Multiple Congenital Anomalies in a Neonate of a Diabetic Mother

Maternal diabetes is known to have teratogenic effects which increase the risk for congenital anomalies, such as caudal dysplasia, cardiac defects, hydronephrosis, and small left colon syndrome. Infants of diabetic mothers have a 10-fold higher frequency of anomalies in the central nervous system and a 5-fold higher frequency of congenital heart defects. However, jejunal atresia combined with multiple anomalies of the face, ears, and hands has rarely been reported. Herein we report a neonate born to a diabetic mother, who had hemifacial microsomia, displacement of the lacrimal ducts, polydactyly of the right hand, microtia of the right ear and proximal jejunal atresia presenting as bile regurgitation on the 1st day of life.

A Case of Hydromyelia with Erythematous Depressed Patch on Low Back in Newborn Infant

The hydromyelia is one kind of four types of syringomyelia, chronic progressive and degenerative disorder, which develops pathological cavity or syrinx within spinal cord. It is rare and comprises dilated spinal syrinx. Its clinical manifestations include muscle weakness without pain in arm and hand, dissociated segmental dysesthesia, and loss of pain and temperature sensation. It is also frequently associated with hydrocephalus. We report a case of hydromyelia with erythematous depressed patch on low back in term neonate.

A Case of Congenital Laryngeal Atresia with Single Umbilical Artery Who Required a Tracheotomy / 소아과

Congenital laryngeal atresia is a rare cause of airway obstruction that is almost always lethal within a few minutes after birth. Therefore congenital laryngeal atresia should be diagnosed in the prenatal period. If not, it should be considered in newborn infant with life-threatening symptoms at birth such as cyanosis and dyspnea that need emergent procedures like a tracheotomy. We report a case of congenital laryngeal atresia with single umbilical artery diagnosed in a one-day-old neonate who required a tracheotomy and ventilator care after intubation failure.

Repetition of Apoptosis Induced by Amiloride Derivatives in Human Umbilical Vein Endothelial Cells

PURPOSE: Human umbilical vein endothelial cells(HUVECs) play an important role in regulating blood flow by releasing vasoactive substances. It has been reported that endothelial impairment and dysfunction might be a primary cause of placental vascular disease, which is manifested clinically as preeclampsia in mother and intrauterine growth restriction in fetus. Furthermore, the frequency of apoptotic changes is increased in umbilical and placental tissues from growth-restricted pregnancies. However, the various mechanisms of umbilical endothelial cell apoptosis have not been broadly proposed. We investigate the effects of amiloride derivatives on apoptotic death of HUVECs and identify their ionic mechanism. METHODS: HUVECs were purchased from Clonetics, and cultured on endothelial cell growth medium. MTT assay and flow cytometry were used for assessing cytotoxic effect and confirming the apoptosis. Changes in intracellular ion concentrations were measured with specific fluorescent dyes and fluorescence imaging analysis system. RESULTS: Amiloride derivatives elicited cytotoxic effects on HUVECs with dose-dependent manners and the rank order of potency is HMA(IC50 11.2 micrometer), MIA>EIPA>>amiloride. HMA-induced cytotoxicity is dependent on extra- and intracellular pH, that is, increase extra- and intracellular pH augmented the cytotoxic effects of HMA. HMA dose-dependently reduced intracellular major ions, such as K+ and Cl-. Interestingly, the depletion of intracellular ions induced by HMA was also significantly enhanced at alkaline extracellular pH. CONCLUSION: Amiloride derivatives induce apoptosis of HUVECs with dose and pH dependent manners. They reduce intracellular K+ and Cl- concentration, which is also extracellular pH dependent.

Clinical and Epidemiologic Features of Rotavirus Outbreak in a Nursery

PURPOSE: Although RV infection is less common in neonate than older infants, because of high transmissibility and morbidity, it is devastating disease in nursery. With experience of RV infection outbreak in our nursery, we report its clinical and epidemiological characteristics. METHODS: From March 2002 to September 2003, 39 neonates were diagnosed with RV infection in nursery by immunochromatographic method. In addition to prevalence time, monthly distribution, and method of blocking outbreak of the disease, demographic, clinical and laboratory data for the neonates were evaluated. RESULTS: After occurring index patient in a nursery of Hanyang University Hospital in Seoul at March 22, 2002, the RV infection was increasing. Although the nursery was disinfected with 99% alcohol, 6 cases of new RV infections developed during July 2002. Eradication of RV infection was achieved after closing the nursery with cohort twice for 17 days and for 10 days. During period of this study, total 39 cases of RV infection were identified and the incidence of infection was 11.5%. Unlike to older infants, the majority of neonatal patient were asymptomatic (47.3%). CONCLUSION: We propose that instead of disinfection using 99% alcohol, long-term isolation with cohort is preferable to control RV transmission in nursery.

Linear and Non-linear Analysis of Cardiovascular System in Preterm Infants

PURPOSE: We investigated the autonomic and complex modulation in heart rate and blood pressure in preterm infants. METHODS: In 20 healthy preterm infants and 20 full-term infants (gestational age of 32.5+/-2.3 and 39.2+/-1.0 weeks each, P<0.0001), we recorded electrocardio gram and non-invasive blood pressure simultaneously and continuously during their sleep in the supine position. To evaluate the autonomic and complex modulation in heart rate and blood pressure, we performed power spectral analysis and analysis of the determinism. RESULTS: When compared to full-term infants and in the analysis of R-R interval, the preterm infants had significantly lower high-frequency power (30.7+/-15.1% vs 20.3+/-7.7%, P<0.05), higher low- to high-frequency power ratio (1.9+/-1.6 vs 3.0+/-2.1, P<0.05), and significantly lower prediction error (4.1+/-2.8% vs 2.9+/-1.3%, P<0.05). In the analysis of blood pressure, they showed no significant difference. CONCLUSION: Compared to heart rates of full-term infants, the heart rates of preterm infants are less modulated by cardiac parasympathetic activity and more deterministic.

A Comparative Study of the Effects of Intravenous Indomethacin and Oral Mefenamic Acid in the Treatment of Premature Infants with Patent Ductus Arteriosus

PURPOSE: For the management of patent ductus arteriosus(PDA) in premature infants, fluid restriction, correction of anemia, mechanical ventilation, diuretics, and surgery have been used, and the closure rate of PDA has improved significantly since the introduction of indomethacin and mefenamic acid as pharmacologic treatments of PDA. We studied to evaluate and compare the therapeutic effects of indomethacin and mefenamic acid in the management of premature infants with PDA. METHODS: 32 inborn premature infants who were hospitalized in NICU and diagnosed as PDA by cardiac sector were retrospectively studied and divided into two groups : An indomethacin treated group and a mefenamic acid treated group. Their gestational age, birth weight, blood urea nitrogen(BUN), creatinine(Cr), platelet count, urine output, fluid therapy, postnatal age, closure rate of PDA, and etc. were examined and conpared through the medical record review. RESULTS: The mean postnatal age on drug use was 4.6 days in intravenous indomethacin treated group(n=18), 9.0 days in oral mefenamic acid treated group(n=14), and the mean gestational age was 32.0 weeks and 32.3 weeks, respectively. After the use of each drugs, platelet count and urine output decreased, whereas blood urea nitrogen and creatinine increased. The closure rate of PDA was 94.4%(17/18) in the indomethacin treated group and 85.7%(12/14) in the mefenamic acid treated group(P=0.568). On the multivariate analysis except for the drugs, the most significant factor on PDA closure in preterm neonates was total amount of intake(P=0.000). CONCLUSION: We conclude that intravenous indomethacin is as effective as oral mefenamic acid in the therapy of preterm infants with PDA.

49, XXXXY Syndrome with Multicystic Kidney in a Neonate

The 49, XXXXY Klinefelter variant is distinctive; classic findings include mental retardation, hyp ogonadism and radioulnar synostosis. Its incidence is estimated to be 1/80,000 to 1/100,000 male births. We report a case of 49, XXXXY syndrome confirmed by chromosomal study in neonatal period, whose clinical features included a coarse face, short neck, micropenis, and other multiple minor anomalies including simian creases. Echocardiography showed patent ductus arteriosus (PDA), and pulmonary hypertension. A multicystic kidney was found by abdominal ultrasonography.

A case of water birth / 대한산부인과학회잡지

Recently, water birth - labor and/or delivery under warm water - is acceptable and natural to many foreign countries as a method of gentle birth. Although some limitations after water birth were reported, a recent international conference explored many of the issuses and indicated the potential scale and the advantages for its inclusion among the options for labor and delivery under water. We experienced a case of water birth who underwent labor and delivery under water. She delivered normal healthy female baby without conventional episiotomy. No obstetrical ans fetal complications were observed during entire procedure of water birth. So, we report this case with brief review of the literatures.

Risk Factors for Neonatal Sepsis in Premature Infants Admitted to Neonatal Intensive Care Unit

PURPOSE: The purpose of this study is to find out the risk factors of sepsis except the prematurity itself. METHODS: Seventy-seven premature infants less than 37 weeks of gestation, who were admitted to the neonatal intensive care unit of Hanyang University Kuri Hospital between July 1995 and December 1996, were enrolled in this study. All 77 premature infants, 14 patients proven to have sepsis by blood culture. They were matched with 24 controls by gestational age and date of birth. The risk factors for neonatal sepsis between the groups were compared. RESULTS: Fourteen of 77 subjects(18.2%) had culture-proven sepsis. Among them, all but one, who had confirmed sepsis on the first day of life, were late-onset >72 hours of age(16+/-6 days of life). Gestational age and birth weight of sepsis group(mean+/-SD) were similar to those of controls: 31.6+/-3.6 week vs 31.5+/-3.3 weeks; 1673+/-832g vs 1651+/-513g, and survival rate was also similar between the two groups(n=ll, 79% for sepsis group vs n=20, 77% for the control). In the analyses of risk factors of sepsis only parenteral nutrition and duration of parenteral nutrition were significantly more frequent and longer in the sepsis group compared to the control(n=8, 73% vs n=6, 30%, P=0.022; 20+/-15 days vs 7+/-4 days, P=0.0364). CONCLUSION: Incidence of neonatal sepsis in premature infants <37 weeks of gestaton admitted to neonatal intensive care unit was 18.2%. Ninty-three pevcent of the infants was late-onset sepsis. Sepsis group had more frequent use and longer duration of parenteral nutrition. In order to reduce neonatal sepsis in premature infants, use and duration of paventeral nutrition should be restricted.

A Study of Serum Total and House Dust Mite-Specific IgE, and ECP Levels in Healthy Korean Children Under 7 Years of Age / 소아알레르기및호흡기학회지

PURPUSE: Serum IgE have been shown to be related to allergic disease and used for an initial diagnosis of allergic diseases. House dust mite such as Dermatophagoides pteronyssinus(Dp) and D. farinae(Df) is very important for inhalant allergens, which may be a cause and/or triggering factor of atopic diseases. On the other hand, eosinophil cationic protein (ECP) causes epithelial damages of the airway, and bronchial hyperresponsiveness has been used as a useful indication of allergic inflammation. To date, there are few studies on the longitudinal patterns of total and inhalant allergen-specific IgE, and ECP in normal children in Korea. The present study was performed to determine the reference levels of serum total and Dp- and Df-specific IgE and ECP in healthy children under 7 years of age by the groups of different age and gender. METHODS: Total, and Dp- and Df-specific IgE and ECP concentrations were measured by fluoroimmunoassay(UniCAP, Pharmacia-UpJohn, Sweden) in serum from 449 healthy children under 7 years of age by using a population-based cohort followed from 1996 through 1997. All subjects were enrolled from eight large health organizations in geographically defined area such as Seoul and four local cities. RESULTS: Serum total IgE concentration showed steady increase with age from birth to 4 years, and a plateau. In contrast, Dp- and Df-IgE levels showed apparently continuous increments after 4 years of age. ECP showed variable increase until 4 years of age and slow decrease afterwards. There were no statistically significant differences in those results by gender and/or the living area, but much higher increments of Dp- and Df-IgE of boys from 3 years of age through 6 years were found. CONCLUSION: We found feasible results of total, Dp- and Df-specific IgE, and ECP in serum from healthy children under seven years of age, which may be useful for a reference.

IL-5 and IFN-gamma Levels in Nasopharyngeal Secretions from Non-Asthmatic Wheezing Children with Respiratory Syncytial Virus, Influenza A Virus Infection and Asthmatic Children / 소아알레르기및호흡기학회지

BACKGROUND: Infection with respiratory virus has been shown to exacerbate asthma. However, the role of a respiratory virus in the pathogenesis of chronic asthma and/or wheezing in young children has not been clearly defined. And it also has been debated whether virus-induced wheezing in young children is an entity different from allergic asthma, or just a different expression of the same disease. In this study, we attempted to evaluate the importance of eosinophilic inflammation, comparing IL-5 and IFN-gamma levels in nasopharyngeal secretions in wheezing children with or without viral infection and the controls. METHODS: We compared IL-5 and IFN-gamma levels in nasopharyngeal secretions from 38 non-asthmatic wheezing children with viral infections (RSV in 21 children, influenza A virus in 17 children), 12 asthmatic children without viral infections and 16 children as the controls. RESULTS: The present study reported that RSV infection in children induced more releasing of IL-5 in nasopharyngeal secretions than the influenza A virus infected ones and the controls. On the other hand, the releasing of IFN-gamma levels in nasopharyngeal secretions from children with influenza A virus infection was significantly higher than those of the children with RSV infection or asthmatic children. CONCLUSION: RSV infection in children may play a role in the immune response toward a Th2 phenotype as increasing IL-5 secretion in nasopharyngeal secretion. Increased IFN-gamma production in response to the influenza A virus infection may be related to the effective Th1 responses.

Comparison of Phototherapy Guidelines for Neonatal Jaundice in Healthy Term Newborns

PURPOSE: We hypothesized that phototherapy, if the total serum bilirubin (TSB) is > or = 14mg/dl, would decrease not only in frequency and duration, but complications due to phototherapy, such as weight loss, rash, temperature instability, feeding intolerance, and diarrhea, would decrease when compared to phototherapy TSB > or = 10mg/dl after 48 hours of life in healthy term newborns without hemolysis. METHODS: Forty healthy newborns born by cesarean section in Hanyang University Kuri Hospital from February, 1996 and March, 1996 were enrolled and randomly divided into two groups according to different guidelines of phototherapy after 48 hours of age; study group, phototherapy TSB > or = 14mg/dl and control group, phototherapy TSB > or = 10mg/dl. TSB and body weight were measured every 24 hours from 48 hours of life to 144 hours of life. Exclusion criteria included a positive Coombs test and any pathologic conditions. RESULTS: Eventually, 17 cases were enrolled to the study group and 16 cases to the controls. Ninety-four percent of all newborns were TSB > or = 7mg/dl and 82% TSB > or = 10mg/dl. Among the newborns who reached TSB > or = 10mg/dl, 44% of them were at 48 hours of life. Phototherapy was given in the study group less frequently and shorter than in the controls (6% vs. 82%, P or = 10mg/dl were significant higher in the study group compared to the controls (11.4 +/- 1.4 vs 10.1 +/- 1.7 P=0.046; 11.2 +/- 0.7 vs 8.5 +/- 2.8, P=0.028, respectivelyy). There were no significant differences in complications of phototherapy in two groups. CONCLUSION: Phototherapy if TSB > or = 14mg/dl after 48 hours of life in healty term newborns without hemolysis decreased frequency and duration of phototherapy without any risk of kernicterus compared to phototherapy if if was at TSB > or = 10mg/dl.h

The Changing Patterns of Microorganisms and Results of Antiobiotic Susceptibility Tests from the NICU

PURPOSE: Results of bacterial cultures and susceptibility tests in the neonatal period have shown changes according to the year they were reported, and the increase in pathogenic organisms has become a topic of great interest. This study was carried out to determine the trend in the occurrence of microorganisms and susceptibility testing results conducted on neonates from the newborns hospitalized in the NICU at Hanyang University Hospital during the past 1- years. METHODS: The laboratory data of microorganisms isolated by culture of various specimens from the NICU from January, 1986 to December, 1995 were retrospectively analyzed. The study period was divided in two 5-year periods. RESULTS: 1) The total number of neonates in the first half was 6,392, and 8,364 in the second half. Of these, positive blood cultures were observed in 62(1.0%) and 166(2.0%), respectively. Isolation from other specimens totalled 834(450 in the first half and 384 in the second). 2) There was a total of 13 specimens other than blood, from which bacteria were isolated. There 380 urine specimens and 20 umbilical secretions in the first half and 167 bronchial secretion and 101 umbilical secretions in the second. 3) The microorganisms cultured in the first half included 215 Gram positive, 232 Gram negative organisms, and 3 fungi. Common organisms included 119 cases of E. coli(26.4%), 66 cases of MSSA(14.7%) and 64 cases of CNS(14.2%). In the second half, there were 182(47.4%) Gram positive, 192(50.0%) Gram negative organisms, and 10(2.6%) fungi. The most common organisms were MRSA(123 cases, 32%), E. cloacase(56 cases, 14.6%), CNS(29 cases, 7.6%), and Klebsiella (29 cases, 7.6%). 4) There were a decrease in organisms susceptible to Oxacillin, Gentamicin, Cephalothin, and Ampicillin in the second half. CONCLUSIONS: The changes in the NICU during the past 10 years include a great increase in MRSA, Enterobacter, and Candida, reflecting the increasing trend of nosocomial infections. Furthermore, there was an increase in resistance to Oxacillin and Gentamicin while there was good susceptibility to Vancomycin and Chloramphenicol even in the second half.

Assessment by questionnaire of disease status of the pupils in two primary schools in Seoul

We studied the disease status by question-naire in seoul of the pupils in two primary schools on May, 1991 and carried out statistical analysis of their results. The following results were observed: 1) Total number of answered pupil was 2330; 1103 were male and 1227 were female and the ratio of male to female was 1:1.1. Average age was 9.27 years. 2) Number of the pupil with any present described was 499(21.4%) Majority was as follows: (1) Respiratory system diseases; 358(71.1%) (2) Skin & Subcutaneous tissue diseases; 36(7.2%) (3) Circulatory system diseases; 14 (2.8%) (4) Infectious diseases; 11 (2.2%) (5) Trauma; 7 (1.4%) 3) Number of the pupil with any disease on treatment was 225 (9.7%). Majority was as follows: (1) Respiratory system diseases; 108 among 358 (2) Skin & Subcutaneous diseases; 22 among 36 (3) Infectious diseases; 11 among 11 (4) Trauma; 3 among 7 (5) Mental disorders; 1 among 6 4) Number of the pupils with the past history of diseases described was 561 (24.1%). Majority was as follows: (1) Respiratory system diseases; 217 (38.7%) (2) Infectious diseases; 105 (18.7%) (3)Trauma; 74 (13.2%) (4) Nervous system & Sense organ diseases; 39 (7.0%) (5) Digestive system diseases; 27 (4.8%) 5) Number of the pupils with the past hospitalization history was 190 (8.2%). Majority was as follows: (1) Respiratory system diseases; 48 (25.3%) (2) Trauma; 41 (21.6%) (3) Infectious diseases; 18 (9.5%) (4) Genitourinary system diseases; 9 (4.7%) (5) Digestive system diseases; 6 (3.2%) 6) Number of the pupils with the past history fo sugery was 362 (15.5%). The types of surgery of the causative diseases requiring surgery were as follows: (1) Circumcision; 98 (4.2%) (2) Trauma; 73 (3.1%) (3) Tonsillectomy & Adenectomy; 46 (2.0%) (4) Inguinal herniectomy; 25 (1.1%) (5) Appendictomy; 10 (0.4%) (6) Intussusception; 10 (0.4%) 7) Number of the pupils with hearing disturbance was 498 (21.4%), with present illness of otitis media 19 (0.82%) and with the past history of otitis media 15 (0.64). 8) Number of the pupils with visual disturbance was 498 (21.4%), with myopia 233 (10%), with hyperopia 49 (2.1%), with strabismus 16 (0.7%), color blindness 7 (0.3%). 9) Number of the pupils hoping to consult with the physicians were 446 (19.1%). The contents of their consultation were as follows: (1) Dental problems; 81 (18.0%) (2) Extremity pain; 56 (13.0%)(3) Abdominal pain; 52 (12.0%) (4) Skin disease; 34 (7.6%) (5) Headache; 30 (6.7%) 10) Number of the pupil sttended to school inspite of disease was 846 (36.3%). The caustive diseases were as follows: (1) Upper respiratory infection; 217 (25,7%) (2) Abdominal pain; 27 (3.2%) (3) Fever; 24 (2.8%) (4) Trauma; 8 (0.9%) (5) Infection (Measles, Mumps, Chicken pox et.); 6 (0.7%) .

Cutaneous late phase reaction in children with atopic asthma / 소아알레르기및호흡기학회지

No abstract available.

Clinical study of group B streptococcal infection in infants less than two months of age

No abstract available.

A clinical study on twin

No abstract available.

A Case of Recessive Epidermolysis Bullosa Dystrophica

No abstract available.

A clinical and Statistical study of Meconium Stained Baby: A Two Year Prospective Study

No abstract available.