Serum alkaline phosphatase (AP) activity is elevated in hepatobiliary disease, bone disease, pregnancy and certain neoplasms. Recently we experienced marked elevation of serum AP activity after administration of albumin preparation in nephrotic patients who suffered from hypovolemic symptoms. So serum AP activity and the isoenzymes in the albumin preparations & patient's serum after the administration of albumin preparation were studied. Serum AP activity was significantly higher after administration of albumin preparation (318+/-101 IU/L) then before (123+/-43 IU/L). The predominant isoenzyme after administration of albumin was placental type, while liver and bone type was predominant before administration. AP activity in albumin preparation was high (2,133+/-1,410 IU/L) and the isoenzyme was mostly placental type. So we concluded that marked elevation of serum AP activity after administration of albumin was traced to the placental type AP isoenzyme in some albumin preparations which was manufactured from the plasma of placental origin. Elevated serum AP activity like these may lead to erroneous interpretation. Manufactures should notify alkaline phosphatase activity in albumin preparations of placental origin.
Administration, Intravenous* ; Alkaline Phosphatase* ; Bone Diseases ; Humans ; Hypovolemia ; Isoenzymes ; Liver ; Plasma ; Pregnancy

We examined the effect of various levels of dietary protein on long term prognosis of Adriamycinnephropathy of S-D rat, fed with high protein (30%), intermediately low (10%), and strictly low (5%) protein diet for 15 weeks. 1) In rats fed with strictly low protein diets (5%), proteinuria and serum creatinine decreased and creatinine clearance and histological changes were relatively well preserved. But hypoproteinemia and weight loss were more marked and 2 rats died due to severe ascites and pleural effusion in cachexic state. 2) In rats fed with high protein diets (30%), general health condition and weight gain were relatively well preserved. But there were massive proteinuria, progressive increase in serum creatinine and progressive decrease in creatinine clearance. Focal glomerular sclerosis and severe tubulointerstitial change on histologic examination were marked. 3) With intermediately low protein diet (10%), renal function and pasma protein levels were relatively well preserved compared with high protein diet group. But weight gain did not increase normally. 4) We tentatively conclude that appropriately restricted dietary protein can prevent functional and histological renal damage. But too strict protein restriction aggravate nutitional state and general condition.
Animals ; Ascites ; Creatinine ; Diet ; Diet, Protein-Restricted ; Dietary Proteins* ; Hypoproteinemia ; Pleural Effusion ; Prognosis* ; Proteinuria ; Rats ; Renal Insufficiency ; Sclerosis ; Weight Gain ; Weight Loss

Eosinophils play a major role in the airway inflammation in asthma. to verify an association between airway responsiveness of asthmatics and eosinophil and/or ECP, we measured serum ECP in 23 children with atopic asthma during acute attacks and stable states, and in 10 normal healthy controls. Peak flows were monitored in 15 children. The data suggest that serum ECP levels were higher in acutely ill asthmatics than in stable state. With successful therapy for asthma, serum ECP levels were mostly decreased. However, rising ECP values after treatment may suggest unsatisfactory results with conventional therapy despite a predicatable PEFR. ECP should prove a helpful for monitoring airway responsiveness which had been evoked by inflammation and/or late phase reaction in asthma.
Asthma* ; Child* ; Eosinophil Cationic Protein ; Eosinophils* ; Humans ; Inflammation ; Peak Expiratory Flow Rate

Clinical observation was carried out for 147 patients with mucocutaneous lymph node syndrome (MCLS) who were admitted to the Department of Pediatrics, Wonju Christian Hospital during the period from June, 1983 to June, 1992. A spinal tap was performed on 114 of these patients and the following results were obtained. 1) The incidence of aseptic meningitis in patients with MCLS was 52.6%. (60 cases of the 114 cases who had spinal taps (52.6%).) 2) The predominent age group for aseptic meningitis was 6 months to 1 year of age (35%). 3) For the majority, the value of glucose and protein in the CSF were within normal limit or only mildly elevated. 4) The neurologic manifestations associated with aseptic meningitis in patients with MCLS were irritability (78.3%), vomiting (25.0%), nuchal rigidity (11.7%), convulsion (5.0%) and facial nerve palsy (1.7%) in that order.
Facial Nerve ; Gangwon-do ; Glucose ; Humans ; Incidence ; Meningitis, Aseptic* ; Mucocutaneous Lymph Node Syndrome* ; Muscle Rigidity ; Neurologic Manifestations ; Paralysis ; Pediatrics ; Seizures ; Spinal Puncture ; Vomiting

A large proportion of patients with systemic lupus erythematosus (SLE) are women of reproductive age. Their fetal outcome is undoubtedly less favourable than in healthy women. Although there is no evidence of an increase in congenital anomalies, increased frequencies of miscarriage, stillbirth, growth retardation, and preterm delivery are recognized. It mainly depends on the compromise of uteroplacental circulation such as renal disease, hypertension and thrombopoietic action of antiphos-pholipid antibody. Besides a small proportion of the newborn infants get a neonatal lupus sydrome, the most serious component being congenital heart block. This complication occurs almost exclusively in the offspring of women with anti-Ro/SSA antibodies. In order to find out the effect on fetus and newborn infants born to SLE mother, we reviewed clinical records of 11 infants born to 9 mothers with confirmed or suspected SLE at Seoul National University Hospital between June 1981 and May 1991. The results obtained were as follows: 1) Seven mothers among 9 were confirmed as SLE and 2 were suspected. 2) There were 6 spontaneous abortions (20.0%) and 5 stillbirths (16.7%) in 5 mothers among thirty pregnancies of 9 mothers. 3) Among 11 newborns, 4 (36.4%) were premature and 2 (18.2%) were small for gestational age. 4) Six mothers had proteinuria, over 4+, in Albustix. Four of these, including 3 preeclampsia mothers, delivered preterm babies. Two of premature babies were born through Cesarean section due to fetal distress and expired of hyaline membrane disease and its complications. The other 2 had thrombocytopenia and leukocytopenia at birth. One of these had intracranial hemorrhage at birth and seizure. 5) There were 2 mothers who had positive anticardiolipin antibody with SLE or without SLE. One with SLE was continuing positivity of the antibody during pregnancy and delivered premature baby who expired of HMD and PDA. The other who had seroconversion to negativity during the first trimester developed intermittently sinus bradycardia without apnea for 3 days. 6) Two of 11 newborns had only talipes equinovarus. 7) One mother who had anti-Ro/SSA antibody delivered monozygotic twin. The first baby was neonatal lupus erythematosus with complete heart block and skin pigmentation. All of them were suspected to right aortic arch and Kommerell's diverticulum on echocardiogram. As the above results, SLE mothers can cause serious effect on fetus and newborn when accompanied with active renal impairment, hypertension and positive antiphospholipid antibody. So we should treat mother with SLE even during pregnancy and it may give better outcome to mother and fetus. It will be useful for diagnosis and treatment of neonatal lupus erythematosus that the prenatal test for anti-Ro/SSA antibody, fetal monitoring, fetal echocardiogram and postnatal close observation for skin are taken.
Abortion, Spontaneous ; Antibodies ; Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid ; Aorta, Thoracic ; Apnea ; Bradycardia ; Cesarean Section ; Clubfoot ; Diagnosis ; Diverticulum ; Female ; Fetal Distress ; Fetal Monitoring ; Fetus ; Gestational Age ; Heart Block ; Humans ; Hyaline Membrane Disease ; Hypertension ; Infant* ; Infant, Newborn ; Intracranial Hemorrhages ; Leukopenia ; Lupus Erythematosus, Systemic* ; Mothers* ; Parturition ; Placental Circulation ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, First ; Proteinuria ; Seizures ; Seoul ; Skin ; Skin Pigmentation ; Stillbirth ; Thrombocytopenia ; Twins, Monozygotic

Eight neonates with transient tricuspid insufficiency are presented which was confirmed clinical and two dimensional echocardiographic assessment. We found that two dimensional Doppler echocardiography was very useful in the detection of transient tricuspid insufficiency during neonatal age as noninvasive method. Transient tricuspid insufficiency is a clinical disorder in the newborn period caused by myocardial dysfunction, secondary to asphyxia with or without hypoglycemia and associated with right ventricular overloading caused by pulmonary hypertention. The clinical diagnosis was based on a history of perinatal distress, distinctive murmur, ECG changes, biochemical abnormalities and myocardial imaging. 1) The sex ratio of TTI was 1:1. 2) The average gestational age was 34 weeks and mean body weight was 2.06 Kg, respectably. 3) Major symptoms were dyspnea, cyanosis, and tachypnea. 4) Tricuspid regurgitation was detected from the lst day to the 4th day of the life and was improved from the 7th day to the 30th day of the life. 5) The peak velocity through tricuspid valve ranged from the 2.7 m/sec to 4.0 m/sec and the estimated right ventricular pressure ranged from 39 mmHg to 74 mmHg. 6) Associated diseases were neonatal hyperbilirubinemia (100%), prematurity (87.5%), atrial right to left shunt (87.5%), patent ductus arteriosus (75%), hyaline membrane disease (25%), and transient tachypnea of newborn (12.5%).
Asphyxia ; Body Weight ; Cyanosis ; Diagnosis ; Ductus Arteriosus, Patent ; Dyspnea ; Echocardiography* ; Echocardiography, Doppler ; Electrocardiography ; Gestational Age ; Humans ; Hyaline Membrane Disease ; Hyperbilirubinemia, Neonatal ; Hypoglycemia ; Infant, Newborn ; Sex Ratio ; Tachypnea ; Transient Tachypnea of the Newborn ; Tricuspid Valve ; Tricuspid Valve Insufficiency ; Ventricular Pressure

This study included fifty two premature babies in whom EEG was performed at National Medical Center, from Jan. 1990 to Jun. 1991. clinical and EEG records of all subjects were analyzed and the following results were obtained. 1) The day of first EEG performed were;11 cases within 10 days, 20 cases from 11 days to days, 13 cases from 21 days to 30 days and 8 cases beyond 31 days. 2) The results of first EEG were; within normal limit in 34 cases, mild abnormality in 3 cases, moderate abnormality in 11 cases and marked abnormality in 4 cases. 3) The abnormal EEG ratio according to the sex was higher in female than in male (43.5% vs 27.6%). 4) The abnormal EEG ratio according to the gestational age was higher in shorter gestational age group than in longer gestational age group (40.9% under 32 weeks of G.A. vs 30.0% beyond 33 weeks of G.A.). 5) The abnormal EEG ratio according to the birth weight was not significant. 6) The abnormal EEG ratio according to the ventilator use was higher in used group than in not used group (38.5% vs 30.8%). 7) Combined diseases in 18 cases of abnormal EEG group were jaundice (14 cases), hyaline membrane disease (7 cases), asphyxia (4 cases), anemia (4 cases), hydrocephalus, sepsis, PDA, hypocalcemia, UTI and IVH. 8) The mean apgar score in abnormal EEG group was lower than normal EEG group both in one minute and five minute. 9) Two cases among 18 cases of abnormal EEG group showed abnormal brain sonographic findings, but one case among 34 cases of normal EEG group showed abnormal brain sonographic finding. 10) Ten cases were followed up with serial EEG, six cases of which were treated with anticonvulsant. We observed normalization of the EEG in 5 cases of anticonvulsant treated group.
Anemia ; Apgar Score ; Asphyxia ; Birth Weight ; Brain ; Electroencephalography* ; Female ; Gestational Age ; Humans ; Hyaline Membrane Disease ; Hydrocephalus ; Hypocalcemia ; Infant, Newborn ; Jaundice ; Male ; Sepsis ; Ultrasonography ; Ventilators, Mechanical

The 35 newborns with neonatal sepsis admitted to the Neonatal Intensive Care unit of Dong-A University Hospital during 2 years and 6 months from April 1990 to October 1992, and were reviewed on the bases of incidence, clinical manifestations, underlying conditions, etiologic organisms, results or antibiotics sensitivity test and mortality rates. The results were summarized as follows; 1) The incidence of neonatal sepsis was 1.2% and male predominated. Sepsis was more prevalent in premature babies (7.5%) than in full term babies (0.8%). 2) Neonatal sepsis occured more frequently in low birth weight infant below 2500 g(6.3%) than in normal birth weight infant. 3) Underlying conditions associated with neonatal sepsis were as follows; pneumonia (25.7%), HMD (17.1%), urinary tract infection (11.4%), DIC (8.6%). 4) Common clinical manifestations observed in neonatal sepsis were jaundice (45.7%), poor feeding (22.9%), abdominal distension (20.0%), lethargy, convulsion, apnea and diarrhea in order. 5) Blood culture report revealed that gram negative organisms (57.1%) were more frequently associated with neonatal sepsis than gram positive organisms (37.1%). Klebsiella pneumoniae was the most common microorganisms in neonatal sepsis. 6) Vancomycin (100%), cephalothin (84.6%) and chloramphenicol (84.6%) were the sensitive drug to gram positive organisms. Gram negative organisms were sensitive to amikacin (100%), and cephalothin (95%). 7) Overall mortality rate was 17.1% in all patients with neonatal sepsis, 7.7% in gram positive sepsis and 25% in gram negative sepsis. We conclude that the etiologic organisms of neonatal sepsis have been altered, and have to choose appropriate antibiotics which particularly sensitive to these gram negative organisms such as Klebsiella pneumoniae, Pseudomonas aeruginosa, and also have to specify antibiotics according to the predominant organisms of the each institute.
Amikacin ; Anti-Bacterial Agents ; Apnea ; Birth Weight ; Cephalothin ; Chloramphenicol ; Dacarbazine ; Diarrhea ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Jaundice ; Klebsiella pneumoniae ; Lethargy ; Male ; Mortality ; Pneumonia ; Pseudomonas aeruginosa ; Seizures ; Sepsis* ; Urinary Tract Infections ; Vancomycin

No abstract available.

No abstract available.