Effects of Insulin-like Growth Factor-I and 1,25-(OH)2 Vitamin D3 Concentration on Intrauterine Growth of Newborns from Mothers with Preeclampsia / 소아과

PURPOSE: This study was undertaken to observe the blood levels of IGF-I and 1,25-(OH)2 Vit. D3 in maternal and neonatal compartments and the effects of IGF-I concentration on intrauterine fetal growth and 1,25-(OH)2 Vit. D3 metabolism in the presence of preeclampsia. METHODS: Thirty-four full-term pregnant women with preeclampsia and their newborns(preeclampsia group) and 10 normotensive full-term pregnant women and their newborns(normotensive group) were observed. IGF-I and 1,25-(OH)2 Vit. D3 concentrations in maternal and umbilical cord blood were analysed. RESULTS: Maternal and umbilical cord blood levels of IGF-I and 1,25-(OH)2 Vit. D3 were significantly lower in the preeclampsia group than in the normotensive group. In the preeclampsia group, maternal and cord blood levels of IGF-I of small-for-gestational age newborns were significantly lower than those of appropriate-for-gestational age newborns. The birth weight and length of newborns correlated with IGF-I concentrations of maternal and umbilical cord blood in small-for-gestational age newborns of preeclampsia group. The correlation between IGF-I and 1,25-(OH)2 Vit. D3 was significant in the umbilical cord blood of preeclampsia group, but only in appropriate-for-gestational age newborns. CONCLUSION: It is suggested that the lower level of IGF-I is the primary factor of intrauterine growth retardation in preeclampsia, and the effect of IGF-I on the metabolism of 1,25-(OH)2 Vit. D3 is different according to the presence of preeclampsia and intrauterine fetal growth retardation.

The Activity of sICAM-1 and sVCAM-1 in Plasma of Preeclamptic Mother and Neonatal Cord Blood

PURPOSE: Current concepts of preeclampsia have been focused on dysfunction of the maternal vascular endothelium, a central pathogenetic feature of the disease. But it is uncertain whether maternal preeclampsia has a harmful effect on fetal or neonatal vascular endothelium. In this study, plasma levels of endothelial adhesion molecules in preeclamptic mother and cord blood were determined to delineate vascular effects of preeclampsia on neonates. METHOD: Quantitative determinations of sICAM-1 and sVCAM-1 were measured from plasma of preeclamptic mother and neonatal cord blood in pairs according to gestational age and was compared to nonpreeclamptic control groups. RESULTS: Plasma ICAM-1 level was significantly higher in the maternal groups compared to corresponding cord groups (P<0.001). Preeclamptic maternal groups showed significantly higher sICAM-1 level compared to control maternal groups (P<0.001) and preterm maternal groups showed higher levels than term maternal groups (P<0.001). The level of sICAM-1 was significantly elevated in preeclamptic preterm cord groups than other cord groups (P<0.001). In respect to plasma sVCAM-1 level, higher value was observed in the preeclamptic preterm cord groups than preeclamptic preterm maternal groups. CONCLUSIONS: Elevation of the plasma sICAM-1 level caused by factors including vascular endotherial damage in preeclamptic mothers was observed in their neonates but with much lesser degree than their mothers. Factors associated with preterm labor other than maternal preeclampsia may seem to influence vascular endothelial injury in the cord blood.

The Effect of Preeclampsia on Neonatal Outcome of Premature Infants Delivered before 35 Weeks Gestation / 대한주산의학회잡지

OBJECTIVE: The purpose of this study was to determine neonatal outcomes according to laboratory and clinical features in preeclampsia before 35 weeks gestation. METHODS: The medical records of all patients delivered at the hospital from January 1, 1996 through March 31, 2002 were reviewed for the occurrence of preeclampsia before 35 weeks gestation. We compared their maternal medical and obstetric courses and neonatal outcomes with those in a group of non preeclamptic patients who delivered at similar gestational ages. RESULTS: The preeclampsia group had lower mean birth weight, 1-minute Apgar score and umbilical arterial pH. But there were no difference in the incidence of neonatal death, respiratory distress syndrome, grade 3 and 4 intraventricular hemorrhage, and culture-proven sepsis. Results were similar when analysis was limited to infants born before 32 weeks. CONCLUSION: Maternal preeclampsia does not improve neonatal outcome of infants born before 35 weeks gestation.

Extracorporeal Membrane Oxygenation(ECMO) in Neonates

No abstract available.

A Clinical Study of Group B Streptococcal Infection: Five Years Experience

PURPOSE: To evaluate clinical characteristics associated with group B streptococcal (GBS) infection in infants less than 3 months. METHOD: Medical records of patients (< = or90 days of age) who were confirmed to have GBS infection were reviewed during five year study period. Data for onset of age, clinical manifestations, risk factors, clinical course, antibiotics used, results of sensitivity of antibiograms and complications were collected. RESULTS: The episodes of GBS infection were found in 38 patients. The incidence of early-onset disease was 15.7% and male to female ratio was 1.2: 1. The associated obstetric factors included prematurity, twin, meconium staining and abortion. Fever, poor oral intake, lethargy, irritability, seizure and respiratory distress were common clinical presentations for diagnosis of sepsis and meningitis. GBS was isolated from 25 among 28 cases of cerebrospinal fluids and its sensitivity to penicillin and 3rd generation cephalosporins were 56% and 60%, respectively. The initial antibiotics used included ampicillin and gentamicin in 12 cases, 3rd generation cephalosporins and gentamicin in 11 cases. Subdural effusion and hygroma, hydrocephalus, ventriculitis, infarction, leukoencephalomalacia and basal ganglia hemorrhage were complications of meningitis caused by GBS. CONCLUSION: The early diagnosis and appropriate choice of antibiotics in treatment of patients with GBS infection is very important in respect to increased incidences of resistance to penicillins and to decrease mortalities and morbidites associated with GBS infection.

The Incidence of Feeding Intolerance in the Full Term Neonates with Hypoxic-Ischemic Encephalopathy

PURPOSE: We investigated incidence of feeding intolerance and time when normal enteral feeding can be established in full term neonates with hypoxic-ischemic encephalopathy (HIE). METHODS: We reviewed medical records of 61 full term infants with HIE who were admitted to St. Paul's Hospital from Jan. 1996 to Dec. 2001. The incidence of feeding intolerance, day of first feeding, and day of full enteral feeding were studied in respective to Sarnat stages. RESULTS: Among the full term with HIE, 32 were classified into stage I, 20 into stage II, and 9 into stage III. The incidence of feeding intolerance was 6%, 30%, and 89% for stages I, II and III, respectively. There was only one case of necrotizing enterocolitis among infants of stage III HIE. Feeding first began on 0.13+/-0.01 postnatal day (PND) in normal infants compared to 0.15+/-0.03 PND in infants of stage I, 3.24+/-1.82 PND in stage II and 5.58+/-2.50 PND in stage III. The incidence of feeding intolerance, day of first feeding, and day of normal enteral feeding achieved in infants with stage I were not different from those of normal infants but significantly higher and delayed in infants with more severe degrees of encephalopathy. CONCLUSION: The first feeding should vary according to severity of encephalopathy so as to lower the incidence of feeding intolerance and the risk of necrotizing enterocolitis. We suggest that infants of stageIencephalopathy be first fed as same as normal infants, but precaution is in order when deciding an appropriate time to start feeding in infants of stage II, III encephalopathy.

The Incidence of Feeding Intolerance in the Full Term Neonates with Hypoxic-Ischemic Encephalopathy

PURPOSE: We investigated incidence of feeding intolerance and time when normal enteral feeding can be established in full term neonates with hypoxic-ischemic encephalopathy (HIE). METHODS: We reviewed medical records of 61 full term infants with HIE who were admitted to St. Paul's Hospital from Jan. 1996 to Dec. 2001. The incidence of feeding intolerance, day of first feeding, and day of full enteral feeding were studied in respective to Sarnat stages. RESULTS: Among the full term with HIE, 32 were classified into stage I, 20 into stage II, and 9 into stage III. The incidence of feeding intolerance was 6%, 30%, and 89% for stages I, II and III, respectively. There was only one case of necrotizing enterocolitis among infants of stage III HIE. Feeding first began on 0.13+/-0.01 postnatal day (PND) in normal infants compared to 0.15+/-0.03 PND in infants of stage I, 3.24+/-1.82 PND in stage II and 5.58+/-2.50 PND in stage III. The incidence of feeding intolerance, day of first feeding, and day of normal enteral feeding achieved in infants with stage I were not different from those of normal infants but significantly higher and delayed in infants with more severe degrees of encephalopathy. CONCLUSION: The first feeding should vary according to severity of encephalopathy so as to lower the incidence of feeding intolerance and the risk of necrotizing enterocolitis. We suggest that infants of stageIencephalopathy be first fed as same as normal infants, but precaution is in order when deciding an appropriate time to start feeding in infants of stage II, III encephalopathy.

The Effect of Erythromycin on Gastric Antrum and Low Esophageal Sphincter in the Newborn Rabbit

PURPOSE: We studied smooth muscle strips from rabbit gastric antrum and low esophageal sphincter (LES) to explore the difference between newborn and adult rabbit on erythromycin (EM)- induced contractions. Another aim of this study was to determine the mechanism of LES contractile activities induced by erythromycin (EM). METHODS: Muscle strips prepared from newborn and adult rabbits were stimulated with agonists such as KCl, motilin and EM, and the isometric tensions were measured. To study the underlying mechanism of EM-stimulated contraction of LES, the receptor antagonsts, including tetrodotoxin, hexamethonium, atropine, propranolol and phentholamine, were used. A high concentration of motilin (1 micrometer) was employed to provoke tachyphylaxis. RESULTS: Antral smooth muscle and LES from newborn rabbits developed less active force than those from adult rabbits when stimulated with KCl, motilin and erythromycin, however, the effective concentrations (EC50s) were similar in both age groups. Antral smooth muscle strips showed both tonic and phasic contractions but LES muscle strips showed only tonic contractions. These findings were observed in both newborn and adult rabbits. The contraction force of antral smooth muscle strips in response to agonists was greater than that of LES. The contractile response of LES to repeated motilin or EM administration was markedly decreased. EM- induced contractions of LES were markedly decreased by motilin tachyphylaxis but were unaffected by tetrodotoxin, hexamethonium, atropine or propranolol plus phentolamine. CONCLUSOIN: The data suggest that the contractilities of antrum and LES smooth muscle from newborn rabbit are less than those from adult ones, however, the effective concentratons of EM (EC50) are not different between the two age groups. The results also suggest that erythromycin induces the contraction of rabbit LES via motilin receptor in vitro.

A Case of Hemimegalencephaly with Focal Seizure / 대한소아신경학회지

Hemimegalencephaly is a rare brain malformation characterized by congenital hypertrophy of one cerebral hemisphere, ipsilateral ventriculomegaly, hemiparesis, intractable epilepsy, and mental retardation, which often results in early death. We reported a case of hemimegalencephaly in a 1-month-old male with the chief complaint of intractable focal seizure.

A Case of Recurrent Bacterial Meningitis and Mucocele After Cranial Trauma / 감염

Recurrent bacterial meningitis can be caused by acquired or congenital anatomic defects, infection, or alterations in immune mechanism. Intracranial anatomical defects possibly combined with trauma can be the major cause of recurrent bacterial meningitis. Mucocele is a chronic, expansile and cyst-like lesion of the paranasal sinuses, most frequently found in the frontal sinus containing sterile mucoid secretions. Secondary infection of a mucocele may create a pyocele. Although pathogenesis of a primary mucoceles remains uncertain, causatives factors of secondary mucoceles have been suggested to include chronic inflammation, trauma, allergy and obstructing tumors. We experienced a case of recurrent bacterial meningitis with frontal sinus mucocele, which might be secondary to cranial trauma.

A Case of Inflammatory Linear Verrucous Epidermal Nevus

Inflammatory linear verrucous epidermal nevus(ILVEN) is a relatively rare skin disorder, characterized by chronic inflammatory psoriasiform pattern. This chronic skin disorder is generally believed to be resistant to various treatments, although some authors have reported success with 13-cis-retinoic acid and 585 nm pulsed laser therapy. We experienced a 15-month aged female ILVEN patient who has been suffered from linear erythematous verrucous pathes mainly located on left inguinal area, hand, and foot with persistent itching sense. This skin lesion have been developed at birth, and more spread out toward right extremity after 1 year old age . We initially treated this skin lesion with topical corticosteroids and oral anti-histamines, but this treatment was not successful. So we retreated this patient with etretinate(oral retinoid) and topical 13-cis-retinoic acids, we found that therapeutic responses to these applications were more remarkable. Now, we closely observe this patient's clinical course further more.

The Report of the Epidemiology of Measles which Prevailed in the Kyungi-Incheon Districts from July, 1993 & June, 1994

PURPOSE: As a result of the development and the supply of vaccination, the epochal progress in vaccination against measles has been made. Nevertheless measles intermittent prevalence throughout the world was reported and measles prevailed throughout country in 1993 & 1994. So, we studied the epidemics of measles which prevailed in the Kyungi-Incheon districts and then evaluated the effects of the present vaccination indirectly and estimated the necessity of booster vaccination in addition to initial and second vaccination. METHODS: This study was based on the questionnaires to 233 patient who were diagnosed as measles in Holy Family Hospital and Our Lady Of Mercy Hospital from July, 1993 to June, 1994. RESULTS: 1) The incidence peaked in Jan(24.0%) and April(23.2%). 2) In sex distribution, we could not find any difference between boys(116 case) and girls(117 case). 3) The age distribution showed that the children between 0 and 12 month of age were 81 cases(34.8%), the children between 13 and 24 month of age 28 cases(12.0%), 8 year old children 21 cases(9.0%), 6 year old children 18 cases(7.7%), 7 year old children 16 cases(6.9%) and 9 year old children 14 cases(6.0%). 4) 6 month age group with one-dose schedule of vaccination was 2 cases. 9 month age group with one-dose schedule of vaccination was 14 cases and their outbreak age was 4.1+/-3.3 years old. 12 month age group with one-dose schedule of vaccination was 1 case. 15 month age group with one-dose schedule of vaccination was 48 cases and their outbreak age was 7.8+/-2.9 years old. Age group with two-dose schedule of vaccination was 51 cases and their outbreak age was 7.3+/-2.9 years old. Therefore, trimed mean age of 15 month age group with one-dose schedule was 7.8+/-2.0 years old and their 99% confidence interval was 7.0~9.2 years old. Trimed mean age of two-dose schedule age group was 8.3+/-2.0 years old and their 99% confidence interval was 7.6~9.2 years old. 5) Among the siblings(n=236) of subjects 224 cases were vaccinated and among vaccinated children 18 cases infected(8.0%). 6) There were no reinfected subjects. CONCLUSIONS: 15 months age group with one-dose schedule and two-dose schedule group showed similar outbreak age. In the case that measles prevails, the proper time for vaccination seems to be at or earlier than 6 months of age and the booster dose should also be considered at age 6.

Two Male Siblings with Pseudohypoaldosteronism Type I

Pseudohypoaldosteronism (PHA) is rare herediary salt wasting syndrome due to peripheral resistance to aldostrone. PHA type I, subdivided into isolated renal insensitivity to aldosterone of autosomal dominant inheritance and multiple target organ defect of autosomal recessive inheritance, and PHA type II show similar clinical manifestations except hypertension which is limited to type II. PHA type I is charaterized by hyponatremia, hyperkalemia, high plasma aldosterone and renin activity. Variable degrees, completely asymptomatic to severe fatal, of salt loosing manifestationsdehydration, hypotension, failure to thrive, and renal tubular acidosis usually start during infancy. Sodium loss not only from kidney but also from sweat gland, salivary gland and colon may occur in some cases. Recently we experienced two cases of PHA, a 27 days of age male newborn infant with charateristic clinical symptoms and typical laboratory manifestations of PHA, confirm diagnosed as PHA type I of isolated renal defect by pilocarpin iontophoresis showing normal sodium concentration in sweat gland, and his asymptomatic 6 year-old brother with the history of salt loosing symptoms treated until second year of life diagnosed as PHA type I by markedly elevated plasma aldosterone and renin activity. Brief review and related literatures were also presented.

Clinical study of epstein-barr viral lymphadenitis by using in-situ hybridization technique / 감염

No abstract available.

Treatment of severe aplastic anemia: comparison between bone marrow transplantation and immunomodulation

No abstract available.

A case of hyperimmunoglobulin E syndrome

No abstract available.

Two cases of hybrid leukemia

No abstract available.