The Effectiveness of Intravenous Immunoglobulin for Clinically Suspected Neonatal Sepsis / 소아과

PURPOSE: The purpose of this study is to determine the effectiveness of intravenous immunoglobuin (IVIG) administration in fullterm neonates having clinically suspected neonatal sepsis. METHODS: Forty full-term neonates admitted to the neonatal intensive care unit with clinically suspected neonatal sepsis, who had at least two positive diagnostic criteria were enrolled. Twenty neonates were enrolled into the IVIG arm and 20 in the placebo arm. Neonates with a gestational age of less than 36 weeks and those with any major congenital malformation were excluded. The neonates were randomized to receive 1 g/kg of IVIG or equivalent amount of normal saline. The treatments including antibiotics and supportive care were administered. RESULTS: The neonates in the therapy and placebo groups were comparable in terms of birth weight, gestational age, sex distribution, duration of antibiotics therapy and admission, elevation of serum IgG level, mortality rate, change of CBC, and serum level of acute phase reactants etc. CONCLUSION: Serum IgG values increased significantly 5 days after administration of IVIG in the IVIG-treated group and decreased significantly 5 days after administration of normal saline in the placebo group. However, there was no significant difference in the duration of antibiotics therapy and admission, or of mortality between the IVIG-treated and placebo groups. No adverse reactions to the IVIG infusions were noted during the study. Our preliminary observations suggest that the administration of 1 g/kg IVIG to neonates had some effect on augmentation of humural immune status in neonates with clinically suspected sepsis. But further study is needed to verify the benefit of IVIG infusion to neonatal sepsis.

A Case of Biliary Atresia with Ileal Atresia / 소아과

Biliary atresia is a progressive obliterative cholangiopathy. However, the actual causes remain unknown, although a number of factors such as developmental malformation, viral infection, toxicity of bile constituents, and anatomic abnormality in the hepatobiliary system have been considered. Recently, several studies have been done to find out specific gene expression. Some cases of biliary atresia are associated with anomalies of cardiovascular system, digestive tract and spleen. Few cases of biliary atresia with congenital ileal atresia were reported. We experienced a case with biliary atresia combined with ileal atresia. Ileal resection and end to end anastomosis operation were done at second days of the life because of congenital ileal atresia. Jaundice and acholic stool were noticed a few days after the operation. He was diagnosed as biliary atresia and received Kasai operation at 23 days of the life. Therefore, we report the case with a brief review of the related literature.

A Case of Mesodiverticular Band Causing Small Intestinal Obstruction / 대한소아소화기영양학회지

Meckel's diverticulum is found in about 3% of the population, often incidentally during laparotomy or at autopsy. Over 50% of patients who develop symptoms from this anomaly are younger than 2 years of age. The most common symptom of this lesion is intestinal obstruction. Rarely Meckel's diverticulum is complicated by a mesodiverticular band, which is believed to be a remnant of a vitelline artery. We report a 11-year-old girl with small bowel obstruction because of an intestinal hernia beneath the mesodiverticular band. The causative factor was a stenotic area in the terminal ileum caused by a ringlike lipovascular mesenteric band encroaching externally on the lumen. Although the incidence of mesodiverticular bands complicating Meckel's diverticulum is quite low, the rapid clinical course and the associated high mortality rate make this an important disease.