Serum IGF-I and IGFBP-3 in 919 Healthy Korean Children and Adolescents: Normal Values and Correlations with Age, Sex, Height, Body Mass Index and Bone Age / 대한소아내분비학회지

PURPOSE: IGF-I and IGFBP-3 are usually used for the diagnosis of growth hormone deficiency. Until now we don't have normal values of IGF-I and IGFBP-3 in Korea. Therefore, we evaluated the normal values of IGF-I and IGFBP-3 in healthy Korean children and adolescents and compared with reference values in Pediatric endocrinology which was published by the Korean society of pediatric endocrinology. We also evaluated correlation of age, sex, height, body mass index and bone age with serum IGF-I and IGFBP-3 levels. METHODS: We studied the serum levels of IGF-I and IGFBP-3 in 919 and 686 normal healthy children and adolescents respectively who were examined for the growth evaluation at the department of Pediatrics, Ajou University Hospital from January, 1994 to September, 2004. IGF-I and IGFBP-3 were measured using IRMA method. RESULTS: Serum levels of IGF-I and IGFBP-3 were increased with age from early childhood into adolescence. Serum IGF-I correlated significantly with age, sex and BMI but serum IGFBP-3 correlated significantly only with age and sex (P<0.05). IGF-I levels in our data were lower than reference values in Pediatric Endocrinology during early childhood but were higher in puberty. IGFBP-3 levels were higher throughout childhood and puberty. CONCLUSION: There was a significant difference between our data and reference values which were evaluated in U.S.A., so longitudinal antegrade large scale study must be undertaken to obtain the normal reference range of healthy Korean children and adolescents. We believe that one should take into account the patient's age, sex, height, BMI and bone age when measuring serum IGF-I and IGFBP-3 levels for the evaluation of short stature.

Manifestation of Coronary Artery Lesions after Immunoglobulin Re-treatment in Initial Immunoglobulin-resistant Kawasaki Disease / 소아과

PURPOSE: To evaluate the predictable factors for why initial intravenous immune globulin(IVIG) therapy failed and the outcome of coronary lesions after additional IVIG retreated in initial IVIG-resistant Kawasaki disease(KD). METHODS: Retrospective studies were performed on 284 cases of KD treated with one episode of high-dose IVIG and 63 cases with additional IVIG retreatment at this hospital from January 2000 to June 2003. 2D echocardiogram was done at admission, two months later and every two or three months when coronary lesion had improved more than two months later. RESULTS: In 69(24.3%) of 284 cases with post-first course of IVIG therapy, 19(43.2%) of 63 cases with additional IVIG retreatment, coronary abnormality had been shown by initial 2D-echocardiogram examined at acute stage. In five(1.8%) of 284 patients with post-first course of IVIG therapy, and in three(4.8%) of 63 cases with additional IVIG retreatment, coronary lesions still remained at follow-up echocardiogram. Even though there was a tendency of increased coronary lesions in the group with additional IVIG retreatment, there was no significant differences in the incidence of coronary lesions between the two groups. There were no significant differences in age, sex, and other clinical findings between the two groups. CONCLUSION: Combination therapy with high doses of IVIG and aspirin is generally effective as a standard treatment for KD but not always. Coronary lesion did not increased despite additional IVIG therapy for initial IVIG-resistant KD. There was no predictable factor for initial IVIG-resistant KD.

The Effect of Repetitive Hypoxia on Production of Lipid Peroxidation in Newborn Rat Brain

PURPOSE: Among many pathophysiologic mechanisms of hypoxic-ischemic brain injury, reactive oxygen species (ROS) cause or contribute to brain damage relates to their ability to attack the fatty acid moiety of plasma and subcellular membranes. Because ROS are generated by hypoxia-ischemia especially during reperfusion period of recovery, repetitive hypoxia-reoxygenation in newborn brain may result in more severe damage than a similar single insult. It is to determine whether repetitive hypoxia-reoxygenation may produce more ROS than a similar single insult in newborn rat brain. METHODS: We compared the production of lipid peroxidation in 3 days old rat brain following normoxia, repetitive hypoxia-reoxygenation and an equal duration of sustained hypoxia-reoxygenation by measuring 8-isoprostane-F2alpha. 8-isoprostane-F2alpha is free radical catalyzed metabolites of arachidonic acid, which is produced independent of cyclooxygenase. RESULTS: Compared to a single duration hypoxia-reoxygenation, repetitive hypoxia- reoxygenation produce more ROS (8-isoprostane-F2alpha) in newborn rat brain (P < 0.005). CONCLUSION: It can be speculated that repetitive hypoxia is more detrimental than equal duration of single insult in new born rat brain. Relations between increased ROS production and brain injury following repetitive hypoxia-reoxygenation should be evaluated.

A Case of Constitutional Interstitial Deletion of 5q

Constitutional interstitial deletions of 5q are rare conditions and phenotypic correlations are not well defined in the literature. We report a case of a male infant with constitutional interstitial deletion 5q15q22. The infant showed hypertelorism, cleft palate and bilateral undescended testis. He also had atrial septal defect and small patent ductus arteriosus, and showed no response in brain stem audoimetry. Our report gives weight to the previously reported cases that karyotype-phenotype correlation may be speculated in 5q deletion.