PURPOSE: It has been known for a long time that infants of insulin dependent diabetic mothers are prone to develop macrosornia, organomegaly, hyperbilirubinemia, respiratory distress syndrome, hypoglycemia, hypocalcemia, septicemia and congenital anomalies in the neonatal period. And echocardiographic asymmetrical- ventricular septal hyper- trophy(ASH) has been observed in the newborn infants of diabetic mothers. The etiology of the ASH remains unknown, although fetal hyperglycemia and subsequent glycogen deposits have been postulated as contributing factors. Therefore, we have studied whether large for gestational age(LGA) has played an important role of developing ASH. METHODS: We compared echocardiographic findings in neonates of LGA and appro- priate for gestational age(AGA), who were admitted to the Department of Pediatrics, Chung Ang University Hospital from April 1994 to March 1997. RESULTS: 1) Mean LVED in LGA and AGA were 1.96+0.06cm and 1.94+0.04cm, respectively. 2) Mean LVPW in LGA and AGA were 0.37+0.05cm and 0.370.05cm, respectively. 3) Mean IVS in LGA and AGA were 0.400.09cm and 0.380.09cm, respectively. 4) Mean IVS/ LVPW in LGA and AGA were 1.09+0.12 and 1.040.17, respectively. There was no statistical significance between two groups in echocardiographic findings. CONCLUSION: There is no relation between LGA and ASH in the neonate. According- ly, we may not need to perform echocardiography LGA routinely.
Echocardiography ; Gestational Age* ; Glycogen ; Humans ; Hyperbilirubinemia ; Hyperglycemia ; Hypertrophy* ; Hypocalcemia ; Hypoglycemia ; Infant ; Infant, Newborn* ; Insulin ; Mothers ; Pediatrics ; Sepsis

PURPOSE: Antiepileptic drug (AED) therapy has been reported to induce immunological alterations in epileptic patients. However, despite extensive studies, the accumulated data are not consistent and there is still confusion and controversy over the effects of AEDs on the immune system. This study tries to elucidate the effects of anticonvulsant on some immune parameters, and serum concentration of IgA, IgG, IgM. METHODS: Thirty pediatric epileptic patients[Group A (n=12) : patients on carbamazepine, Group B (n=10) : patients on valproic acid and Group C (n=8) : patients on carbamazepine and valproic acid] were enrolled in this study and the levels of IgA, IgG, and IgM were determined before treatment and after 10 months of anticonvulsant therapy. Paired t-test was used to evaluate the data. p values<0.05 were considered significant. RESULTS: The mean serum concentratrions of IgG was elevated in patients receiving anticonvulsants (p<0.05) but mean concentrations of IgA and IgM were not different significantly. CONCLUSION: Our results demonstrate that anticonvulsants elevate the serum concentrations of IgG level, suggesting that anticonvulsants may increase humoral immunity and decrease the opportunity of infectious disease, thus decreasing the convulsion.
Anticonvulsants ; Carbamazepine* ; Child* ; Communicable Diseases ; Humans ; Immune System ; Immunity, Humoral ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Seizures ; Valproic Acid*

The so called MOYAMOYA disease is characterized by idiopathic progressive bilateral occlusions of internal carotid arteries near the supraclinoid portion, with a distinctive picture of abnormal net like vessels in the base of the brain. The term MOYAMOYA is a Japanese expression for "PUFF OF A SMOKE", suggested by Suzuki & Takaku in 1969. We have experienced typical 3 cases of so called MOYAMOYA disease during 1979, which were confirmed by bilateral carotid angiography. All 3 cases were involved bilateral sides of the brain and the exact causes were not detected in spite of various laboratory examinations. All of our cases were compatible with the criteria of Moyamoya disease, suggested by Takeuchi in 1978. In addition to the case report a review of history, etiology & pathogenesis of Moyamoya Disease were discussed.
Angiography ; Asian Continental Ancestry Group ; Brain ; Carotid Artery, Internal ; Humans ; Moyamoya Disease*

We report herein a case of epidermolysis bullosa (Weber-Cockaynetype) in a 22-year-old male soldier. He had tense egg sized bulla on the both feet for about 10 years. The lesions were exacerbated during hot weather but were mild. After entering military service, lesions became severe by mecanical trauma such as prolonged walking or marching. Histopathological findings showed subepidermal bulla and a few inflammatory infiltration in the dermis.
Dermis ; Epidermolysis Bullosa* ; Foot ; Humans ; Male ; Military Personnel ; Ovum ; Transcutaneous Electric Nerve Stimulation ; Walking ; Weather ; Young Adult

BACKGROUND: Healthcare-associated infections (HAIs) are among the most important threats to patient safety. When hospitalized children face these threats, there is morbidity, mortality, prolonged hospitalization, and increased healthcare costs. Research on local healthcare epidemiology is necessary to enhance collective knowledge and evidence formanaging this problem. METHODS: We performed a retrospective analysis of databases of patients who were diagnosed with HAIs at Chung-Ang University Hospital (CAUH) from 2007 through 2011. Cases were selected from the microbiology registry databases. The data on prevalence of HAIs in various wards and its annual trends were compared to previously reported nationwide data. Moreover, we analyzed the patterns of antibiotic susceptibility results for HAI pathogens. RESULTS: A total of 181 HAIs were identified in 122 patients. The HAI rate among pediatric patients at CAUH was 2.4/1,000 person-hospital days. Urinary tract infections (UTIs) (53 episodes, 29.3%) were the most common, followed by pneumonia (33 episodes, 18.2%). Staphylococcus aureus was found to be the most common gram-positive organism, whereas Escherichia coli was the most common gram-negative organism. Methicillin-resistant S. aureus (MRSA) comprised 84% of the S. aureus infections. Imipenem resistance was detected in 58.8% and 55.0% of Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively. CONCLUSION: Between 2007 and 2011, UTIs were the most common type of HAIs, and MRSA was the most common pediatric HAI pathogen, both in the general ward and intensive care unit at the CAUH. Further research on the epidemiology and pathogenesis of HAIs is necessary and prevention measures should be implemented to prevent HAIs in children.
Acinetobacter baumannii ; Child ; Child, Hospitalized ; Delivery of Health Care ; Escherichia coli ; Health Care Costs ; Hospitalization ; Humans ; Imipenem ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Patient Safety ; Patients' Rooms ; Pneumonia ; Prevalence ; Pseudomonas aeruginosa ; Retrospective Studies ; Staphylococcus aureus ; Urinary Tract Infections

Orthostatic or postural proteinuria is the most common cause of asymptomatic proteinuria in children. As orthostatic proteinuria (OP) is a benign disease with relatively good prognosis, it has no specific management, and patients only need to be observed. However, if OP shows a persistently high level of proteinuria, in theory, glomerular changes can occur. An 11-year-old girl was referred to the hospital due to asymptomatic proteinuria and was diagnosed as having OP based on the results of clinical and laboratory examinations, urinalysis, and protein/creatinine (TP/Cr) ratio at both supine and erect positions. During follow-up observation, the 24-hour TP/Cr ratio was persistently higher than 1.5 mg/mg for 2 years. We performed renal biopsy, which showed mesangial proliferative glomerular lesions with focal effacement of the podocyte foot processes, but without immune depositions. OP can be accompanied by glomerular lesions if moderate to severe proteinuria persists.
Biopsy ; Child ; Female ; Follow-Up Studies ; Foot ; Glomerulonephritis ; Humans ; Pathology* ; Podocytes ; Prognosis ; Proteinuria* ; Urinalysis

Orthostatic or postural proteinuria is the most common cause of asymptomatic proteinuria in children. As orthostatic proteinuria (OP) is a benign disease with relatively good prognosis, it has no specific management, and patients only need to be observed. However, if OP shows a persistently high level of proteinuria, in theory, glomerular changes can occur. An 11-year-old girl was referred to the hospital due to asymptomatic proteinuria and was diagnosed as having OP based on the results of clinical and laboratory examinations, urinalysis, and protein/creatinine (TP/Cr) ratio at both supine and erect positions. During follow-up observation, the 24-hour TP/Cr ratio was persistently higher than 1.5 mg/mg for 2 years. We performed renal biopsy, which showed mesangial proliferative glomerular lesions with focal effacement of the podocyte foot processes, but without immune depositions. OP can be accompanied by glomerular lesions if moderate to severe proteinuria persists.
Biopsy ; Child ; Female ; Follow-Up Studies ; Foot ; Glomerulonephritis ; Humans ; Pathology* ; Podocytes ; Prognosis ; Proteinuria* ; Urinalysis

A healthy 18-year-old woman presented with an asymptomatic tiny papular eruption on the hands, forearms, legs and trunk. A skin biopsy from the left forearm revealed a typical lichen nitidus lesion associated with an adjacent transepidermal perforating lesion. We report a case of perforating lichen nitidus, and briefly review the relevant literature of perforating lichen nitidus.
Adolescent ; Biopsy ; Female ; Forearm ; Hand ; Humans ; Leg ; Lichen Nitidus* ; Lichens* ; Skin

Spontaneous coronary artery dissection is a rarely identified entity whose exact incidence, etiology, pathogenesis, medium-term evolution and optimal treatment have not yet been firmly estabilished. The cause of spontaneous disection remains unclear but theories of etiology include a medial eosinophilic angiitis, pregnancy induced degeneration of collagen and rupture of the vasovasoum. Most paients die suddenly, but a clinical spectrum is seen including and unstable angina, myocardial infarction and cardiogenic shock. We experienced 4 cases with spontaneous coronary artery dissection found angiographically which caused myocardial infarction and unstable angina. Our patients were treated medically.
Angina, Unstable ; Collagen ; Coronary Vessels ; Eosinophils ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Pregnancy ; Rupture ; Shock, Cardiogenic ; Vasculitis

PURPOSE: c-fos is rapidly and transiently induced in the intact CNS by a wide variety of exogenous stimuli that include seizures, glutamate receptor activation, sensory stimulation and stress. In adult animals, systemic KA administration produces limbic seizures that results in c-fos protein expression, irreversible morphological changes and localized neuronal death. So we studied the pattern of c-fos protein expression and histological findings in hippocampal formation, following kainic acid-induced seizures during the postnatal period in the rat. METHODS: Sprague-Dawley rat pups ranging from 8 to 10 days of age, received kainic acid(KA, 5mg/kg) by intraperitoneal injection. Control rats were injected with normal saline. The rats were perfused and fixed with 4% buffered paraformaldehyde at varying time-intervals after KA injection, the brains were sectioned and immunohistochemically stained for c-fos protein and performed HE staining. RESULTS: In the hippocampus, immunohistochemistry showed that c-fos protein expressed at 12 hr after KA injection and disappeared thereafter. c-fos protein expressed in all sectors of the hippocampus but most densely expressed in CA1 and CA3 sectors. Rarely c-fos expression was seen in the granular cell layer of dentate gyrus. There were no histologic changes in the hippocampus at 2 weeks after KA injection. CONCLUSION: c-fos, a proapoptotic gene in adult rats, seemed to have an additive role in neuronal cell adaptation to exogenous stimuli in neonatal rats. As a result, it suggests that the roles of c-fos in neuronal cells after noxious stimuli are different between neonatal and adult rats.
Adult ; Animals ; Brain* ; Dentate Gyrus ; Hippocampus* ; Humans ; Immunohistochemistry ; Injections, Intraperitoneal ; Kainic Acid* ; Neurons ; Rats* ; Rats, Sprague-Dawley ; Receptors, Glutamate ; Seizures