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PURPOSE: The aim of this study is to compare the iron status of fullterm and preterm infants and to investigate effects of gender, IUGR, and maternal diabetes mellitus (DM) on iron status of infants. METHODS: We evaluated newborn infants admitted at neonatal intensive care unit (NICU) of Kyungpook National University Hospital from July 2011 to April 2013. The five parameters were measured: hemoglobin, hematocrit, ferritin, total iron binding capacity, and transferrin saturation. RESULTS: Serum ferritin was lower in preterm infants than in fullterm infants (209.5 vs 323.5 ng/mL, P=0.003). Hemoglobin, hematocrit, total iron binding capacity, and transferrin saturation levels were not influenced by gestational age. Maternal DM was associated with decreased serum ferritin (204.3 vs 347.8 microg/L, P=0.008). There was no difference of ferritin levels between male and female as well as between IUGR infants and non-IUGR infants. CONCLUSION: In this study, low gestational ages and maternal DM are associated with low ferritin level. Careful monitoring of iron status is required for preterm infants and infants of DM mother.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Male , Diabetes Mellitus , Ferritins , Fetal Growth Retardation , Gestational Age , Hematocrit , Infant, Premature , Intensive Care, Neonatal , Iron , Mothers , TransferrinABSTRACT
PURPOSE: To introduce and demonstrate the advantages of the new hybrid two-dimensional (2D) proton spectroscopic imaging (Sl) over the single voxel spectroscopy (SVS) and conventional 2D Sl in the clinical application of spectroscopy for pediatric cerebral disease. MATERIALS AND METHODS: Eighty-one hybrid 2D proton spectroscopic imaging was performed in 79 children (36 normal infants and children, 10 with hypoxic-ischemic injury, 20 with toxic metabolic encephalopathy, seven with brain tumor, three with meningoencephalitis, one with neurofibromatosis, one with Sturge-Weber syndrome and one with lissencephaly) ranging in age from the third day of life to 15 years. In adult volunteers (n = 5), all three techniques including hybrid 2D proton Sl, SVS using PRESS sequence, and conventional 2D proton Sl were performed. Both hybrid 2D proton Sl and SVS using PRESS sequence were performed in clinical cases(n= 12). All measurements were peformed with a 1.5-T scanner using standard head quadrature coil. The 16 x 16 phase encoding steps were set on variable field of view (FOV) depending on the size of the brain. The hybrid volume of interest inside FOV was set as 75 x 75 x 15 mm3 or smaller to get rid of unwanted fat signal. Point-resolved spectroscopy (TR/TE = 1,500 msec/135 or 270 msec) was employed with standard chemical shift selective saturation (CHESS) pulses for water suppression. The acquisition time and spectral quality of hybrid 2D proton Sl were compared with those of SVS and conventional 2D proton Sl. RESULTS: The hybrid 2D proton Sl was successfully conducted upon all patients. The 2D spectral data acquisition time was less than 6 minutes, while the data acquisition time of SVS was 4.3 minutes. This was short enough for pediatric application. The spectra acquired with hybrid 2D proton Sl showed nearly the same sensitivity and spectral resolution with SVS. The spectral quality of hybrid 2D proton Sl was, on the other hand, far better than that of conventional 2D proton Sl. The other advantage of hybrid 2D proton Sl was that the extent of metabolic abnormalities could be evaluated through the characteristics of the relative levels of the three metabolites, i.e., N-acetylaspartate, choline, and creatine. CONCLUSION: The hybrid 2D proton Sl can be successfully employed for the evaluation of the metabolic abnormalities in the various pathologic conditions of pediatric brain without penalty in acquisition time and spectral quality when compared to SVS. The extent of metabolic abnormalities, which cannot be obtained with SVS technique, also can be evaluated with hybrid 2D proton Sl.
Subject(s)
Adult , Child , Humans , Infant , Brain Diseases, Metabolic , Brain Neoplasms , Brain , Choline , Creatine , Hand , Head , Magnetic Resonance Spectroscopy , Meningoencephalitis , Neurofibromatoses , Protons , Spectrum Analysis , Sturge-Weber Syndrome , Volunteers , WaterABSTRACT
Early diagnosis of childhood cancer is very important for the prognosis. Ultrasonography of routine examination for pregnant woman is now a popular method. We experienced two cases of congenital Wilms tumor suspected by prenatal ultrasonography from mothers and confirmed by nephrectomy soon after birth. One of the cases was stage II with favorable histology and was treated with vincristine(2.0 mg/m2) and actinomycin D(45 microgram/kg) for 60 weeks by National Wilms Tumor Study(NWTS) IV treatment protocol, K-4 A regimen. The other was stage I with favorable histology and was treated with vincristine(1.5 mg/m2) and actinomycin D(15 microgram/kg) for 24 weeks by NWTS IV, EE regimen. The post-chemotherapy follow-up evaluation of these two children for 3 years and 2 months and 1 year and 7 months respectively were quite normal with 100% of Karnovsky scores. Early diagnosis, especially in prenatal, is very important for the prognosis of childhood cancer. Routine ultrasonographic examination in pregnant women is also desirable for the detection of solid tumor of fetus if it does not harmful for the fetus.
Subject(s)
Child , Female , Humans , Clinical Protocols , Dactinomycin , Early Diagnosis , Fetus , Follow-Up Studies , Mothers , Nephrectomy , Parturition , Pregnant Women , Prenatal Diagnosis , Prognosis , Ultrasonography , Ultrasonography, Prenatal , Wilms TumorABSTRACT
PURPOSE: This study was conducted to evaluate the effect of IVIG infusion on renal function in VLBW infants. IVIG has been proved quite safe in neonates given prophylactic and therapeutic doses. But nephrotoxicity is not recognized as adverse in IVIG therapy, only several previous adult cases have been noted. METHODS: For a total of ten VLBW infants who had not been received any medication except parenteral nutrition, vitamin and Fe supplements was assigned for study. To observe changes in renal function after preventive dose of IVIG administration(500mg/kg, 1dose) serum BUN and creatinine, 2-microglobulin( 2-MG) and N-acetyl- -D-glucosaminidase(NAG) were obtained prior to study and 1, 3 and 7 days after infusion. RESULTS: 1) There were no elevation of serum BUN and creatinine after IVIG administration, 2) There was transient increase of urine NAG from 1.1+/-0.7 u/mg creatinine before infusion to 2.7+/-5.3 u/mg creatinine on the first day of infusion, which was not statistically significat, decreasing to pretreatment level on the 3rd and 7th days after infusion. 3) There was transient increase of urine 2-MG from 294.6+/-223.8 microgram/mg creatinine before infusion to 680.0+/-108.9 microgram/mg creatinine on the first day and 416.0+/-246.3 microgram/mg creatinine on 3rd day after infusion, which was not statistically significant. CONCLUSIONS: It was found that prophylactic dose of IVIG in VLBW infants does not cause clinically significant impairment of renal function. but mild increment of urine NAG and 2-MG may suggest the possibility of renal tubular damage. Based on these results, further evaluation of the effect of IVIG on renal function in VLBW infant is recommended.
Subject(s)
Adult , Humans , Infant , Infant, Newborn , Acetylglucosaminidase , Creatinine , Immunoglobulins, Intravenous , Infant, Very Low Birth Weight , Parenteral Nutrition , VitaminsABSTRACT
This study was conducted to evaluate the effect of intraveneous immunoglobulin (IVIG) infusion on renal function in neonates. IVIG has provided quite safe in neonates given therapeutic doses. But nephrotoxicity is not a recognized adverse events of IVIG therapy, only several previous adult cases having been described. A total twenty five neonates suspected sepsis was randomely assigned to IVIG (n=12) or control (n=13) group. Neonates assigned to IVIG group received IVIG (1g/kg, 1 dose) adjunct to ampicillin and gentamicin, and neonates assigned to control group received same antibiotics. To observe changes in renal function with IVIG therapy, serum BUN, creatinine, urine creatinine, beta2-microglobulin ( beta2MG) and N-acetyl-beta-D-glucosam-inidase (NAG) were obtained before and 24 hours, 3 and 7 days after initiation of therapy. There were no statistically significant changes in serum BUN and creatinine in both groups. Transient increase of urine NAG was observed at 24 hours after therapy in IVIG group. Urine beta2MG of IVIG group remained in pretreatment level, whereas decreased with age in control group, so, at 7th day IVIG group have higher urinary excretion of beta2MG compared to control group. According to these results, it was found that IVIG therapy in neonates might cause transient renal tubular damage.
Subject(s)
Adult , Humans , Infant, Newborn , Ampicillin , Anti-Bacterial Agents , Creatinine , Gentamicins , Immunoglobulins , Immunoglobulins, Intravenous , SepsisABSTRACT
No abstract available.
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No abstract available.
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A clinical observation was done on 38 children with idiopathic nephrotic syndrome, who had been admitted to our pediatric department during past 3 years period, from January 1978 to September 1980. The following results were obtained: At the beginning of illness, 42% were in the age group of 3~7year, and male to female ratio was approximately 3:1 of male preponderance. During initial attack and subsequent relapses, pitting edema on extremities was noticed in all cases, followed in frequency by generalized edema in 71%, ascites and /or pleural effusion in 65.8% and GI trouble in 47.4%. Response to initial continuous steroid therapy showed complete remission(group 4) in 37.8%, partial remission(group 23) in 46% and no response(group 1) in 16.2%, Within 2 weeks after instiution of steroid therapy, both diuresis and disappearance of proteinuria were noted in 57.1%. Nephritic manifestations, eg. Hematruia, hypertension & azotemia, were seen in 21.6%, 10.8%, 24.3% respectively, and the majority of children with these manifestations showed poor response to steroid therapy. Nine out of 21 patients in whon follow-up could be done over 1 year, experienced one or more relapses, giving 43% relapse rate during the 1st year, and URI was accompanied in about half of these episodes. Percutaneous renal biopsy done on 17 patients who showed steroid dependency or no response to poor response toward steroid therapy showed the following results: Minimal change nephrotic syndrome in 8, membranous nephropathy in 3, membranoproliferative glomerulonephritis in 3, focal segmental sclerosis in 1 and focal proliferative glomerulonephritis in 2. And male to female ratio was 13:4. ?Pulse?therapy with bolus dosasge of methylprednisolone was tried on 9 patients, resulting in disappearance of relapse or significant improvement in blood chemistry & urinary finding in 5. And 2 out of 5 patients in whom immunosuppressant therapy with cytoxan was giveu due to poor response to steroid, experienced complete remission. During the same study period, secondary nephrotic syndrome was observed in 6 out of 54 patients with acute glomerulonephritis, and heavy proteinuria over 2 gm/m2/day, was seen in 6 patients with acute glomerulonephritis and 2 patients with congestive heart failure.
Subject(s)
Child , Female , Humans , Male , Ascites , Azotemia , Biopsy , Chemistry , Cyclophosphamide , Diuresis , Edema , Extremities , Follow-Up Studies , Glomerulonephritis , Glomerulonephritis, Membranoproliferative , Glomerulonephritis, Membranous , Heart Failure , Hypertension , Methylprednisolone , Nephrosis, Lipoid , Nephrotic Syndrome , Pleural Effusion , Proteinuria , Recurrence , SclerosisABSTRACT
A clinical and laboratory study was conducted on 58 children who had been admitted to out pediatric department from February to September 1979, under the clinical diagnosis of septicemia. Following results were obtained: 1. Boys were affected more frequently than girls(1.3:1), and highest incidence was noticed in newborn period, comprising 50% of the total cases. 2. The common clinical manifestations, in order of frequency, were fever, lethargy, jandice, poor sucking and abdominal distension, and hyperbilirubionemia was the most common assocaited disease, followed by anemia and leukemia. 3. Clinical course revealed death in 6 patients(10.3%), discharge against advice in 7cases(21.1%) and complete recovery in the remaining 45 cases(77.6%). 4. Peripheral blood count showed leukocytosie in 40%, leukopenia in 12.1% and thrombocytopenia was seen in 45% of cases. 5. Gram staining of buffy coat smear showed bacteria in 34.5% and especially high ratio was noticed in newborn infants(48.3%). 6. Positive blood culture was seen in 39.7% with highest ratio of 45% in newborn infants. In positive blood culture group, toxic granules were noted in 32.8%, shift to left in 25.9%, hrombocytopenia in 18.9% and positive buffy coat smear in 15.5%. In summary, thrombocytopenia, toxic granules, shift to left were quite helpful in early diagnosis of sepsis. In addition to diagnostic value, examination of buffy coat smear could aid physician to select appropriate antibiotic regimen especially in sepsis of newborn period.