This study was conducted to investigate the safety of the umbilical venous blood for antologous transfusion in the premature newborn babies. Umbilical venous blood was collected with aseptic technique immediately after delivery from 270 healthy mothers admitted to the Yeungnam University Hospital between March 1,1992 and August 31,1992 . The volume of the blood and the time taken for collecting the blood were measured. Also the hematological and biochemical changes of the blood during storage in the refrigerator of blood band and the incidence of bacterial contamination were studied. It took 67.6+/-25.9 seconds on the average for collecting the blood from an umbilical vein and the average volume of the blood was 77.1+/-23.2ml which would be sufficient volume for one time transfusion of 10ml/kg of packed red blood cells for the neonates. The hemoglobin and hematocrit values did not change significantly during storage for three weeks. Thus significant hemolysis did not seem to occur during storage. However, platelet counts decreased significantly from 248+/-59x10E3/mm3 to 193+/-47x10E3/mm3(p<0.01). Although plasma calcium level was not changed (8.4+/-0.9mg/dL), sodium was decreased significantly from 184.3+/-11.1mEq/L to 170.9+/-13.9mEq/L(p<0.01) and potassium was incresed from 5.0+/-1.0mEq/L to 26.7+/-4.8mEp/L.(p<0.01). Plasma glucose level was decreased from 521.7+/-106.7mg/dL to 294.3+/-120.8mg/dL (p<0.01), blood pH and bicarbonate concentrations were decreased significantly from 6.825+/-0.110 to 6.378+/-.087 and from 13.5+/-1.6mEq/L to 2.1+/-1.0mEq/L respectively (p<0.01). The smear of the umbilical venous blood and peripheral blood of the neonates stained by KleihauerBetke method revealed no significant differences in the percentages of adult red blood cells. Also there were no differences in the percentages of adult ted blood calls in the umbilical venous blood samples according to time for collection. The degree of decrement of hemoglobins (1.2gm/dL) after delivery in the mothers who had sampling of the umbilical venous blood was not different from that in the mothers who didn't hava sampling. The bacterial contamination rate of the umbilical venous blood was 3.5% (95% confidence interval was from 0.7 to 6.3). It seems to be safe to use the umbilical venous blood in the neonates for autologous transfusion but confirmation of bacterial contamination by culture is necessary.
Adult ; Blood Glucose ; Calcium ; Erythrocytes ; Hematocrit ; Hemolysis ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Infant, Newborn* ; Mothers ; Plasma ; Platelet Count ; Potassium ; Sodium ; Umbilical Veins

No abstract available.
Child* ; Glomerulonephritis* ; Humans

Neonatal and obstetrical problems related to the low birth weight infants were evaluated by a retrospective review of the medical records of the 186 low birth weight infants born at Yeungnam University Hospital during 3 years and 8 months from May 1, 1983 to February 28, 1987. The results were as follows: 1. The incidence of the low birth weight infants was 4.98% among 3,803 live births. 2. Male to female ratio was 1.02:1. 3. The incidence of the low birth weight infants was lowest in mothers of 25 to 29 years, increased in mothers of 19 years of less and 30 to 39 years significantly. 4. There was no difference in the incidence of low birth weight infants between primiparous and multiparous mothers. 5. Common obstetrical complications associated with low weight infants were multiple pregnancy, toxemia and premature rupture of membrane in order of frequency. 6. Common neonatal problems in low birth weight infants were jaundice, idiopathic respiratory, distress syndrome, asphyxia and metabolic derangement such as hypocalcemia and hypoglycemia in order of frequency.
Asphyxia ; Clinical Study* ; Female ; Humans ; Hypocalcemia ; Hypoglycemia ; Incidence ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Jaundice ; Live Birth ; Male ; Medical Records ; Membranes ; Mothers ; Pregnancy ; Pregnancy, Multiple ; Retrospective Studies ; Rupture ; Toxemia

Peritoneal dialysis has been widely considered to be the dialytic treatment of choice for acute renal failure in infants and young children, because the technique is simple, safe and easily adapted for these patients. Also peritoneal dialysis in infants might have more effective ultrafiltration and clearance than in adults. In certain circumstances associated with hemodynamic instability, ordinary volume peritoneal dialysis (30-50 ml/kg body weight per exchange) or hemodialysis may not be suitable unfortunately. But frequent cycled, low volume, high concentration peritoneal dialysis may be more available to manage the acute renal failure of newborns and infants. Seven infants underwent peritoneal dialysis for hemodynamically unstable acute renal failure with low exchange volume (14.2±4.2 ml/kg), short exchange time (30 to 45 minutes) and hypertonic glucose solution (4.25% dextrose). Age was 1.9±1.3 months and body weight was 4.6±1.6 kg. Etiology of acute renal failure was secondary to sepsis with or without shock (5 cases) and postcardiac operation (2 cases). Catheter was inserted percutaneously with pigtail catheter or Tenkhoff catheter by Seldinger method. Dialysate was commercially obtained Peritosol which contained sodium, chloride, potassium, magnesium, lactate and calcium. Net ultrafiltration (ml/min) showed no difference between low volume dialysis and control (0.27±0.09 versus 0.29±0.09). Blood BUN decreased from 95.7±37.5 to 75.7±25.9 mg/dl and blood pH increased from 7.122±0.048 to 7.326±0.063 after 24 hours of peritoneal dialysis. We experienced hyperglycemia which were controlled by insulin (2 episodes), leakage at the exit site (2), mild hyponatremia (1) and Escherichia coli peritonitis (1). Two children of low volume dialysis died despite the treatment. In our experience, low volume and high concentration peritoneal dialysis with frequent exchange may have sufficient ultrafiltration and clearance without significant complications in the certain risked acute renal failure of infants.
Acute Kidney Injury ; Adult ; Body Weight ; Calcium ; Catheters ; Child ; Dialysis ; Escherichia coli ; Glucose Solution, Hypertonic ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Hyperglycemia ; Hyponatremia ; Infant* ; Infant, Newborn* ; Insulin ; Lactic Acid ; Magnesium ; Methods ; Peritoneal Dialysis* ; Peritonitis ; Potassium Chloride ; Renal Dialysis ; Sepsis ; Shock ; Sodium ; Ultrafiltration

To evaluate the meaning of anti-HCV detection in patients treated with IVIG, serum levels of aspartate aminotranstferase(AST), alanine aminotransterase(ALT), HCV Ab titer were measured after treatment with IVIG in 36 patients diagnised of Kawasaki disease or neonatal sepsis. Also polymerase chain reaction (PCR) for the detection of HCV was done in 8 patients with persistent HCV Ab positivity at 3 months after IVIG treatment. The results were as follows 1) HCV Ab was positive in all 36 patients at 1 week after IVIG treatment, but in only 8 cases it was positive at 3 months after IVIG treatment. 2) AST, ALT were elevated in 9 cases at 1 week after IVIG treatment, but they were normalized in all cases at 3 months after IVIG treatment. 3) PCR for the detection of HCV was done in 8 patients with persistent HCV Ab positivity at 3 months after IVIG treatment, but HCV was not isolated in any cases. These results suggested that detection of anti-HCV was merely transitory phenominon of HCV Ab transmission, did not show any evidence of HCV infection due to HCV transmission.
Alanine ; Aspartic Acid ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Mucocutaneous Lymph Node Syndrome ; Polymerase Chain Reaction ; Sepsis

The recent availability of recombinant human erythropoietin has opened new perspectives in the management of a variety of anemias. Clinical trials have been initiated in several countries using different approaches and methodology. We randomly assigned twelve premature infants(gestational age < 32 week) at high risk of requiring erythrocyte transfusion for anemia of prematurity with either subcutaneous recombinant human erythropoietin or a placebo. Treatment with rHuEPO was initiated at a dose of 100 units/kg day for 3 days a week. All patients were given supplemental oral iron therapy at a dose of 3 mg/kg per day, as tolerated and oral vitamin E at a dose of 25 units per day. Treated and control babies did not differ with respect to weight, hematocrit, overall mean reticulocyte count or rate of growth respectively. However, reticulocyte counts increased earlier in patients given rHuEPO. We conclude that rHuEPO administration is safe and feasible at the dose studied.
Anemia* ; Erythrocyte Transfusion ; Erythropoietin* ; Hematocrit ; Humans* ; Iron ; Pilot Projects* ; Reticulocyte Count ; Vitamin E ; Vitamins

No abstract available.
Syphilis, Congenital*

BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.
Acinetobacter baumannii* ; Acinetobacter* ; Anti-Bacterial Agents ; APACHE ; Diagnosis ; Humans ; Medical Records ; Mortality ; Pneumonia, Ventilator-Associated* ; Sulbactam*

No abstract available.
Carboxyhemoglobin* ; Humans ; Hyperbilirubinemia* ; Infant, Newborn*

PURPOSE: The ureteral stent is very effective for the drainage of urine and maintenance of renal function in patients with ureteral strictures. Retrograde ureteral stunting is a common procedure. However, there is a need for antegrade ureteral stunting with percutaneous nephrostomy in cases of severe ureteral strictures. In these cases, retrograde exchange of ureteral stent is very difficult. Hence, we tried an easier and more efficient exchanging method available in these cases and also assessed its clinical results. MATERIALS AND METHODS: We performed retrograde ureteral scent exchange In the patients using the following procedure. First, the distal tip of the previously Inserted ureteral stunt was pulled out 2cm beyond the external meatus. Second, a guide-wire was inserted into the scent through the hole upto the kidney and then the stunt was completely removed. Third, a cystoscopic sheath without obturator was introduced into the bladder passing over the guide-wire. Fourth, a new ureteral stent was introduced into the ureter over the guide-wire with pusher. RESULTS: We experienced successful exchange of ureteral steno 95 times on 9 ureters in 8 patients with severe ureteral strictures who had antegrade ureteral stenting performed. CONCLUSIONS: From these results, we conclude that this exchanging method is very safe and effective.
Constriction, Pathologic* ; Drainage ; Humans ; Kidney ; Nephrostomy, Percutaneous ; Stents* ; Ureter* ; Urinary Bladder