Oscillometric Blood Pressure of Upper and Lower Extremities and Aortic Blood Flow Velocity in Neonates

PURPOSE: We studied the blood pressure difference between the upper and lower extremities in healthy newborn infants and the effect of isthmic narrowing of the aorta on making a possible difference. METHODS: The blood pressure was measured with an oscillometric blood pressure device from four extremities of 62 healthy infants aged 1-15 days. A Doppler echocardiography was performed for each infant to measure the aortic blood flow velocities in the ascending, just above and below the aortic arch isthmic narrowing. RESULTS: The blood pressure readings were as follow : right arm 69.7 (+/-7.5)/42.7(+/-7.2)mmHg, right calf 69.5(+/-6.1)/42.6(+/-6.3)mmHg, left arm 69.0(+/-7.3)/43.1(+/-6.3)mmHg, and left calf 68.9(+/-7.4)/42.9(+/-5.6)mmHg. The estimated pressure gradient between the ascending aorta and aorta below the isthmus was 2.4+/-1.3mmHg and between opposite sides of the isthmus was 1.2+/-0.8 mmHg. CONCLUSION: Unlike in childhood and adolescence, the blood pressure in the lower extremities of healthy newborn infants is not higher than in the upper extremities. But the isthmic narrowing of the aortic arch does not explain this phenomenon.

The Changes of Apoptosis and Viability in Stem Cells after Thawing with Lapse of the Time

PURPOSE: Thawed stem cells should be infused as early as possible because delay of infusion leads to decrease of cell viability and formation of DNA clumping. The procedure of 10% Dimethyl sulfoxide(DMSO) removal and a long distance from the thawing location to the patient are the main causes of delay of infusion that results in the loss of cell viability and apoptosis. Therefore, we investigated the changes of cell viability and apoptosis after thawing with lapse of time. METHODS: Five samples of mobilized peripheral blood were evaluated. We measured cell viability, colony forming unit(CFU) and apoptosis at 0, 1, 2, 4, and 24 hours after thawing. The state of stem cells were divided into live, apoptotic and dead with double staining using annexin V and 7-aminoactinomycin D(7-AAD) in flow cytometry. RESULTS: Viability of the total cells after thawing was 77.3(53.3-97.7)%. The percentage which recovered to initial CFU at 1, 2, 4 and 24 hours after thawing decreased to 63.9%, 50.2%, 45.8% and 11.6%, respectively. The proportion of apoptotic cells among CD34+ cells after thawing were increased from 0.2% at 0 hour to 16.5% at 1 hour, 21.9% at 2 hours, and then decreased to 15.0% at 4 hours, 2.7% at 24 hours because they were replaced by dead cells. CONCLUSION: Thawed cells changed to apoptotic and had less colony forming capacity from 1 hour after thawing, and were then replaced by dead cells from 4 hours after thawing.

A Case of Intestinal Tuberculosis Diagnosed by Colonoscopy / 대한소아소화기영양학회지

Childhood intestinal tuberculosis is difficult to diagnose for its protean clinical manifestations, especially in cases without pulmonary involvement. Differential diagnosis with Crohn's disease, inflammatory bowel disease and other malignancy is also important. Surgery has often been required for pathologic confirmation or therapy. Colonoscopy may be performed safely under consciousness sedation in children for bacteriologic and histopathologic confirmation of the biopsy specimen in addition to gross appearance of the lesion. We have experienced a case of intestinal tuberculosis presenting with chronic abdominal pain, diarrhea, weight loss and anemia in a 9 year old girl who was diagnosed by a colonoscopic examination and culture of the biopsy specimen from the ascending colon. The patient was managed with antituberculous drugs and recovered uneventfully.