No abstract available.
Humans ; Infant, Newborn* ; Microbubbles*

No abstract available.
Colloid Cysts* ; Colloids* ; Lateral Ventricles*

No abstract available.
Humans ; Infant, Newborn* ; Phototherapy* ; Riboflavin*

No abstract available.
Humans ; Infant, Newborn*

No abstract available.
Humans ; Infant, Newborn*

No abstract available.
Acantholysis* ; Captopril* ; Penicillamine* ; Rifampin* ; Skin*

PURPOSE: This study is designed to find out the clinical characteristics, growth status, and response to growth hormone treatment in children with organic growth hormone deficiency(GHD) after treatment of brain tumors. METHODS: Fifty-three children with organic GHD were evaluated for pituitary function, serum insulin-like growth factor-1(IGF-1), and insulin-like growth factor binding protein-3(IGFBP-3) concentrations. We also observed their growth status and corresponding change with or without growth hormone treatment. RESULTS: The causes of organic GHD were craniopharyngioma(47%), germinoma (19%), and medulloblastoma(17%), and 18 children(35%), diagnosed with brain tumors, presented with symptoms suggesting hormonal deficit. Initial height was -2.5+/-.2 SDS in craniopharyngioma, -1.7+/-.1 SDS in germinoma, and -2.1+/-.6 SDS in medulloblastoma, and children with craniopharyngioma showed the highest obesity rate, at 21.4+/-9.3%. After treatment for brain tumors, children with craniopharyngioma had the lowest values of peak GH, IGF-1, and IGFBP-3 concentrations, which were 1.1+/-.3 ng/mL, 74.1+/-6.6 ng/mL(-1.7+/-.2 SDS), and 1.9+/-.0 mg/L(-2.0+/-.1 SDS) respectively. The numbers of deficient hormones increased from 2.4+/-.1 to 3.2+/-.2 after treatment of brain tumors(P<0.05). Nine children showed normal or accelerated growth velocity(growth velocity 7.0+/-.8 cm/yr) without GH replacement and they had higher body mass index(BMI), IGF-1 concentrations, and IGFBP-3 SDS(P<0.05) compared to the others(growth velocity 1.9+/-.9 cm/yr). Height SDS increased every year during the first three years of GH treatment(P<0.05), 0.5+/-.4 SDS(n=20) for the first year, 0.4+/-.4 SDS(n=14) for the second, and 0.3+/-.5 SDS(n=11) for the third, and it increased by 1.1+/-.9 SDS(n=11) in total. CONCLUSION: The numbers of deficient pituitary hormones were increased after operation, irradiation, and/or chemotherapy. Children with GHD showed good response to GH replacement. Some children grew normally in spite of growth hormone deficiency, and their BMI, serum levels of IGF-1 and IGFBP-3 SDS were increased compared to those of the decreased growth group. This study suggests that further studies are needed to determine the mechanism of growth with low GH concentrations.
Brain Neoplasms* ; Brain* ; Child* ; Craniopharyngioma ; Drug Therapy ; Germinoma ; Growth Hormone* ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Medulloblastoma ; Obesity ; Pituitary Hormones

The fetal hemoglobin, which is structurally different from adult hemoglobin, has higher affinity for oxygen and higher resistance to denaturation with alkali than adult hemoglobin. Intrauterine growth retarded neonates have higher mortality and morbidity than normal neonates. In this article, to determine the changes of fetal hemoglobin by gestational age in infants appropriate in weight for gestational age (AGA)and to explain the mechanism underlying the increased fetal hemoglobin synthesis in intrauterine growth retarded newborn infants, the proportion of fetal hemoglobin and adult hemoglobin at birth and 1 month of age was checked in 25term infants small for gestational age(TSGA). The results were compared with 50 preterm infants appropriate in weight for gestational age (paga) and 40 term infants appropriate in weight for gestational age (TAGA). The results were as forllows. 1)The decrease of fetal hemoglobin by gestational age in infants of AGA at birth was statistically significant (p<0.01). 2) The fetal hemoglobin at birth was 74.47+/-2.4%n the TSGA group, 78.01+/-5.05% in the PAGA group and 68.32+/-4.84% in the TAGA group. The differnce between each group was statistically significant (p<0.01). 3) The fetal hemoglobin at one month of age was 55.68+/-3.76% in the TSGA group, 35.74 (13.33%in the PAGA group and 59.96+/-5.53% in the TAGA group. The difference between TSGA and TAGA infants was not significant (p>0.05). 4) The decrese rate of fetal hemoglobin between first day and one month of postantal age was 54.2% in the PAGA infants, 25.2% in the TSGA infants and 12.2% in the TAGA infants. 5) The fetal hemoglobin at forty weeks of postconceptional age was 13.20+/-5.09%in the transfused PAGA group, 62.34+/-3.01% in the nontransfused PAGA group, 64.08+/-2.08% in the TSGA group and 68.32+/-4.12% in the TAGA infants. The difference between transfused PAGA group and other groups was statistically significant (p<0.05).
Adult ; Alkalies ; Fetal Hemoglobin* ; Gestational Age* ; Humans ; Infant ; Infant, Newborn* ; Infant, Premature ; Mortality ; Oxygen ; Parturition

PURPOSE: Retinopathy of prematurity (ROP) is a disorder of developing retinal blood vessels in extremely premature infants. In the 1950's, the relationship of ROP and prolonged administraion of oxygen was demonstrated by many randomized clinical trials. After than, Oxygen use was severely restricted and the incidence of ROP was decreased. However, with the development of modern intensive care, ventilator, artificial surfactant, and other technology, the survival of extremely premature infants and incidence of ROP are increasing So we studied the time of development and risk factors of ROP. We also studied to decide the optimal time of mass screening in the preterm infants. METHODS: We studied 436 infants who was admitted in NICU of Ewha Womans Uninvesity Hospital for the treatment of RDS, prematurity or other reasons. They were examined by indirect opthalmoscope to schedule. RESULTS: 1) Among 436 infants, 49 infants (11.2%) were diagnosed as a retinopathy of prematurity. 2) The indicence of ROP increased with small gestational ages and low birth weights and the mean gestational age in the group of ROP was 30.9+/-4.0weeks and mean birth weight was 1450+/-352gms. 3) Mean age of first diagnosing time was 5.6 weeks after birth and the range of distribution was very wide. But mean age of first diagnosing time in gestational age was 36.3 weeks and it's range was narrow 4) The risk factors of ROP were prolonged use of oxygen, high concentration of oxygen with ventilator, frequent apnea, sepsis, hyaline membrane disease, bronchopulmonary dysplasia, the use of xanthine derivatives, phototherapy over than 1 week, surfactant treatment, perinatal asphyxia. CONCLUSION: Retinopathy of prematurity has a relationship with small gestational period, low birth weights, long duration of high oxygen, and other risk factors. The optimal period of mass screening in preterm infants for ROP is from 33 weeks to 36 weeks gestational age rather than chronological age after birth.
Apnea ; Appointments and Schedules ; Asphyxia ; Birth Weight ; Bronchopulmonary Dysplasia ; Female ; Gestational Age ; Humans ; Hyaline Membrane Disease ; Incidence ; Infant ; Infant, Extremely Premature ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Critical Care ; Mass Screening ; Oxygen ; Parturition ; Phototherapy ; Retinal Vessels ; Retinopathy of Prematurity* ; Risk Factors* ; Sepsis ; Ventilators, Mechanical ; Xanthine

PURPOSE: Adults with GH deficiency(GHD) have abnormal body composition, reduced physical performance, altered lipid metabolism, increased cardiovascular diseases, and reduced quality of life. Administration of GH to these patients reduce clinical abnormalities to normal ranges. Therefore, patients with childhood-onset GHD might need to continue GH replacement after the attainment of final height. Recently studies have shown that a high proportion of patients with childhood-onset GHD are no longer GHD when retested at young adult. METHODS: GH secretion was reevaluated with insulin and clonidine after completion of GH treatment in 29 young adult patients(21.3+/-2.8 yrs, 17 men, 12 women) with childhood-onset GHD diagnosed at a mean age of 11.4+/-3.5 yr. The mean duration of GH treatment was 3.7+/-3.0 yrs. Eleven(11 men) with idiopathic patients presented in 2(18%) isolated GHD and 9(82%) in multiple pituitary hormonal deficiencies. Eighteen(6 men, 12 women) with organic patients presented in 4(22%) isolated GHD and 14(88%) in multiple pituitary hormomal deficiencies, which was caused from craniopharyngioma, germinoma & other lesions. Blood sampling were done as usual method for checking LH, FSH and TSH concentration after injection of gonadotropin releasing hormone & thyrotropin releasing hormone. Serum cortisol levels were also checked after insulin injection and all hormonal concentrations were measured with radioimmunoassay method. Total cholesterol, high density lipoprotein (HDL)-cholesterol, low density lipoprotein(LDL)-cholesterol concentrations were measured by standard techniques. Bone density was measured in the level of lumbar spine and femur with DEXA. M-mode, two-dimensional and pulsed Doppler echocardiographic studies were performed. Quality of life was assessed from Beck depression inventory questionnaire with age-matched control. RESULTS: All patients with idiopathic and organic GHD were confirmed as GHD through combined pituitary function retesting at young adult. The additional pituitary hormonal deficiencies were increased in numbers. Their total cholesterol and triglyceride levels were increased especially in patients with organic GHD. There were no specific abnormal findings in echocardiographic findings compared to normal reference. Bone density with DEXA showed osteopenia(T score <-1) was found in 20/24(83%) and osteoporosis(T score <-2.5) in 8/24(33%) in young adult GHD. Quality of life was evaluated with BDI questionnaire and showed mild depression in 32% and moderate to severe depression in 11%. CONCLUSION: 82% of patients with idiopathic and 88% of organic GHD have additional pituitary hormonal deficiencies in childhood, showing multiple pituitary hormonal deficiencies rather than isolated GHD and has GHD permanently in all young adults with idiopathic and organic GHD and that is a little different findings from other foreign reports and needs to follow up in future.
Adult ; Body Composition ; Bone Density ; Cardiovascular Diseases ; Cholesterol ; Clonidine ; Craniopharyngioma ; Depression ; Echocardiography ; Femur ; Germinoma ; Gonadotropin-Releasing Hormone ; Humans ; Hydrocortisone ; Insulin ; Lipid Metabolism ; Lipoproteins ; Male ; Quality of Life ; Surveys and Questionnaires ; Radioimmunoassay ; Reference Values ; Spine ; Thyrotropin-Releasing Hormone ; Triglycerides ; Young Adult*