Effect of Fluconazole Prophylaxis to Control Candida Infection in High-Risk Preterm Infants / 대한주산의학회잡지

OBJECTIVE: Candida species are becoming one of the most common pathogens associated with nosocomial infection in the neonatal intensive care units (NICU). This study was undertaken to evaluate the efficacy of fluconazole prophylaxis (FP) to control candida infection in high-risk preterm infants. METHODS: A prospective, randomized clinical trial was conducted over a 17-month period (Aug. 2008-Dec. 2009) in very low birth weight (VLBW) infants who were admitted to NICU of Dongsan Medical Center, Keimyung University. The 55 VLBW infants with mechanical ventilation, central vascular access and parenteral nutrition at early time of life were enrolled for this study. The infants were randomly assigned to FP and control group in the first three days of life. Fluconazole was administered by intravenous route for 4- to 6-week after birth at dose of 3 mg per kilogram of body weight. All enrolled infants underwent weekly surveillance culture for candida colonization. RESULTS: The 28 infants with FP and the 27 control infants were similar in comparison of the perinatal parameters such as gestational age, birth weight and antenatal steroid therapy. And also, there were no differences between the two groups in terms of presence of common risk factors for invasive candida infection. During prophylactic period, candida colonization was identified in 5 infants of the fluconazole group and 15 infants of the control group (17.9% vs. 55.6%; P<0.005). And also candida sepsis was more frequently developed in the control group, but the result was not significant. No differences in liver function tests after prophylactic period were noted. Between two groups, prognostic factors such as duration of stay in hospital, combined diseases and mortality were not different. CONCLUSIONS: FP may help to control candida infection in high-risk preterm infants, but large scaled multicenter studies including development of resistant strains are necessary before initiation of routine prophylaxis.

A Case of Childhood Acute Lymphoblastic Leukemia with Monosomy 20 and Parotid Gland Involvement / 소아과

Hypodiploidy exists in 3-15% of patients with childhood acute lymphoblastic leukemia(ALL) and is associated with a poor prognosis. Monosomy 7 and monosomy 20 account for most karyotypic abnormalities in patients in whom whole chromosomes are lost and their incidences are rare. Parotid tumors in the pediatric age group are unusual and in 1996, there was a case of invasion of the parotid glands of ALL in a 6-year-old boy with swelling of both parotid glands. But invasion of acute lymphocytic leukemia to the parotid gland has not yet been reported in Korea. Here, we report a 33 month-old boy with swelling of both parotid glands who was diagnosed to have ALL with monosomy 20 & parotid gland invasion.

Establishment and Characteristics of the B Cell Line (KEB1) from the Bone Marrow Cells of the Patient Infected with Epstein-Barr Virus / 대한혈액학회지

BACKGROUND: Cell lines can be established when the cells are clonally selected and propagated continuously in vitro culture system. Recently we established a B cell line (KEB1) from the bone marrow cells of the patient infected with Epstein-Barr virus (EBV). METHODS: The patient's initial platelet count was 1,000/microliter and peripheral blood smear showed atypical lymphocytes accounting 20% of the differentials of WBC. Antibodies to EBV and PCR for EBV were positive but heterophil antibody was negative. Mononuclear cells were obtained by Ficoll-paque separation and suspended in RPMI media with 10% FCS. After incubation in 37degrees C, 5% CO2 incubator, cells grew continuously and finally immortalized to B cell line. RESULTS: Cells showed abundant, clear basophilic cytoplasms and a few vacuoles. Cells had granular reaction in PAS stain and were positive to B cell antibodies. Immunohistochemical stain showed positive expression for EBV antibody. Electron microscopic finding of cultured cells showed several viral particles, and immunoelectron microscopic finding showed electron dense expression. Immunophenotyping of cultured cells was positive for B lymphoid lineage, and karyotypings had hypotetraploidy. Cells expressed MAGE and SSX gene. Cytotoxicity showed relative resistance to mistletoe and several chemotherapeutic agents compared to leukemic cell line. CONCLUSION: KEB1 cell line was established from the bone marrow cells of the patient with infectious mononucleosis. The characteristics of the cell lines including morphology, immunophenotype, karyotype, gene analysis (MAGE, SSX) and chemosensitivity were analyzed. There should be further studies of these cell lines including gene analysis, telomerase activity and cytokine production. This cell line might be helpful to establish another normal lymphocyte cell line and to predict the toxicity of chemotherapy.

Influencing Factors on Duration and Frequency of Febrile Convulsion / 대한소아신경학회지

OBJECTIVE: We studied the correlation of duration and frequency of febrile convulsion with peripheral leukocytosis and hyponatremia and identified whether peripheral leukocytosis and hyponatremia to be prognostic factors. METHODS: Two hundred sixty three children who admitted to Pediatric Department of Dongsan Medical Center for febrile convulsion from April, 1999 to March, 2001 were studied. We grouped patients according to the duration of convulsion, daily frequency and total frequency. Body temperature on admission, leukocytes count, platelet count, serum Na level and CSF findings were analysed among the groups. RESULTS: Febrile convulsions occurred more ofthe in males(61%) than females(31%) and most frequently occured in winter(37.2%). There were no meaningful differences in serum sodium concentration and peripheral WBC count among groups according to seizure duration. There were no meaningful differences between groups according to seizure frequency. The protein concentrations of CSF were high in children who developed seizures before 9 months of age(P<0.003). There were no meaningful differences among groups according to seizure types. CONCLUSION: When we compared each group, we could not find any significant statistical correlation. We concluded that peripheral leukocytosis and serum Na level are not predicting factors but they are helpful to find etiology of fever.

Perinatal Factors Influencing to the Response of Surfactant Replacement Therapy for the Neonatal Respiratory Distress Syndrome Patients / 대한주산의학회잡지

No abstract available.