratoma is characterized that has more than one germ cell layer in various stages of maturation and differentiation. The incidence of mature teratoma varies from 2 to 9% of all germinal testicular tumor. Only 3 cases of bilateral teratoma have been reported in the literature to date. The teratoma can occurs at all ages but is most common between the age of 15-35 year. It is relatively infrequently seen in childhood and infancy. In these age group, teratoma tends to be a benign. Recently, we experienced one case of bilateral testicular teratoma in 4 month-old infancy. We report a case of bilateral testicular teratoma found infancy with review of related literatures.

A Case of Desmoplastic Infantile Ganglioglioma.: Kwang Chul Song, Seong Ho Kim, Jang Ho Bae, Oh Ryong Kim, Byung Yon Choi, Soo Ho Cho, Dong Seok Kim; Yeungnam Univ J Med. 1997;14(2):451-458. Published online December 31, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.2.451

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Abstract PDF: The desmoplastic infantile ganglioglioma is very rare cerebral tumor. It has been known to be characterized by its voluminious size, intense desmoplasia and the frequent presence of astrocytic and ganglioglionic differentiation. Also, It is usually presented in infantile period and predilected in the frontal and parietal lobes. We treated a huge desmoplastic infantile ganglioglioma(8?7?6cm) on the right frontotemporo-parietal area with only gross total resection. It includes solid mass & several cysts and shows the areas of the proliferation of spindle cells exhibiting storiform pattern in dense desmoplastic stroma and the areas composed of spindle shaped glial component.

Original Articles

The Measurement of Blood Flow of Anterior Cerebral Artery in Premature Newborns Using Duplex Dopple Ultrasonography.: Mi Soo Hwang, Kyeung Kug Bae, Jae Kyo Lee; Yeungnam Univ J Med. 1997;14(1):77-84. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.77

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Abstract PDF: We measured the blood flow velocity of the anterior cerebral artery via anterior fontanelle approach of fifty five preterm neonates with duplex Doppler sonography and analyzed the waveform and calculated pulsatility index were increased with increasing gestational age, birth weight, and age of the neonate, but resistive indices decreased. In sick babies, characteristic resistive index increment were seen in patients with intraventricular hemorrhage, but no statistical difference was seen in patients with respiratory distress syndrome. Our results suggest that duplex Doppler sonography is a use ful noninvasive means of monitoring cerebrohemodynamics in normal pretem neonates and flow change of sick babies.

Infantile Hypertrophic Pyloric Stenosis.: Young Soo Huh, Gyu Rag Kim, Son Moon Shin; Yeungnam Univ J Med. 1996;13(2):199-210. Published online December 31, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.2.199

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Abstract PDF: Infantile hypertrophic pyloric stenosis(IHPS), which occurs three of 1,000 live births, is a major cause of 1 nonbilious vomiting of early infancy but its etiology and pathogenesis are still obscure. The operation of pyloromyotomy as described by Ramstedt in 1912 remains the standard of care for the treatment of IHPS. From January 1993 to October 1996, 35 infants with IHPS were surgically treated and the following results were obtained. 1. Thirty-five patients comprised 32 males and 3 females, and the ratio of male to female was 10.7:1. 2. The most prevalent age group was between 2 weeks and 8 weeks. 3. Of 35 infants, first born babies were 23 cases(65.7%). 4. Breast feeding was in 23 cases(65.7%). 5. The body weight percentile at admission was lower than 50 percentile in all 35 cases. 11. A total of seven associated anomalies were noted in six patients. 12. All 35 cases were treated with Fredet-Ramstedt pyloromyotomy. 13. There were postoperative complications of wound infection in 2 cases. Intermittent nonprojectile vomiting was presented in 8 cases(22.9%) after operation, but one of them was relieved in 13 days and the rest were relieved within one week by adjustment of oral intake.

Low volume peritoneal dialysis in newborns and infants.: Young Hoon Park, Soo Ho Ahn, Son Moon Shin, Jeong Ok Hah; Yeungnam Univ J Med. 1991;8(2):128-137. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.128

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Abstract PDF: Peritoneal dialysis has been widely considered to be the dialytic treatment of choice for acute renal failure in infants and young children, because the technique is simple, safe and easily adapted for these patients. Also peritoneal dialysis in infants might have more effective ultrafiltration and clearance than in adults. In certain circumstances associated with hemodynamic instability, ordinary volume peritoneal dialysis (30-50 ml/kg body weight per exchange) or hemodialysis may not be suitable unfortunately. But frequent cycled, low volume, high concentration peritoneal dialysis may be more available to manage the acute renal failure of newborns and infants. Seven infants underwent peritoneal dialysis for hemodynamically unstable acute renal failure with low exchange volume (14.2±4.2 ml/kg), short exchange time (30 to 45 minutes) and hypertonic glucose solution (4.25% dextrose). Age was 1.9±1.3 months and body weight was 4.6±1.6 kg. Etiology of acute renal failure was secondary to sepsis with or without shock (5 cases) and postcardiac operation (2 cases). Catheter was inserted percutaneously with pigtail catheter or Tenkhoff catheter by Seldinger method. Dialysate was commercially obtained Peritosol which contained sodium, chloride, potassium, magnesium, lactate and calcium. Net ultrafiltration (ml/min) showed no difference between low volume dialysis and control (0.27±0.09 versus 0.29±0.09). Blood BUN decreased from 95.7±37.5 to 75.7±25.9 mg/dl and blood pH increased from 7.122±0.048 to 7.326±0.063 after 24 hours of peritoneal dialysis. We experienced hyperglycemia which were controlled by insulin (2 episodes), leakage at the exit site (2), mild hyponatremia (1) and Escherichia coli peritonitis (1). Two children of low volume dialysis died despite the treatment. In our experience, low volume and high concentration peritoneal dialysis with frequent exchange may have sufficient ultrafiltration and clearance without significant complications in the certain risked acute renal failure of infants.

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