Clinical Study of Perinatal Infarcts / 대한주산의학회잡지

OBJECTIVE: Perinatal infarcts are an important cause of neonatal neurologic morbidity accounting up to 10~20% of neonatal seizures and annual incidence rate is about one in 4,000 live births. The purpose of this study is to describe the clinical presentation, course, radiologic and Electroencephlogram (EEG) findings and to evaluate the neurologic outcome of cerebral infarcts. METHODS: Between January 2000 to May 2004, 8 of 40,204 delivered newborns (0.02%) were diagnosed as having cerebral infarcts. The clinical presentation, course, radiologic and EEG findings were characterized by retrospective chart review and neurological outcome was evaluated by neurological examination and developmental test (Bayley Scales of Infant Development-II) at out-patient department. RESULTS: There were 5 males and 3 females. Six cases of them were full term, and other 2 cases were near-term neonates. Five cases presented neonatal seizure and 3 presented apnea or respiratory distress. All cases showed abnormal finding in the cranial ultrasonography that was performed immediately after the first symptoms. After then, diagnosis of cerebral infarct was confirmed by computed tomography and magnetic resonance imaging. Abnormal EEG finding was found in the 4 cases and a correlation between the location of these abnormalities and cerebral infarcts existed. The location of infarct was on the left hemisphere in five of the 8 cases and predominantly in the distribution of the middle cerebral artery. 7 cases were followed and the mean duration of follow up was 17 months (range 3~42 months). Neurologic outcome was normal in 3 cases and abnormal in 4 cases. Mild hemiparesis was present in 3 cases and recurrent epilepsy in 1 case. Developmental test was performed in 4 cases, all of them were normal. CONCLUSION: Neonatal seizure is an important presentation as the first sign of perinatal infarcts and cranial ultrasound can be used for initial evaluation of these perinatal infarcts. Neuological sequelae remains over half of the patients. Performing long term follow-up study of large cohort study is needed.

The Developmental Outcome of Fetal Mild Isolated Ventriculomegaly / 소아과

PURPOSE: This study is directed to evaluate standardized developmental test performances of infants and children who, as fetuses, had mild isolated cerebral ventriculomegaly diagnosed by ultrasound. METHODS: All prenatal sonographic findings from 2001 to 2002 were evaluated. Live isolated mild ventriculomegaly (IMVM) of 10-15 mm were observed in 95 cases (1.1 percent). Standardized developmental testing of 40 cases of IMVM and 36 cases in a comparison group were offered to parents Both groups of children were adjusted to normal antepatum subjects with respect to sex, race, indication for ultrasound and gestational age at the time of ultrasound. Test of cognitive and motor development (Bayley Scales of Infant Development, Second Edition; BSID-II) were administered by developmental examiners. RESULTS: Forty cases and 34 comparison sujects completed the testing. The IMVM and comparison groups were similar with respect to parental age, gestational age, birth weight, familial socioeconomic status. The IMVM subjects scored lower than the comparison group on both the BSID-II, but there was not statistically significant. differences; metal development index (MDI) (92.7+/-12.9 vs 94.7+/-14.1, P=0.47) and psychomotor development index (PDI) (100.3+/-14.1 vs 101.3+/-10.7, P=0.75). Eleven cases (27.5 percent) of IMVM group and five cases (14.7 percent) of the comparison group were developmentally delayed, but most cases in both groups showed mild delays. Resolution or lack of progression, lateral ventricle diameter < or= 12 mm and females were associated with better scores, but there were not statistically significant. Polarity, and head circumference were not related to later development. CONCLUSION: This study show children with MIVM did not delay performance in the developmental test, but we might suggest a tendency to increase the risk of mild developmental delay.

A Case of Congenital CMV Infection associated with Incontinentia Pigmenti

Congenital cytomegalovirus (CMV) infection is one of the most frequent congenital infections in neonates. It can manifest as asymptomatic infection in 90% or symptoms may appear in 10% of the patients. Asymptomatic congenital CMV infection is likely to be a leading cause of sensorineural hearing loss, mental retardation and microcephaly. Incontinentia pigmenti is a rare multisystemic ectodermal disorder, which is characterized by vesicular, verrucous, and pigmented cutaneous lesions, and is frequently associated with various developmental defects of the eyes, CNS, teeth, hair, and nail. It is regarded as an X-linked dominent genetic disorder. We are reporting a case of neonate who presented with delayed development and bilateral hearing loss due congenital CMV infection which was incidentally assoicated with incontinentia pigmenti.

Comparison of Body Temperature Measured by Non-Contact Temporal Artery Thermometer with Those by Other Methods in Neonates / 대한주산의학회잡지

OBJECTIVE: In this study, we tested the correlation between the body temperature measured by non-contact temporal artery thermometer which has been developed recently and the rectal temperature using conventional glass mercury thermometer, also evaluate the reliability of non-contact temporal artery thermometer by comparing with other methods of temperature measurement. METHODS: One-hundred-and-seventeen newborn infants who were born at Samsung Cheil Hospital were included in this study. Tympanic and forehead temperatures were taken three times each with tympanic thermometer and non-contact infrared temporal artery thermometer respectively on a newborn infant by two authors. we also measured the rectal and axillary temperatures by using a mercury-in-glass thermometer. RESULTS: The normal body temperature measured by non-contact temporal artery thermometer was 36.2 +/- 0.22degrees C, and rectal, axillary and tympanic temperatures were 36.8 +/- 0.30degrees C, 36.7 +/- 0.30 and 36.1 +/- 0.27degrees C, respectively. There was a significant correlation between temperatures measured by non-contact temporal artery thermometer and rectal temperature (p<0.01, r=0.891). The differences between repeated measurements by non-contact temporal artery thermometer were significantly less than those by tympanic thermometer (p<0.01). CONCLUSION: Forehead temperature measured by non-contact temporal artery thermometer is correlated with rectal temperature and has good reproducibility. It can be used to measure body temperature in newborn infants.

A Case of Pulmonary Infiltration with Eosinophilia in Visceral Larval Migrans by Toxocara Canis / 결핵

Human toxocariasis is a zoonotic parasitic disease caused by the larva of toxocara canis or cati. It is one of the most commonly reported zoonotic helminth infection in the world. Human are infected mainly by the accidental ingestion of embryonated eggs due to the pica, geophagia, the consumption of contaminated raw vegetables and poor personal hygiene particularly in childhood. In adults, the consumption of raw meat from potential paratenic hosts e.g. chickens, lambs, rabbits and dogs is a major cause of human toxocariasis. The larva can reach various organs such as the liver, lung, brain, and eye by the hematogenous spread and cause visceral larva migrans We experience a case of pulmonary infiltration with eosinophilia by visceral larva migrans after eating the raw liver and kidney of a dog.