Anti-HLA antibody related neonatal thrombocytopenia is an uncommon disorder caused by platelet antigen incompatibility between mother and fetus in Korea. Mothers who lack the specific platelet antigen produce the IgG against the platelet antigen which the fetus inherits from the father. These IgG antibodies are then transported across the placenta into the fetal circulation where they lead to the destruction of fetal platelets. We report a case of neonatal alloimmune thrombocytopenia related with anti-HLA antibody in second baby of dizygotic twin who had petechia on trunk and platelet count 43,000/mm. Initially, mother and twin showed the positives in antiplatelet antibodies. In microlym- phocytotoxic test at 6 months of age, anti-HLA antibodies was negative in twins but anti-HLA A2, A24 was positive in their mother. The patient was treated with intravenous immunoglobulin and clinically improved and her platelet count was norrnalized.
Acrocephalosyndactylia* ; Antibodies ; Blood Platelets ; Fathers ; Fetus ; Humans ; Immunoglobulin G ; Immunoglobulins ; Infant, Newborn ; Korea ; Mothers ; Placenta ; Platelet Count ; Thrombocytopenia, Neonatal Alloimmune ; Twins ; Twins, Dizygotic

The morphologic abnormalities of the endocrine pancreas that underlie persistent neonatal hyperinsulinemic hypoglycemia and are included under the heading "nesidioblastosis" appears to be heterogeneous. This characteristic morphologic finding is ductuloinsular complexes showing endocrine cells budding off the ductoepithelium and merging with adjacent endocrine cell clusters. A case of nesidioblastosis associated with hyperinsulinemic hypoglycemia occurred in a 6/365 year-old male neonate. Microscopic finding of near totally resected pancreas revealed irregular sized islets and ductuloinsular complexes, both of which contained hypertrophied B cells with a few mitosis. Because of persistent hypoglycemia after first operation, he received second operation 8 days after. This histologic finding was more severe comparative to that of first operation. According to these findings, the pathogenesis of nesidioblastosis may be congenital or developmental defect of a kind of compensatory mechanism by unknown stimuli to acquire persistent hypoglycemia.
Male ; Infant, Newborn ; Humans

Partial trisomy 10q syndrome is a rare chromosome anomaly characterized by severe mental and growth retardation, craniofacial dysmorphia with prominent forehead, fine arched eyebrows, deep set small eyes and micrognathia, In addition, other physical manifestations have been reported as skeletal anomaly, congenital heart disease, inguinal hernia, and so on. We report a case of partial trisomy 10q syndrorne with certain stigmata which confirmed by chromosome analysis.
Christianity ; Eyebrows ; Forehead ; Heart Defects, Congenital ; Hernia, Inguinal ; Trisomy*

Many modalities of the treatment of fractures of distal 1/3 of tibia were introduced. But, May anatomical bone plate is considered to be a valuable method in treating distal 1/3 tibial fractures because of reduction potentiality by their contour, ability of firm fixation, decreased complications. Twenty two patients having distal 1/3 tibial fractures, were treated by May anatomical bone plate, at the Department of Orthopedic Surgery, Inchon Chirstian Hospital from January 1988 to December 1993. The results were follows; 1. Ninteen cases(86%) out of 22 were closed fractures and the remaining 3 cases(14%) were open fracrues, the comminuted fractures were 6 cases(22%) and the segmental fractures were 2 cases(9%). 2. Average interval from injuy to operation was 16.8 days and 21 cases had associated injuries. 3. The mean duration of bone union was 16.9 weeks. 4. Seven cases(31.8%) of delayed union and two cases(9.1%) of superficial infection were noted.
Bone Plates ; Fractures, Closed ; Fractures, Comminuted ; Humans ; Incheon ; Methods ; Orthopedics ; Tibia ; Tibial Fractures

Lead is one of the most widespread environmental toxins and its poisoning in children was considered a rarity, usually resulting from unique circumstances such as inappropriate use of leadbased body cosmetics or direct administration of lead-containing folk medicines. The increasing concern about children with lower levels of lead exposure has developed, but there are no data regarding the mean blood lead levels and the incidence of symptomatic or asymptomatic lead poisoning in Korean children. We analyzed the zinc protoporphyrine (ZPP) values and blood lead concentrations in 163 pediatric inpatients for a prospective study of lead exposure. The blood lead concentrations in all 163 children were 15~54 g/dl, of whom 111 children (68.1%) were 25~54 g/dl which needs decision to chelate based on the EDTA provocation test. Among 111 children whose blood lead concentrations are 25~54 g/dl, 59 children(53.2%) were between 7 months and 3 years of age, which revealed no significant higher incidence of lead exposure than any other age group. The ZPP values in 126 children (77.3%) were above 35 g/dl. The mean blood lead concentration and ZPP values are 27.8 g/dl and 48.8 g/dl, respectively. We conclude that there are many asymptomatic children with increased absorption of lead in the urban area of Korea, and we need further studies regarding lead poisoning. It is important that there must be a national counterplan and that pediatricians continue to pay attention to lead posioning in children.
Absorption ; Child ; Edetic Acid ; Humans ; Incidence ; Inpatients* ; Korea ; Lead Poisoning ; Poisoning ; Prospective Studies ; Zinc

No abstract available.
Balloon Valvuloplasty* ; Constriction, Pathologic*

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

The Journal of the Korean Medical Association (JKMA) established a new web site in July, 2010 available at http://jkma.org/. Here, we introduce the basic structure and concept of the new web site. The new web site provides current medical information from Korea to KMA members as well as global readers. The history of Korean medicine will also be organized in an easily accessible. Starting from this basic platform, JKMA will improve and expand other online functions in the near future. We hope every member of the Korean Medical Association enjoys browsing the content of JKMA through the new site and using the information they find in their clinical practice.
Korea

PURPOSE: Both antithrombin III(ATIII) and Gabexate mesilate(Foy) are effective for the treatment of disseminated intravascular coagulation(DIC). However, their mechanisms of action are slightly different, and combined effect of ATIII and Foy in premature infant with DIC has not been studied. We evaluated therapeutic efficacy of treatments with either ATIII or Foy alone or both in combination. METHODS: We studied 23 premature infants of gestational ages between 30 and 36 weeks with DIC. Group A(n=10) was treated by ATIII only, Group B(n=7) by Foy only and Group C(n=6) by both ATIII and Foy. Three groups were compared for volume of blood sampling and transfusion and hematologic data. RESULTS: Improvement of hematologic data(platelet, PT, aPTT, fibrinogen, FDP) was not significantly different among 3 groups. The mean volume of blood sampling during 5 days of treatment was 30 mL, 22.5 mL, and 30 mL, respectively. The mean volume of packed RBC transfusion was 12.8 mL, 9 mL, and 2.5 mL, respectively: and mean volume of platelet transfusion was 25.9 mL, 10 mL, and 0 mL, respectively, showing no significant statistical difference. But the mean volume of FFP transfusion was 141 mL only in group B, significantly higher compared to other groups. CONCLUSION: The combination therapy of ATIII and Foy significantly decreased the volume of FFP transfusion and may be more effective than monotherapy with ATIII or Foy alone in DIC of premature infant.
Dacarbazine ; Disseminated Intravascular Coagulation* ; Fibrinogen ; Gabexate* ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature* ; Platelet Transfusion ; Thrombin*

Renal papillary necrosis is rare. It usually occurs in association with diabetes mellitus, pyelonephritis, urinary tract obstruction, analgesic abuse and sickle cell hemoglobinopathies. The basic pathophysiologic process in renal papillary necrosis appears to be ischemic necrosis. We experienced a case of renal papillary necrosis associated with diabetes mellitus. This 59 years old female was diabetic for 10 years and had persistent pyuria, not controlled with antibiotics. The excretory urography showed nonvisualized left kidney and retrograde pyelography showed multiple irregular filling defect in pelvis and ureter. The nephrectomized kidney showed typical findings of papillary necrosis, grossly and microscopically.
Anti-Bacterial Agents ; Diabetes Mellitus* ; Female ; Hemoglobinopathies ; Humans ; Kidney ; Middle Aged ; Necrosis* ; Pelvis ; Pyelonephritis ; Pyuria ; Ureter ; Urinary Tract ; Urography