The passive immunization of pregnant female rats to S-100 protein often leads to ultra-structural abnormalities in the brain glial structures of the offspring of these rats and induces signs of delayed development in the fetal brain. Additionally passive immunization of pregnant animals with certain antigens induces permanent Ag-specific changes in the immune response of their offspring. The purpose of this study was to investigate serum immunoreactiviy (SIR) to S-100 in cerebral-palsied and developmentally-delayed children as well as in their healthy parents and to evaluate its significance related to radiologic findings of brain MRI and single photon emission computed tomography (SPECT). The subjects were children with cerebral palsy and delayed development that had abnormal findings on brain MRI or Brain SPECT. SIR to S-100 protein was measured by ELISA method in the patients, their healthy parents, 20 normal adult controls and 22 normally developed children. The SIR to S-100 protein was significantly higher in the cerebral-palsied and developmentally-delayed children when compared to that of the normal control group children. Increased SIRs were detected in healthy mothers but not in their fathers. There was no difference of SIR between the cerebral-palsied and developmentally-delayed children or any significant difference of SIRs according to the findings of the brain MRI or to developmental quotients. But, the SIRs to S-100 protein were higher in the group of more abnormal findings on brain SPECT.
Adolescence ; Adult ; Cerebral Palsy/immunology* ; Cerebral Palsy/blood ; Child ; Developmental Disabilities/immunology* ; Developmental Disabilities/blood ; Female ; Human ; Male ; Nerve Tissue Protein S 100/blood* ; Parents* ; Reference Values

PURPOSE: Neurosonography, cerebral doppler and electrophysiological study are valuable in predicting neurodevelopmental outcome. The purpose of this study was to analyze characteristics of neonatal neurosonographic findigs, cerebral doppler and electrophysiological findings in infants withmotor disturbance. METHODS: The subjects were 33 infants hospitalized at Yonsei Severance Medical Center NICU from January, 1990 to December, 1992. 19 of these patients underwent neonatal cranial ultrasonogram and cerebral doppler and were diagnosed with cerebral palsy(CP) after Vojta treatment. 14 patients alose received Vojta treatment after discharge but showed only delayed development(DD). The cases were studied retrospectively and color doppler sonograpy was performed within 3 days of birth, 5-7 days after birth and weekly thereafter, and the cerebral blood flow velocity of the anterior cerebral artery was measured and comparison between normal pre-term and full-term infants done. Electroencephalogeraphy(EEG) and brainstem auditory evoked potential(BSAEP) were performed before discharge, with follow-up studies done only in cases showing abnormal findings, whereas visual evoked potential(VEP) was performed after discharge interhemispheric fissure was seen in 7 cases of CP and 1 cases of DD, showing a singnificatn frequency in CP, whereas there was no difference in the linear echogenecity of the basal ganglia. 4) Abnormal EEG was seen in 12 cases(63%) of CP group and 4 cses(29%) of DD group. The follow up EEG was normalized in all DD patients but CP patients conhtinues to show significant EEG abnormalities (7 cases out of 9). BSAEP and VEP abnormalities showed no significant difference between the 2 groups. 5) There was no significant difference in the average resistance index(RI) which was calculated from the cerebral blood flow velocity measured by cerebral doppler among normal newborns, CP and DD patents group. But average RI of CP patients was significantly lower than that of normal newborns, indicating an increase in cerebral blood flow in early life with severe neurologic sequelae. CONCLUSIONS: Neurosogography, cerebral doppler and electrophysiological studies performed in the perinatal period of children with motor disturbance show characteristic abnormal finding, with significant differences among childrem diagnosed with CP and DDD.
Anterior Cerebral Artery ; Basal Ganglia ; Blood Flow Velocity ; Brain Stem ; Cerebral Palsy ; Child ; Dichlorodiphenyldichloroethane ; Electroencephalography ; Follow-Up Studies ; Humans ; Infant* ; Infant, Newborn ; Parturition ; Retrospective Studies ; Ultrasonography

PURPOSE: Neurosonography, cerebral doppler and electrophysiological study are valuable in predicting neurodevelopmental outcome. The purpose of this study was to analyze characteristics of neonatal neurosonographic findigs, cerebral doppler and electrophysiological findings in infants withmotor disturbance. METHODS: The subjects were 33 infants hospitalized at Yonsei Severance Medical Center NICU from January, 1990 to December, 1992. 19 of these patients underwent neonatal cranial ultrasonogram and cerebral doppler and were diagnosed with cerebral palsy(CP) after Vojta treatment. 14 patients alose received Vojta treatment after discharge but showed only delayed development(DD). The cases were studied retrospectively and color doppler sonograpy was performed within 3 days of birth, 5-7 days after birth and weekly thereafter, and the cerebral blood flow velocity of the anterior cerebral artery was measured and comparison between normal pre-term and full-term infants done. Electroencephalogeraphy(EEG) and brainstem auditory evoked potential(BSAEP) were performed before discharge, with follow-up studies done only in cases showing abnormal findings, whereas visual evoked potential(VEP) was performed after discharge interhemispheric fissure was seen in 7 cases of CP and 1 cases of DD, showing a singnificatn frequency in CP, whereas there was no difference in the linear echogenecity of the basal ganglia. 4) Abnormal EEG was seen in 12 cases(63%) of CP group and 4 cses(29%) of DD group. The follow up EEG was normalized in all DD patients but CP patients conhtinues to show significant EEG abnormalities (7 cases out of 9). BSAEP and VEP abnormalities showed no significant difference between the 2 groups. 5) There was no significant difference in the average resistance index(RI) which was calculated from the cerebral blood flow velocity measured by cerebral doppler among normal newborns, CP and DD patents group. But average RI of CP patients was significantly lower than that of normal newborns, indicating an increase in cerebral blood flow in early life with severe neurologic sequelae. CONCLUSIONS: Neurosogography, cerebral doppler and electrophysiological studies performed in the perinatal period of children with motor disturbance show characteristic abnormal finding, with significant differences among childrem diagnosed with CP and DDD.
Anterior Cerebral Artery ; Basal Ganglia ; Blood Flow Velocity ; Brain Stem ; Cerebral Palsy ; Child ; Dichlorodiphenyldichloroethane ; Electroencephalography ; Follow-Up Studies ; Humans ; Infant* ; Infant, Newborn ; Parturition ; Retrospective Studies ; Ultrasonography

BACKGROUND: We compared the yields of mobilized PBSCs from single day of normal volume leukapheresis (NVL) in children and adults, and factors affecting the yields, to understand differences in mobilization efficiency between adults and small children with healthy marrows.METHODS: This study involved 18 adult volunteer donors and 47 small children weighing less than 20 kg who participated in a clinical trial of cell therapy in children with cerebral palsy. Donor factors analyzed to identify predictors of the yield of apheresis included age, gender, weight and complete blood cell count (CBC) with differential counts as well as equipment parameters.RESULTS: The yields of total nucleated cells (TNCs) and CD34⁺cells in the apheresis products of the children were significantly lower than in those from healthy adults. However, the efficiency of recovery of PBSCs (total CD34⁺ cell counts/TNCs) was significantly higher in small children (0.48±0.30%) than in adults (0.10±0.05%) (P < 0.05). Multivariable analysis of adult donor factors showed that the processed volume and flow rate of apheresis were significantly associated with the yield of TNCs (P < 0.05, for both), but not of CD34⁺cells. However, in multivariable analysis of child donor factors, body weight and circulating WBC count on the day of apheresis were significantly associated with the yield of TNCs (P < 0.05, for both) and of CD34⁺cells (P < 0.05, for both).CONCLUSION: The predictors of PBSC yields from a single day of NVL in adults and small children are different. Also mobilization is more effective in small children than in adults.
Adult ; Blood Cell Count ; Blood Component Removal ; Body Weight ; Bone Marrow ; Cell- and Tissue-Based Therapy ; Cerebral Palsy ; Child ; Hematopoietic Stem Cell Mobilization ; Humans ; Leukapheresis ; Tissue Donors ; Volunteers

OBJECTIVETo observe therapeutic effect of scalp-acupuncture plus body-acupuncture on spastic cerebral palsy and its effects on bone density and blood trace elements Ca, Cu, Zn, and Fe in the children with spastic cerebral palsy.

METHODSEighty children of spastic cerebral palsy were randomly divided into an observation group and a control group, 40 cases in each group. The observation group were treated with scalp-acupuncture plus body-acupuncture combined with body therapy and performance therapy, and the control group with simple body therapy and performance therapy, once each day, for 3 courses, 30 days constituting one course. Changes of bone density and the trace elements were compared before and after treatment.

RESULTSThe total effective rate was 87.5% in the observation group and 67.5% in the control group with a significant difference between the two groups (P < 0.05); after treatment, the bone density and blood Ca, Cu, Zn and Fe contents in the two groups significantly increased (P < 0.05, P < 0.01) with the observation group being superior to the control group (P < 0.05, P < 0.01).

CONCLUSIONThe scalp-acupuncture plus body-acupuncture combined with body therapy and performance therapy can improve bone density and contents of trace elements in the children of spastic cerebral palsy, and has a definite therapeutic effect on spastic cerebral palsy.

Acupuncture Therapy ; methods ; Bone Density ; Cerebral Palsy ; metabolism ; therapy ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Medicine, Chinese Traditional ; Scalp ; Trace Elements ; blood

Protein C (PROC) is a potent anticoagulant inactivating coagulation factors Va and VIIIa. PROC deficiency is very rare condition inherited as an autosomal dominant or recessive trait, and associated with various thromboembolic and ischemic conditions. Moreover, severe form of PROC deficiency can cause fatal hemorrhagic complications due to consumptive coagulopathy. We reported two children with hemorrhagic stroke who were diagnosed as severe PROC deficiency caused by two different types of compound heterozygous PROC gene mutations. We described results of laboratory tests, genetic analysis, brain magnetic resonance images, and functional outcomes. Both children received prophylactic anticoagulation therapy and presented with purple-colored skin lesions during rehabilitation. Purpura fulminans caused by insufficient anticoagulation should be differentiated from hematoma caused by excessive anticoagulation therapy in these children.
Blood Coagulation Factors ; Brain ; Cerebral Palsy* ; Child ; Hematoma ; Humans ; Intracranial Hemorrhages* ; Protein C Deficiency* ; Protein C* ; Purpura Fulminans ; Rehabilitation ; Skin ; Stroke

Protein C (PROC) is a potent anticoagulant inactivating coagulation factors Va and VIIIa. PROC deficiency is very rare condition inherited as an autosomal dominant or recessive trait, and associated with various thromboembolic and ischemic conditions. Moreover, severe form of PROC deficiency can cause fatal hemorrhagic complications due to consumptive coagulopathy. We reported two children with hemorrhagic stroke who were diagnosed as severe PROC deficiency caused by two different types of compound heterozygous PROC gene mutations. We described results of laboratory tests, genetic analysis, brain magnetic resonance images, and functional outcomes. Both children received prophylactic anticoagulation therapy and presented with purple-colored skin lesions during rehabilitation. Purpura fulminans caused by insufficient anticoagulation should be differentiated from hematoma caused by excessive anticoagulation therapy in these children.
Blood Coagulation Factors ; Brain ; Cerebral Palsy* ; Child ; Hematoma ; Humans ; Intracranial Hemorrhages* ; Protein C Deficiency* ; Protein C* ; Purpura Fulminans ; Rehabilitation ; Skin ; Stroke

PURPOSE: To determine the relation between the initial plasma cytokine response and the neurological prognosis in term infants with severe fetal distress. METHODS: Infants with severe fetal distress at birth (n=23) were studied prospectively. Cytokine concentrations were measured from umbilical cord blood at 3 and 12 hours of life by enzyme-linked immunosorbent assays for interleukin (IL)-1beta, IL-6, and IL-18. The study groups were divided into good (n=14) or poor prognostic group (n=9) according to survival and presence of cerebral palsy (CP) later and correlations with afore mentioned cytokine levels were determined. RESULTS: Cord blood IL-1beta and IL-18 concentrations were similar in both groups. However, infants with poor prognosis had significantly higher median (range) IL-6 concentration than infants with good prognosis at 3 hours [323.6 (32.6-812.8) vs. 38.4 (6.3- 322.7) pg/mL] (P=0.001), and 12 hours of life [287.1 (16.4-769.1) vs. 66.2 (8.8-757.8) pg/mL] (P<0.05). Significant higher IL-6 levels greater than 200 pg/mL were observed at 3 hours (P=0.005) and at 12 hours of life (P=0.023) for poor prognosis group. CONCLUSION: There was a significant correlation between neurologic outcome and plasma IL-6 levels. Higher concentrations of IL-6 (>200 pg/mL) may be a useful indicator of poor neurological outcome in infants with severe fetal distress.
Cerebral Palsy ; Enzyme-Linked Immunosorbent Assay ; Fetal Blood ; Fetal Distress* ; Humans ; Infant ; Infant, Newborn* ; Interleukin-18 ; Interleukin-6 ; Interleukins ; Parturition ; Plasma ; Prognosis ; Prospective Studies

Tracheoinnominate artery fistula is a rare, fatal complication of tracheostomy, and prompt diagnosis and management are imperative. We report the case of tracheoinnominate artery fistula after tracheostomy in a 14-year-old boy with a history of severe periventricular leukomalacia, hydrocephalus, cerebral palsy, and epilepsy. The tracheoinnominate artery fistula was successfully treated with a stent graft insertion via the right common femoral artery. Endovascular repair of the tracheoinnominate artery fistula via stent grafting is a safe, effective, and minimally invasive treatment for patients in poor clinical conditions and is an alternative to traditional open surgical treatment.
Adolescent* ; Angioplasty ; Arteries ; Blood Vessel Prosthesis ; Brachiocephalic Trunk ; Cerebral Palsy ; Diagnosis ; Epilepsy ; Femoral Artery ; Fistula* ; Humans ; Hydrocephalus ; Infant, Newborn ; Leukomalacia, Periventricular ; Male* ; Stents* ; Tracheostomy*

Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal and gastric aspiration and hypovolemic shock. Therefore, the rapid and correct bleeding control is very important for saving lives in the emergency room. Despite the conventional bleeding control methods of wiring (jaw fracture, wound suture and direct pressure), continuous bleeding can occur due to the presence of various bleeding disorders. There are five main causes for excessive bleeding disorders in the clinical phase; (1) vascular wall alteration (infection, scurvy etc.), (2) disorders of platelet function (3) thrombocytopenic purpura (4) inherited disorders of coagulation, and (5) acquired disorders of coagulation (liver disease, anticoagulant drug etc.). In particular, infections can alter the structure and function of the vascular wall to a point at which the patient may have a clinical bleeding problem due to vessel engorgement and erosion. Wound infection is a frequent cause of postoperative active bleeding. To prevent postoperative bleeding, early infection control using a wound suture with proper drainage establishment is very important, particularly in the active bleeding sites in a contaminated emergency room. This is a case report of a rational bleeding control method by rapid wiring, wound suture with drainage of a rubber strip & iodoform gauze and wet gauze packing, in a 26-year-old male cerebral palsy patient with active oral and maxillofacial bleeding injuries caused by a traffic accident.
Adult ; Airway Obstruction ; Blood Platelets ; Cerebral Palsy ; Drainage ; Emergencies ; Glycosaminoglycans ; Hemorrhage ; Humans ; Hydrocarbons, Iodinated ; Infection Control ; Male ; Mentally Disabled Persons ; Purpura, Thrombocytopenic ; Rubber ; Scurvy ; Shock ; Sutures ; Wound Infection