A Case of Transfusion Transmitted Malaria Infection in Extremely Low Bith Weight Infant

The incidence of malaria in Korea is significantly on the rise since its reemergence in 1993 and no screening test that can prevent the infection has been available. Very low birth weight infants are especially susceptible to malaria infection due to transfusions from multiple donors. We report a case of transfusion transmitted Plasmodium vivax infection in a 120-day-old infant of a gestational age 24 weeks with birth weight of 700 gm who was successfully treated with hydroxychloroquine.

Clinical Characteristics of Premature Infants with Atypical Chronic Lung Disease

PURPOSE: To compare the incidence and clinical characteristics of infants with atypical CLD and those with classic BPD among premature infants less than 32 weeks' gestation. METHODS: Clinical data was collected retrospectively from the 256 premature infants less than 32 weeks' gestation and their mothers during 3-year study period. RESULTS: Among 212 preterm infants less than 32 weeks' gestation who survived to 28 days of life, 19 (9%) had atypical CLD and 38 (17.9%) had classic BPD. Atypical CLD infants were significantly heavier and more mature than classic BPD infants (mean birth weights, 1,100+/-294 g vs 915+/-225 g; and mean gestational age, 26.9+/-1.6 weeks vs 21.1+/-1.3 weeks). Duration of ventilator therapy and oxygen inhalation within 28 days of age were shorter in atypical CLD infants than in classic BPD infants (mean duration of ventilator therapy, 16.3+/-6.9 days vs 27+/-6.8 days; and mean duration of oxygen inhalation, 25.5+/-13.5 days vs 53.8+/-39 days). Oxygen dependency in atypical CLD infants showed bimodal pattern, decreasing gradually to 3-week after birth and upturning to peak at about 5-week after birth. Comparing the respiratory indices between classic BPD and aypical CLD, FiO2 at day 2,7, and 10, and oxygen index at day 2, and 10 were significant in classic BPD, but MAP were not. Considering the birth weight, MAP per birth weight, and modified oxygen index showed more apparent differencies between the two groups. CONCLUSION: 35.5% of total CLD were atypical CLD and showed bimodal pattern in oxygen dependency. Atypical CLD infants were significantly heavier and more mature than classic BPD infants.

Clinical Trial of Vitamin A Supplementation in Very Low Birth Weight Infants at Risk for Chronic Lung Disease / 대한주산의학회잡지

No abstract available.

Growth Response in Children with Idiopathic Growth Hormone Deficiency and Organic Growth Hormone Deficiency during Growth Hormone Treatment / 대한소아내분비학회지

PURPOSE: This study was undertaken to compare the growth promoting effect between patients with idiopathic growth hormone deficiency(IGHD) and those with organic growth hormone deficiency(OGHD). METHODS: Seventeen children with GH deficiency were divided into two groups: 7 IGHD and 10 OGHD including craniopharyngioma(5), sella germinoma(1), prolactinoma(1), Langerhans cell histiocytosis(1) and postirradiation(1). Diagnosis of GHD was made on the basis of two growth hormone provocative tests, serum IGF-1 & IGFBP 3 level, and bone age. Both groups were treated with recombinant human growth hormone(0.6-0.8IU/Kg/week) for 2 years and auxological parameters (height velocity, height SDS CA(standard deviation score for chronologic age)) were analyzed during 2 years of treatment by using KIGS 4.0 software program. RESULTS :The mean pretreatment height velocity in both groups did not differ statistically(2.6+/-.8cm/yr in IGHD vs 2.5+/-.9cm/yr in OGHD: p>0.05). However, height velocity after 2 years of growth hormone treatment was significantly greater in IGHD group than in OGHD group(9.0+/-.3cm/yr in IGHD vs 7.2+/-.8cm/yr in OGHD: P<0.05). The height SDS for CA has improved remakably during 2 years of growth hormone treatment; -3.46 SDS before treatment to -1.53 SDS in IGHD group, -2.3 SDS to -0.5 SDS in OGHD group. CONCLUSION: Growth hormone replacement therapy has remakably improved height velocity and height SDS for CA in both groups during the 2 years of the treatment. However, the height velocity in OGHD group was significantly less than in IGHD, indicating that additional factors such as malnutrition, associated multiple hormone deficiencies, spinal irradiation and sexual precocity might significantly hamper the growth promoting effect in OGHD group during growth hormone treatment.

Abnormalities of Hypothalamic-Pituitary MR Imaging and Pituitary Function in Patients with Growth Hormone Deficiency

PURPOSE: In this study, efforts have been made to evaluate the sella MRI in 14 patients with growth hormone deficiency to define more clearly the structural abnormalities of the hypothalamo- hypophyseal axis, examine frequency of these abnormalities, and determine whether a relationship exists between the sella MRI findings and types of endocrine dysfunction. METHODS: Sella MRI was performed in 14 patients who were diagnosed as growth hormone deficiency (GHD) based on a strict diagnostic criteria. If abnormal sella MR findings were associated, then combined anterior pituitary function test was carried out. RESULTS: Among the 14 patients with GHD, complete deficiency was found in 10 patients and partial deficiency in 4 patients. Three with complete GHD showed normal MRI findings and isolated GHD only. Others revealed 3 pituitary stalk interruption syndrome (PSIS), 2 hypoplastic pituitary gland, 1 prolactinoma, and 1 Langerhans histiocytosis. These patients have multiple endocrine dysfunctions in addition to GHD. Three out of 4 patients with partial GHD, showed normal sella MR findings and isolated GHD. Only one patient with partial GHD had a delayed puberty and hypoplasia of pituitary gland. CONCLUSION: Sella MRI enables us to identify mophologic pictures in GHD previously considered 'idiopathic'. Abnormal sella MR findings strongly suggest that multiple hormone deficiencies are associated. This study justifies that routine sella MRI should be recommended in an attempt to identify the etiology of GHD in case that the diagnosis of GHD is strictly made.