PURPOSE: Newborn infants with diarrhea, metabolic acidosis and dehydration may develop methemoglobinemia without exposure to oxidizing agents. This study was undertaken to investigate clinical features in the development of methemoglobinemia in newborn infants with diarrhea. METHOD: This study involved 16 newborn infants with diarrhea who were admitted to NICU at Dong San Medical Center between January 1995 and June 1996. We investigated the age of onset of methemoglobinemia, sex ratio, level of methemoglobin in the blood, feeding methods, clinical manifestations, arterial blood gas findings, the results of culture findings and the response to therapy. RESULT: 1) The age of onset was beyond the second week of life in most cases, no sex predilection was noted and formula feeding was used in all cases. 2) Methemoglobin level in the blood was 10.1-20.0% in 7 cases, 20.1-30.0% in 6 cases, 30.1-40.0% in 2 cases and above 40.1% in one case. 3) Clinical rnanifestations on admission: moderate to severe dehydration developed in all patients with diarrhea along with respiratory distress in 13 cases, cyanosis in 6 cases, fever was noted in 5 cases, vomiting in 5 cases, while 2 cases presented with abdominal distention. Combined diseases included metabolic acidosis in most cases (93.8%), hypokalemia in 6, failure to thrive in 3, chronic diarrhea in 2, hyponatremia in 2, necrotizing enterocolitis in 1 and hepatitis was found in one case. 4) In all cases, there were no pathogenic organisms found in either blood or urine cultures along with similar negative findings in stool cultures, and Rotazyme test results using ELISA method were negative. 5) Rehydration and correction of acidosis with sodium bicarbonate was accomplished in all patients and 11 cases with greater than 15% methemoglobin were treated with methylene blue, 2mg/kg as a 1% solution in normal saline. Response to methylene blue was indicated in 1 to 2 hours in all cases although there was a reoccurrence of methemoglobinemia after an initial response in 2 cases, they both responded favorably with retreatment with methylene blue. CONCLUSION: In all newborn infant with diarrhea, dehydration and metabolic acidosis, screening tests for early diagnosis of methemoglobinemia should be considered with prompt fluid replacement therapy.
Acidosis ; Age of Onset ; Cyanosis ; Dehydration ; Diarrhea* ; Early Diagnosis ; Enterocolitis, Necrotizing ; Enzyme-Linked Immunosorbent Assay ; Failure to Thrive ; Feeding Methods ; Fever ; Fluid Therapy ; Hepatitis ; Humans ; Hypokalemia ; Hyponatremia ; Infant* ; Infant, Newborn* ; Mass Screening ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Oxidants ; Retreatment ; Sex Ratio ; Sodium Bicarbonate ; Vomiting

No abstract available.
Diagnosis* ; Hemophilia A* ; Molecular Biology* ; Polymorphism, Restriction Fragment Length*

Ectopia cordis is a very rare cardiac anomaly that the heart is partially or totally outside the thorax, and it was classified anatomically as 5 types-cervical, thoracocervical, thoracic (most common type), thoracoabdominal, abdominal types. We experienced a case of ectopia cordis (thoracic type) in a newborn who had the symptom of generalized cyanosis since birth, and expired during operation due to recurrent bradycardia and hypotension. The brief review of literature was made
Bradycardia ; Cyanosis ; Ectopia Cordis* ; Heart ; Humans ; Hypotension ; Infant, Newborn ; Parturition ; Thorax

PURPOSE: Determination of left ventricular myocardial mass with echocardiography is feasible and validated. American Society of Echocardiography(ASE) issued recommendations for the quantitation of the left ventricle by M-mode echocardiography. The purpose of this study is to determine the mean value of left ventricular mass in Korean children. METHODS: We measured left ventricular mass in 498 subjects(male 289, female 209) using ASE cube method with correction in M-mode method. RESULTS: 1) The mean value of left ventricular mass corrected by body surface area are respectively: 54.87+/-27.45 gm/m2 in Korean male children, and 49.57+/-23.16 gm/m2 in Korean female children, by echocardiography in accordance with the ASE convention. 2) The left ventricular mass correlated well with the left ventricular end-diastolic dimension, interventricular septal thickness, left ventricular posterior wall thickness, and left ventricular end-diastolic volume. CONCLUSIONS: These normal values shoud provide a valuable database for further studies of the development of left ventricular mass in patients with various cardiac abnormalities.
Body Surface Area ; Child* ; Echocardiography* ; Female ; Heart Ventricles ; Humans ; Male ; Reference Values* ; Stroke Volume

BACKGROUND: Hematopoietic stem cells of the human fetal liver prior to 15 weeks gestation have remakable advantages for successful engraftment due to embryological immune immaturity, especially in-utero transplantation. This study was undertaken to obtain objective assessment data about the possibility of fetal liver hematopoietic stem cell transplantation in the future. METHODS: Six cases of the fetal liver tissue were obtained from therapeutic abortions at 12~20 weeks gestation. The fetal liver was collected in RPMI media containing 10% fetal calf serum and the cell suspensions were obtained by centrifugation following physical disruption. The number of nucleated cells in each case was counted and the colony numbers in methyl cellulose media were scored according to incubation period with or without growth factors. Some of the cells were cryopreserved in the liquid nitrogen tank, thereafter cell viability and colony numbers were evaluated according to cryopreservation period. RESULTS: The nucleated cell numbers obtained from each fetal liver increased with gestational age. The colony numbers after incubation increased with gestational age and the erythroid lineage was predominant in 3 cases which are under 15 weeks gestation. The colonogenic activity after incubation with combination of hematopoietic growth factors increased in only one case. The cell viability and the colony numbers after cryopreservation was decreased compare to the value before cryopreservation. CONCLUSION: The number of nucleated cells and hematopoietic stem cell colony formation were increased with gestational age and viability of the cells after cryopreservation was decreased. Further systematic studies using more cases would be needed to obtain objective assessment data for fetal liver transplantation program in the future.
Abortion, Therapeutic ; Cell Count ; Cell Survival ; Centrifugation ; Cryopreservation ; Female ; Gestational Age ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells* ; Humans ; Intercellular Signaling Peptides and Proteins ; Liver Transplantation ; Liver* ; Methylcellulose ; Nitrogen ; Pregnancy ; Suspensions

BACKGROUND: The p53 and retinoblastoma(Rb) tumor suppressor genes are associated with the pathogenesis of several types of human cancer. Substantial. proportion of the primary lung cancers or cell lines have been reported to have the p53 and/or the Rb gene mutations. But so far there is no report on the analysis of the Rb gene polymorphism as one of the genetic susceptibility marker. This study was undertaken to establish the gene frequencies of the polymorphic genotypes of the p53 and Rb genes in Koreans to evaluate the possible involvement of these genotypes as a risk factor of lung cancer. METHODS: In this study 145 controls without previous and present tumor history and 128 lung cancer patients were subjected to analysis The two intragenic polymorphisms of the p53 gene(exon 4/AccII, intron 6/MspI) and one intron 17/XbaI polymorphism of the Rb gene were analysed by the method of polymersae chain react lion-restriction fragment length polymorphisms(PCR-RFLPS). The genotype of the intron 3/16 bp repeat polymorphism of p53 was determined by PCR and direct gel electrophoresis. RESULTS: There were no significant differences in the genotype distributions of the p53 gene between lung cart cert patients and controls. But heterozygotes(Arg/Pro) of the exon 4/AcclII polymorphisms were slightly over-represented than controls, especially in the Kreyberg type I cancer, which was known 13 be associated with smoking. The intron 3/16 bp duplication and the intron 6/MspI polymorphisms were in complete linkage disequilibrium. About 95% of the individuals were homozygotes of the common alleles both in the 16 duplication and MspI polymorphisms, and no differences were deteced in the genotype distributions between lung cancer patients and controls. Overall genotype distributions of the Rb gene polymorphisms between lung cancer patients and controls were not significantly different However, the genotype distributions in the Kreyberg type I cancer were significantly different from those of controls(p=0.0297) or adenocarcinomas(p=0.0008). It was noticeable that 73.4% of the patients with adenocarcinomas were heterozygotes(r1/r2) whereas 39.2% of the Kreyberg type I cancer were heterozygous at this polymorphisms. In the lung cancer patients, significant differences were a]so noted between the high dose smokers and low dose smokers including non-smokers(p=0.0258). The relative risk to Kreyberg type I cancer was significantly reduced in the individuals with the genotype of r1/r2(odds ratio=0.46, 95%C.I.=0.25-0.86, p=0.0124). The combined genotype distribution of the exon 4/AccII of the p53 and the intron 17 Rb gene polymorphisms in Kreyberg type I cancers were significantly different from dose of controls or adenocarcinomas. The highest odds ratio were observed in the individuals with the genotypes of Arg/pro and r2/r2(odds ratio=1.97, 95%C.I.=0.84-4.59) and lowest one was in the patients with Arg/Arg, r1/r2 genotype(odds ratio=0.54, 95%C.I.=0.25-1.14). CONCLUSION: The p53 and the Rb gene polymorphisms modulate the risk of smoking induced lung cancer development in Koreans. However, the exact mechanism of risk modulation by these polymorphism remains to be determined. For more discrete clarification of associations between specific genotypes and lung cancer risk, the evaluations of these polymorphisms in other ethnics and more number of patients will be needed.
Adenocarcinoma ; Alleles ; Cell Line ; Electrophoresis ; Exons ; Gene Frequency ; Genes, p53 ; Genes, Retinoblastoma ; Genes, Tumor Suppressor ; Genetic Predisposition to Disease ; Genotype ; Homozygote ; Humans ; Introns ; Linkage Disequilibrium ; Lung Neoplasms* ; Lung* ; Odds Ratio ; Polymerase Chain Reaction ; Risk Factors ; Smoke ; Smoking

OBJECTIVE: The aim of this study is to find out the genes which are related to ovarian cancer cell growth using large circular antisense library. METHODS: Clones for antisense library were uni-directionally sub-cloned into pBS SK (-) vector. LC-antisense molecules were then purified from the culture supernatants of the bacterial competent cells superinfected with M13K07 helper bacteriophages. The LC-antisense library to 240 unigene clone was constructed and utilized in the identification of genes functionally involved in the growth of ovarian cancer cells. RESULTS: The 17 numbers out of the 240 numbers of the antisense library exerted a marked inhibitory effect on the growth of SK-OV 3. CONCLUSION: The putative functional categorization of each gene was then conducted via public databases. These candidates may be used as target genes for drug development or adjuvant of conventional chemotherapeutic drugs.
Bacteriophages ; Clone Cells ; Estrone ; Gene Targeting ; Genetic Therapy ; Ovarian Neoplasms

Animals ; Horns ; Myelin Sheath ; Neurons ; Patch-Clamp Techniques ; Potassium ; Pronase ; Rats ; Sensation ; Sodium ; Thermolysin ; Trigeminal Nucleus, Spinal

PURPOSE: To evaluate the therapeutic effectiveness and useful as well as the ness, systemic effect andeffectiveness, of preoperative TACE when used in patients with unresectable or high risk hepatoblastoma. MATERIALS AND METHODS: We retrospectively evaluated four patients with pathologically proven hepatoblastoma. One was maleand three were female, and they were aged between 8 and 27 (mean, 15) months. All underwent selective hepaticangiography and chemoembolization after superselection of tumor feeding vessels. Cisplatin 90mg/m2 (50-80mg),adriamycine 40mg/m2 (20mg) and lipiodol suspension 4cc ere used and chemotherapeutic angents. Embolization wasthen performed, gelfoam particles. TACE was repeated at intervals of 3 weeks, and after the second episode, allpatients underwent hepatic resection. To evaluate changes in the size, volume, internal texture and margin of themass, as well as the systemic toxicity of chemotherapeutic drugs, we performed contrast-enhanced CT and checkedAFP, CBC and GOT/GPT before and after TACE. RESULTS: In all patients, TACE was successfully performed and majorproblems related to the procedure and toxicity of chemotherapeutic agents used were not noted. The largestdiameter and volume of tumors were reduced by 33% (from 8.3 to 5.6cm) and 69% respectively. Tumor necrosis wasevident in all patients. Lipiodol uptake by tumors was homogenous and tumors were well distinguished from normalparenchyma. Compared to pre-TACE, serum alpha-feto-protein was reduced from 994(range:615-1690ng/ml) to 46ng/ml(42-47ng/ml)after the second TACE, and six months after surgery was in the normal range(13ng/ml;3-23ng/ml).SGOT/SGPT levels were temporally elevated after TACE but normalized within a few weeks. CONCLUSION: TACE can be auseful technique for preoperative treatment of hepatoblestomas. In tomors which are high-risk or inoperable, thetherapeutio agents involved were not shown to be toxic.
Cisplatin ; Ethiodized Oil ; Female ; Gelatin Sponge, Absorbable ; Hepatoblastoma* ; Humans ; Necrosis ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: Many reports exist about the frequency of congenital heart disease (CHD) in the world, but according to the definition of CHD and subjects of study group, many differences existed between the reports. We conducted this study to evaluate the incidence and frequency of CHD by color Doppler echocardiography in neonate, and to suggest a preliminary model of incidence of neonatal CHD in Korea. METHODS: During July 1992 to June 1995, we conducted echocardiography in 285 babies who were suspected as having a CHD. RESULTS: Among the 16,672 neonate born alive at Dong San Hospital, 121 patients with CHD were identified by color Doppler echocardiography (7.26/1,000 live birth). The incidence of CHD of neonate born at our hospital were as follows: Among 121 cases, ventricualr septal defect 37.2%, atrial septal defect 17.4%, patent ductus arteriosus 12.4%, tetraology of Fallot 4.1%, transposition of great artery 4.1%. The incidence of CHD of neonate born at another hospital were as follow: Among 169 cases, ventricular septal defect 53.8%, atrial septal defect 14.2%, tetralogy of Fallot 7.7%. pulmonary stenosis 5.3%, transposition of great artery4.1%. The incidence of isolated ventricular septal defect were as follow: Perimembranous defect 79.4%, muscular defect 14.7%, subpulmonic defect 5.9%. CONCLUSION: In this study, the incidence of CHD was 7.26 per 1000 live births. The incidence of tetralogy of Fallot in neonate was less than that of in children. and among VSD, the incidence of muscular type was relatively high.
Arteries ; Child ; Ductus Arteriosus, Patent ; Echocardiography ; Echocardiography, Doppler, Color* ; Heart Defects, Congenital* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Incidence* ; Infant, Newborn* ; Korea ; Live Birth ; Pulmonary Valve Stenosis ; Tetralogy of Fallot