PURPOSE: This study was designed to examine the effects of adiponectin, leptin, insulin, insulin-like growth factor (IGF)-I and IGF binding protein (BP)-3 levels in cord blood on weight, length, and adiposity at birth in healthy term infants. In addition, we evaluated the mechanism to change the hormone levels in appropriate for gestational age (AGA) during the first month. METHODS: We collected cord blood from 200 term neonates (109 males, 91 females) with no perinatal problems, and measured the hormone levels and anthropometric parameters including weight, length, and skin-fold thickness. Term neonates were divided into 3 groups as follows: birth weight appropriate for gestational age (AGA) (n=132), birth weight less for gestational age (SGA) (n=29), and birth weight more for gestational age (LGA) (n=39). Venous blood samples of 15 fullterm healthy neonates were obtained at 3, 7, and 30 d after birth. RESULTS: The adiponectin, insulin, and IGF-I levels were significantly lower in the SGA group than in the AGA and LGA groups. The leptin levels were significantly higher in the LGA group than in the AGA and SGA groups. Cord blood adiponectin, leptin, insulin, IGF-I, and IGFBP-3 levels correlated significantly and positively with birth weight and the sum of the skin-fold thickness. A significant positive correlation was observed between adiponectin, leptin, and IGF-I levels and birth weight. Adiponectin level correlated significantly with that leptin level (r=0.191, P=0.038), but not with insulin, IGF-I and IGFBP-3 levels. IGF-I levels were higher in females than in males. At 7 d after birth, the leptin level decreased along with physiologic weight loss, and then increased. IGF-I, also decreased at 3 d, significantly increased 1 month later. CONCLUSION: We suggest that adiponectin, leptin, insulin, IGF-I, and IGFBP-3 play an important role in regulating fetal growth. Adiponectin may be involved in regulating fetal growth through mechanisms different from those mediated by insulin or IGF-I. High levels of IGF-I in female neonates indicates a gender difference which serves as evidence for in utero sexual dimorphism. It is likely that IGF-I has a more important role than that of hormones in postnatal growth.
Adiponectin ; Adiposity ; Birth Weight ; Carrier Proteins ; Female ; Fetal Blood ; Fetal Development ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Insulin ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Leptin ; Male ; Parturition ; Weight Loss

Insertion of intravascular catheters may be the most common procedure in neonatal intensive care units. One of these kinds of catheters, umbilical venous catheter is generally used for the small and sick neonates. But the indwelling umbilical venous catheter can cause many complications. The most common complication is thrombus formation in the lumen of the catheter. Neonatal thrombosis has symptomatic or asymptomatic clinical manifestations, which may have serious complications in case of intracardiac thrombosis. In our experience, the infant who has no symptom of thrombosis was treated with low dose aspirin and warfarin for right atrium thrombosis caused by umbilical venous catheterization. So, we report a case of right atrium thrombosis following umbilical catheterization in neonatal intensive care units.
Aspirin ; Catheterization* ; Catheters* ; Heart Atria* ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Neonatal ; Thrombosis* ; Warfarin

Intussusception is the most common cause of intestinal obstruction between 5 month and 11 month of age. However, it is very rare in neonatal period and only 1% incidence was reported. It is exceedingly rare among preterm infants and the signs are similar to those of necrotizing enterocolitis (NEC). So the time from onset of symptoms to diagnosis may be prolonged. The authors report a case of intussusception in very low birth weight infant born at 28 weeks of gestation diagnosed after exploratory laparotomy.
Diagnosis ; Enterocolitis, Necrotizing ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight* ; Intestinal Obstruction ; Intussusception* ; Laparotomy* ; Pregnancy

PURPOSE: Microbial colonization of the intestine begins just after birth and development of the normal flora is a gradual process. The first bacteria colonizing the intestine in newborns are Staphylococcus, Enterobacteriaceae and Streptococcus. For several days after birth, the number of Bifidobacterium spp. increase. The aim of this study was to investigate the changes of microflora for seven days postnatally in neonatal stool. METHODS: Fifteen neonates (breast : formula : mixed feeding 1 : 8 : 6, vaginal delivery : cesarean section 3 : 12) who were born at the Kangdong Sacred Heart Hospital, Hallym University were enrolled. First meconium and stools of postnatal 1-, 3-, and 7-day were innoculated. Blood agar plates for total aerobes, trypton bile X-glucuronide agar for E. coli, phenylethyl alcohol agar for gram positive anaerobes, MRS agar for Lactobacillus spp., bifidobacterium selective agar for Bifidobacterium spp. and cefoxitin-cycloserine-fructose agar for Clostridium difficile were used in the general incubator (CO2 free incubator), CO2 incubator or the anaerobic chamber for 48 or 72 hours at 37oC and then colony forming units were counted. RESULTS: No microflora was identified in the first meconium. Total aerobes, E. coli, and gram positive anaerobes were significantly increased with advancing postnatal days. In only one baby, Lactobacillus acidophilus was detected 2x105 CFU/g in the seven-day stool. Bifidobacterium spp. was detected in two babies. Clostridium difficile was not detected during the seven days. There were no significant differences in the bowel flora depending on the delivery pattern and feeding method. CONCLUSION: This study shows many changes in the intestinal normal flora in neonatal stool during seven days postnatally. If these findings are confirmed with larger studies, the data may be preliminary findings to support use of probiotics in neonates.
Agar ; Bacteria ; Bifidobacterium ; Bile ; Cesarean Section ; Clostridium difficile ; Colon ; Enterobacteriaceae ; Feeding Methods ; Female ; Heart ; Humans ; Incubators ; Infant, Newborn* ; Intestines ; Lactobacillus ; Lactobacillus acidophilus ; Meconium ; Parturition ; Phenylethyl Alcohol ; Pregnancy ; Probiotics ; Staphylococcus ; Stem Cells ; Streptococcus

Chromosome 7q deletion, relatively rare syndrome, was first described by de Grouchy in 1969. The most frequent clinical manifestations of a "7q deletion syndrome" include; low birth weight, postnatal growth retardation, mental retardation, developmental delay, microcephaly, congenital heart disease, hypotonia, bulbous nasal tip and abnormal ears. We report a case of 7q deletion syndrome with microcephaly, upslanting palpabral fissure, micrognathia, bulbous nasal tip, developmental delay and hydronephrosis.
Ear ; Heart Defects, Congenital ; Humans ; Hydronephrosis* ; Infant, Low Birth Weight ; Infant, Newborn ; Intellectual Disability ; Microcephaly ; Muscle Hypotonia

PURPOSE: GnRH stimulation test is golden standard for the diagnosis of central precocious puberty as well as evaluation of treatment, however, it is more expensive and inconvenient. This is the reason why many other tests have been suggested. We studied the efficacy of modified puberty suppression score by single blood sample for evaluation of GnRH agonist treatment in central precocious puberty. METHODS: Twenty-four girls (age, 9.56+/-1.56 years) diagnosed with early puberty or precocious puberty at Kangdong Sacred Heart Hospital from March 2002 to May 2005 were included in this study. All of patients were treated with leuprorelin acetate (83.66-115.12 microgram/kg). Total 24 patients including 11 suppression and 13 non-suppression cases were analyzed. The serum levels of LH, FSH, estradiol and progesterone were measured before and 8 weeks after treatment. The height, weight, bone age and Tanner stage of breast development in each patient were also measured before and 12 weeks after treatment. We modified puberty suppression score by Mul et al. in 1999. We defined scores based on statistical significance - estradiol, 2 points (>=1.36 ng/dL), progesterone, 2 points (>=0.31 ng/dL), LH, 1 point (>=2.0 IU/L), delta BA/delta CA, 1 point (>=0), delta HtSDS, 1 point (>=0.25/6 mo). Total score is 7 points and we defined suppression is less than 3 points. RESULTS: The serum levels of estradiol (<1.36 ng/dL, P=0.000) and progesterone (<0.31 ng/dL, P= 0.003) are significantly lower in suppression group than nonsuppression group. If the score according to modified puberty suppression score (MPSS) is less than 3 points, which is considered as a successful suppression by GnRH agonist. The sensitivity, specificity, positive predictive value and negative predictive value of MPSS are 100%, 92.8%, 90.9% and 100% respectively. CONCLUSION: Single blood sample is simpler and easier than GnRH stimulation test for the evaluation and monitoring of GnRH agonist treatment in central precocious puberty and MPSS by single blood sample may be useful in outpatient clinic.
Adolescent ; Ambulatory Care Facilities ; Breast ; Diagnosis ; Estradiol ; Female ; Gonadotropin-Releasing Hormone* ; Heart ; Humans ; Leuprolide ; Progesterone ; Puberty* ; Puberty, Precocious* ; Sensitivity and Specificity

PURPOSE: Type 2 diabetes mellitus, dyslipidemia, hypertension, cardiovascular disease, called metabolic syndrome (MS), occur more frequently among individuals who were born small for gestational age (SGA). SGA children with catch-up growth in height and high BMI are the most insulin resistant. We investigated the prevalence of MS and evaluated the risk factors affecting the development of MS in children and adolescents born SGA. METHODS: The study population (n=65) were born less than 10th percentile in body weight for their gestational age and the body weights of the control group (n=34) were more than 10th percentile at birth. The SGA and control subjects divided into prepubertal and pubertal groups. We measured serum lipid levels (total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol), fasting sugar levels and insulin levels. Insulin resistance was determined by homeostasis model assessment, fasting insulin glucose ratio and quantitative insulin sensitivity check index. RESULTS: Systolic blood pressure was significantly higher in the pubertal SGA group than in the control group (113.2+/-0.3 vs. 98.7+/-6.4, P=0.001). The prevalence of high triglyceride and high fasting glucose levels were significantly increased in pubertal SGA group than prepubertal SGA group (P<0.05). Insulin resistance was correlated to systolic blood pressure, triglyceride levels, HDL-cholesterol levels, fasting glucose, insulin levels at fasting and 2 hours after oral glucose tolerance test and body fat mass in SGA group (P<0.05). CONCLUSION: We suggest that the monitoring of these risk factors including systolic blood pressure, triglyceride, HDL-cholesterol levels and body fat mass is important for the prevention of MS in children and adolescents born SGA.
Adipose Tissue ; Adolescent* ; Blood Pressure ; Body Weight ; Cardiovascular Diseases ; Child* ; Cholesterol ; Cholesterol, HDL ; Diabetes Mellitus, Type 2 ; Dyslipidemias ; Fasting ; Gestational Age* ; Glucose ; Glucose Tolerance Test ; Homeostasis ; Humans ; Hypertension ; Insulin ; Insulin Resistance ; Parturition ; Prevalence* ; Risk Factors ; Triglycerides

Candida albicans endocarditis is an uncommon manifestation of systemic candidiasis in newborn infants who require intensive care and develops mostly in patients with congenital heart disease; open heart surgery is the majority of predisposing factor. Improvement of techniques managing premature infants leads to increased survival rates, which give much more chances to develop fungal infections and its complications. We report a case of very low birth weight infant who had candidemia and Candida endocarditis, who was successfully treated with AmBisome(R) because of no response to conventional amphotericin B therapy.
Amphotericin B* ; Candida albicans* ; Candida* ; Candidemia ; Candidiasis ; Causality ; Endocarditis* ; Heart Defects, Congenital ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight* ; Critical Care ; Survival Rate ; Thoracic Surgery

OBJECTIVES: A study was to assess the prognostic significance of ascitic anti-p53 autoantibodies in patients with advanced ovarian carcinoma. METHODS: Retrospective study was peformed in 43 ovarian carcinoma patients who presented with a significant amount of ascites at the Department of Obstetrics and Gynecology in Hanyang University Hospital between 1991 to 2000. p53 autoantibodies were determined by highly specific enzyme-linked immunosorbant assay (p53-Autoantibody ELISAplus, CAT QI A53, A CN Bioscience Company, Boston). The 'positive' and 'negative' group were categorized on the basis of the presence of anti-p53 autoantibodies. The clinicopathologic characteristics, disease free survival and overall survival rate in each groups were compared. Statistical analysis was performed by X2 and independent sample t-test. RESULT: Ascitic anti-p53 autoantibodies were found in 16% (7/43) of the study patients. The positive rates were revealed as follows : serous 15% (2/13), mucinous 11% (2/17), undifferentiated, 42% (3/7) in histologic type ; stage I/II5% (1/21), III/IV 27% (6/16); grade I/II12% (3/26), III 24% (4/17). There was no correlation between clinicopathologic characteristics and the presence of ascitic anti-p53 autoantibodies except the stage of disease. The overall survival rate revealed no significant statistical meaning (20.0 vs 35.7 months, p=0.492). In contrast, disease free survival rate was decreased in positive group. (10.0 vs 24.7 months, p=0.032). A significance association was observed between presence of ascitic anti-p53 autoantibody and response to chemotherapy. Ascitic anti-p53 autoantibodies were detected in only 3 (16%) of 18 patients who achieved pathological partial and complete response, but it was detected in 3 (75%) of 4 patients who did not respond to chemotherapy (p=0.046). CONCLUSION: The presence of p53 autoantibodies in ascites is tend to be associated with advanced stage and poorly differentiated group. A significant correlation was observed between presence of ascitic p53 autoantibodies and decrease in disease free survival rate suggesting that it is related to poor prognosis. Moreover, presence of ascitic p53 autoantibodies was also related to chemoresistance. But since this study is retrospective and based on very limited case, further study is warranted to be performed prospectively and based on larger number of study group.
Animals ; Ascites ; Autoantibodies* ; Cats ; Disease-Free Survival ; Drug Therapy ; Gynecology ; Humans ; Mucins ; Obstetrics ; Prognosis ; Qi ; Retrospective Studies ; Survival Rate

PURPOSE: Staphylococcus aureus and its exotoxins have been regarded as having an influence on atopic dermatitis(AD). We aimed to examine the prevalence of S. aureus in the AD lesion, the types of the exotoxins, and the relationship between S. aureus and AD. METHODS: AD patients(n=32) and a normal control group(n=20) were enrolled. The severity of AD was measured by SCORAD index. Through skin culture and PCR, we tried to identify S. aureus and its exotoxins. RESULTS: S. aureus was isolated from 18(56 percent) out of 32 AD patients and its exotoxins were identified from 10(31 percent) out of them. The exotoxin types were as follows; sea in 4, eta in 3, sea+tst-1 in 1, sea+see in 2 patients. On the contrary, S. aureus was isolated from only 1(5 percent) out of 20 subjects of the normal control group, and its exotoxin type was sea. The SCORAD index in the S. aureus(+) group was higher than in the S. aureus(-) group, however it was not significant.(44+/-14.2 vs 38+/-17.1, P= 0.304) The SCORAD index was higher in the exotoxin(+) group than in the exotoxin(-) group(49+/-11.2 vs 38+/-16.2, P<0.05). The prevalence of S. aureus and its exotoxins in the AD group was higher than in the normal control group(P<0.001, P<0.05, respectively). The difference of SCORAD index was significant between the exotoxin(+) group and the exotoxin(-) group, but not between the S. aureus(+) group and S. aureus(-) group.(P<0.05, P= 0.304, respectively) CONCLUSION: The exotoxins of S. aureus were found to influence the severity of AD.
Dermatitis, Atopic* ; Exotoxins* ; Humans ; Polymerase Chain Reaction ; Prevalence ; Skin ; Staphylococcus aureus* ; Staphylococcus*