PURPOSE: The neuophils contribute as an important defence mechanism against bacterial infection. In neonates with infection, not only the number of neutrophils are decreased due to inhibited production but also phagocytic function is impaired resulting in high mortality rate. The purpose of this study is to establish the effectiveness of exogenous granulocyte-macrophage colony-stimulating factor (GM-CSF) in infected neonates by comparing the serum levels of GM-CSF and various hematologic paratmeters in non-infected and infected neonates. METHODS: The study included 50 neonates without infection and 23 neonates with infection who were admitted to neonatal intensive care unit of Chungnam National University Hospital in between May 1998 and February 1999. The total number of white blood cell (WBC) counts, absolute granulocyte counts (AGC) and the serum GM-CSF concentration at birth were measured in non-infected neonates and they were stratified according to birth weight and gestational age. The total number of WBC counts, AGC and the serum GM-CSF concentration at postnatal 7th and 14th day were measured and compared with that of infected neonate's. Neonates with infection were divided either to receive exogenous GM-CSF & antibiotics or antibiotics only; The total number of WBC counts, AGC and the serum GM-CSF concentration at post-treatment 2nd and 7th day were measured and compared. RESULTS: Decreased total number of WBC counts, AGC and the serum GM-CSF concentration at birth were observed with lower birth weight and gestational age. In infected neonates, the total number of WBC counts, AGC and the serum GM-CSF concentration increased more when compared with that of non-infected neonates. Tendency towards increased total number of WBC counts, AGC and the serum GM-CSF concentration were observed after exogenous GM-CSF treatment. CONCLUSION: We recommend the use of GM-CSF in neonates with infection, especially those without increasing total WBC counts, and absolute granulocyte count as a norrnal physiological response.
Anti-Bacterial Agents ; Bacterial Infections ; Birth Weight ; Chungcheongnam-do ; Gestational Age ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes* ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Leukocytes ; Macrophages* ; Mortality ; Neutrophils ; Parturition

Neonatal hydrocolpos is a rare condition that involves fluid accumulation in the vagina. On diagnostic imaging, the dilated vagina, along with the compressed uterus, can simulate a mature cystic teratoma with a mural nodule. Herein, we report the case of a newborn girl with congenital hydrocolpos that was caused by an imperforate hymen; the hydrocolpos mimicking a mature cystic teratoma on abdominal ultrasonography and magnetic resonance imaging. Any newborn girl with a pelvic cystic mass should be suspected as having a congenital vaginal obstruction manifesting as hydrocolpos or hydrometrocolpos. Thorough examination of the external genitalia, as well as imaging of the uterus and vagina, enables correct diagnosis and optimal treatment.
Diagnosis ; Diagnostic Imaging ; Female ; Genitalia ; Humans ; Hydrocolpos* ; Hymen ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging ; Pelvis* ; Teratoma* ; Ultrasonography ; Uterus ; Vagina

PURPOSE: It has been reported that patients with nephrotic syndrome have high serum IgE value and IL-4 involve in IgE synthesis, IL-6 is an autocrine growth factor for the proliferation of mesangial cells. We studied association between serum cytokines and of nephrotic syndrome. METHODS: We measured serum IL-6, IL-4, IFN-Y, CD23 in 14 children with nephrotic syndrome and 3 healthy children by ELISA. And we also measured serum IgG, IgA, IgM and IgE in 14 children with nephrotic syndrome. RESULTS: 1) The serum IL-4 and CD23 levels of nephrotic syndrome were significantly higher than that of control (P<0.01, P<0.05 respectively). 2) There were no differences in serum IL-6 and IFN-Y levels between control and nephrotic syndrome. 3) The serum value of IgG in nephrotic syndrome were more decreased than that in control group. 4) The serum value of IgE in nephrotic syndrome were more increased than that in control group. 5) There was no differences in the serum values of IgA and IgM between nephrotic syndrome and control group. CONCLUSIONS: The children with nephrotic syndrome had higher serum IL-4, CD23, IgE level than healthy children. In conclusion, nephrotic syndrome is highly associated with the cytokines. I expect that the further study of cytokines in nephrotic syndrome is useful for treatment and prediction of prognosis of nephrotic syndrome.
Child ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Interleukin-4 ; Interleukin-6 ; Mesangial Cells ; Nephrotic Syndrome* ; Prognosis

PURPOSE: It has been reported that patients with nephrotic syndrome have high serum IgE value and IL-4 involve in IgE synthesis, IL-6 is an autocrine growth factor for the proliferation of mesangial cells. We studied association between serum cytokines and of nephrotic syndrome. METHODS: We measured serum IL-6, IL-4, IFN-Y, CD23 in 14 children with nephrotic syndrome and 3 healthy children by ELISA. And we also measured serum IgG, IgA, IgM and IgE in 14 children with nephrotic syndrome. RESULTS: 1) The serum IL-4 and CD23 levels of nephrotic syndrome were significantly higher than that of control (P<0.01, P<0.05 respectively). 2) There were no differences in serum IL-6 and IFN-Y levels between control and nephrotic syndrome. 3) The serum value of IgG in nephrotic syndrome were more decreased than that in control group. 4) The serum value of IgE in nephrotic syndrome were more increased than that in control group. 5) There was no differences in the serum values of IgA and IgM between nephrotic syndrome and control group. CONCLUSIONS: The children with nephrotic syndrome had higher serum IL-4, CD23, IgE level than healthy children. In conclusion, nephrotic syndrome is highly associated with the cytokines. I expect that the further study of cytokines in nephrotic syndrome is useful for treatment and prediction of prognosis of nephrotic syndrome.
Child ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Interleukin-4 ; Interleukin-6 ; Mesangial Cells ; Nephrotic Syndrome* ; Prognosis

PURPOSE: We compared the hematologic data, serum biochemical and immunoglobulin values at 1 month of age and anthropometric variables at 1, 4, and 6 months of age between breast-fed and formula-fed infants. METHODS: Healthy full-term infants whose parents agreed with our study were enrolled. The hematologic and serum biochemical and immunoglobulin values were measured at birth and at 1 month of age. Anthropometric variables were measured at birth and 1, 4, and 6 months of age. RESULTS: In general, the hematologic and serum biochemical and immunoglobulin values were not different at 1 month of age between breast-fed and formula-fed infants. And there were no differences in growth between breast-fed and formula-fed infants from 0 to 6 months. CONCLUSION: There were no differences in growth and almost same values of hematology, serum biochemistry, immunoglobulin between breast-fed and formula-fed infants.
Biochemistry ; Hematology ; Humans ; Immunoglobulins ; Infant* ; Parents ; Parturition

Gardnerella vaginalis is a normal component of the vaginal flora and is one of the organisms associated with bacterial vaginosis. It is rarely involved in neonatal infection. Although it is possible that G. vaginalis plays an etiologic role in bacteremia, facial cellulitis and abscess, conjunctivitis, infected cephalhematoma, scalp abscess, respiratory disease and meningitis in newborns, G. vaginalis is an uncommon pathogen of neonatal sepsis and meningitis. We report a 3,830 g term neonate with sepsis and meningitis due to G. vaginalis and review the characteristics of neonatal G. vaginalis infection reported in the literatures.
Abscess ; Bacteremia ; Cellulitis ; Conjunctivitis ; Gardnerella vaginalis* ; Gardnerella* ; Humans ; Infant, Newborn ; Meningitis* ; Scalp ; Sepsis* ; Vaginosis, Bacterial

PURPOSE: The most important management of congenital hydronephrosis consists of the early diagnosis and evaluation of the pathologic abnormalities of congenital hydronephrosis. This study was conducted to investigate the different causes of hydronephrosis and its clinical outcome. METHODS: 54 live neonates who were hospitalized and diagnosed with congenital hydronephrosis at Chungnam National University Hospital from Aug. 1998 to Aug. 2003 were retrospectively analyzed. RESULTS: Hydronephrosis(renal pelvic AP diameter >5 mm) was postnatally detected in 54 cases(2.1%) among 2,539 neonates who were hospitalized from Aug. 1998 to Aug. 2003. There were three times more males than females. Additional imaging studies revealed that ureteropelvic junction obstruction was the most common postnatal diagnosis(48.7%), followed by multicystic dysplastic kidney, vesicoureteral reflux and duplication kidney with ureterocele. Spontaneous regression of hydronephrosis was revealed in 25 renal units(75.8%) of mild hydronephrosis, 14 renal units of moderate hydronephrosis and 1 renal unit of severe hydronephrosis. Operative correction were carried out in 14 renal units(70%) of severe hydronephrosis. CONCLUSION: The most common established cause of congenital hydronephrosis in this study was ureteropelvic junction obstruction. There are many cases of spontaneous regression in mild to moderate congenital hydronephrosis. Urinary tract infections occur in many neonates with hydronephrosis. Therefore, early detection and evaluation of congenital hydronephrosis and continuous follow-up at regular intervals are necessary for conservation of renal function.
Chungcheongnam-do ; Early Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis* ; Infant, Newborn ; Kidney ; Male ; Multicystic Dysplastic Kidney ; Retrospective Studies ; Ureterocele ; Urinary Tract Infections ; Vesico-Ureteral Reflux

PURPOSE: This study was designed to compare the follow up results with clinical and laboratory findings in patients with seizures in the neonatal period. Also, it was aimed to evaluate the usefulness of scoring prognostic factors and its efficacy as a prognostic index. METHODS: The subjects are 67 neonates who were admitted to Chungnam National University Hospital from January 1999 to April 2005 for seizures which occurred within 28 days of birth. These patients were investigated retrospectively from the hospital records. We scored clinical manifestations including gestational age, birth weight, Apgar score at 5 min, etiology, type, onset, duration, and frequency of seizures, neurologic examination results, EEG background activities, and treatment responses. Follow-up examinations were done to analyze the presence of epilepsy and neurologic deficits. A sum of the factors associated with outcomes regarded as a prognostic index, were studied. RESULTS: 50 cases(74.6%) showed normal outcomes, while 7 cases(10.4%) had unfavorable neurologic outcomes and 4 cases(6.0%) favorable neurologic outcomes with epilepsy. 6 cases(9.0%) showed unfavorable neurologic outcomes with epilepsy. All of the data including gestational age, Apgar score at 5 min, etiology, type, duration, and frequency of seizures, neurologic examination results, EEG background activities, and treatment responses were used as a prognostic index by a scoring system. When the cut-off point was 7, sensitivity, specificity, positive predictive value and negative predictive value were 76.5%, 78.0%, 54.2%, and 90.7% respectively. CONCLUSION: A scoring system for neonatal seizures earned high scores in sensitivity, specificity and negative predictive value, so that it seems to be useful as a predicitive prognostic index.
Apgar Score ; Birth Weight ; Chungcheongnam-do ; Electroencephalography ; Epilepsy ; Follow-Up Studies ; Gestational Age ; Hospital Records ; Humans ; Infant, Newborn ; Neurologic Examination ; Neurologic Manifestations ; Parturition ; Retrospective Studies ; Seizures* ; Sensitivity and Specificity

PURPOSE: This study was aimed to analyze the level of serum amino acids according to the sex, birth weight, gestational age in neonates. METHODS: Amino acid was measured by tandem mass spectrometry from the dried blood spots. We measured serum alanine, citrulline, glycine, methionine, ornitine, tyrosine, valine, leucine, phenylalanine levels in 172 neonates admitted to the NICU at Chungnam National University hospital from March 2003 to September 2003 and the data was analyzed according to the sex, birth weight, gestational age. RESULTS: There were no differences of serum amino acid level between term and preterm neonates according to the sex. However, there were significant statistical differences in serum amino acid level according to the birth weight (> or =2,500 g vs. <2,500 g) and gestational age (> or =37 weeks vs. <37 weeks). The level of alanine, citrulline, glycine, methionine, ornitine, tyrosine, valine, leucine was low in under 2,500 g (P<0.05), and in preterm neonates (P<0.05). Especially, preterm neonates under 1,800 g had low levels of valine and leucine (P<0.05). The serum levels of methionine, ornitine, valine, leucine were low in neonates with gestational age of less than 34 weeks (P<0.05). CONCLUSION: Awareness of low serum amino acid levels in preterm neonates is essential to improve nutritional supplements and catch-up growth.
Alanine ; Amino Acids ; Birth Weight ; Chungcheongnam-do ; Citrulline ; Gestational Age ; Glycine ; Humans ; Infant, Newborn* ; Leucine ; Methionine ; Phenylalanine ; Tandem Mass Spectrometry ; Tyrosine ; Valine

PURPOSE: The purpose of this study is to find out the diagnostic significance of serum bile acid on total parenteral nutrition induced cholestasis in premature infants. METHODS: Infants without cholestasis were classified into postnatal days and each change of serum bile acid was measured and analyzed. Also, the serum direct bilirubin, serum bile acid, gamma-glutamic acid transferase, and alkaline phosphatase of premature infants with total parenteral nutrition induced cholestasis were measured for comparison and analysis of their correlation. RESULTS: Changes of serum bile acid analysis after birth showed no significant difference between boys and girls, between premature infants and term infants without cholestasis. Serum bile acid levels are constant after two weeks after birth in neonates without cholestasis. In premature infants with total parenteral nutrition induced cholestasis, the increase of serum direct bilirubin over 2 mg/ dL was 34.9+/-18.3 days after birth, and the increase of serum bile acid was 28.1+/-18.3 days. Its increase was about 1 week faster than serum direct bilirubin, however, there was no statistical significance(P=0.114). Comparing analysis of serum bile acid, gamma-glutamic acid transferase, and alkaline phosphatase, serum bile acid showed the highest correlation to serum direct bilirubin(r=0.487, P= 0.000). CONCLUSION: Serum bile acid is an important parameter of total parenteral nutrition induced cholestasis in premature infants and will be useful for early diagnosis and treatment.
Alkaline Phosphatase ; Bile* ; Bilirubin ; Cholestasis* ; Early Diagnosis ; Female ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Parenteral Nutrition, Total* ; Parturition ; Transferases