PURPOSE: Cerebral palsy or hearing disability of hyperbilirubinemic complication was reduced by blood exchange transfusion(BET) and phototherapy(PT). But in spite of these treatment, abnormal Auditory Brainstem evoked Response(ABR) finding after BET or PT and neurodevelopmental defect due to chronic bilirubin encephalopathy were observed. So we have studied risk factors and outcome of chronic bilirubin encephalopathy after BET, and treatment of hyperbilirubinemia. METHODS: We have analyzed clinical characteristics, the finding and change of ABR after BET in 17 hyperbilirubinemic neonates, and in 8 hyperbilirubinemic neonates who were treated by phototherapy and 15 normal control neonates. RESULTS: 1) Mean bilirubin concentraion were 27.5+/-4.1mg/dL in BET group and 22.1+/-2.3 mg/dL in PT group. There were no difference of clinical findings between BET and PT group. 2) Change of ABR (1) Wave I loss resulted in 4 neonates, wave III loss in 3 neonates, and wave V loss in 2 neonates in BET group(P<0.05). (2) Wave I peak latency and hearing threshold in BET group were significantly increased more than normal control group(P<0.01). 3) In 10 neonates(58.8%) among 17 BET group, 4 neonates(50%) in 8 PT group were observed abnormal initial ABR finding after jaundice treatment. Age at treatment and duration of jaundice(interval between onset of jaundice and treatment) in abnormal ABR group were significant prolongation compared with normal ABR group(P<0.05). 4) Chronic bilirubin encephalopathy(CBE) was observed in 3 neonates(17.6%) among 17 BET group and showed higher of bilirubin level than normalized group after BET (31.1mg/dL vs 26.6mg/dL), other clinical findings showed no significant differences. CONCLUSION: Bilirubin level was significantly elevated in CBE more than in BET group and duration of jaundice, age at treatment were longer in abnormal ABR group than in normal ABR group. So not only bilirubin level but also duration of jaundice shoud be considered at jaundice treatment, and ABR has a potential utility in detection of acute brain toxicity of bilirubin and follow up evaluation of bilirubin encephalopathy.
Bilirubin ; Brain ; Brain Stem ; Cerebral Palsy ; Follow-Up Studies* ; Hearing ; Humans ; Hyperbilirubinemia ; Infant, Newborn* ; Jaundice ; Kernicterus ; Phototherapy* ; Risk Factors

No abstract available.
Asthma* ; Atrial Natriuretic Factor* ; Egg Hypersensitivity* ; Ovum*

Neuroblastoma stage IV-S patients have frequent spontaneous remission and high survival rate. Many investigators have recommended minimal or no therapeutic intervention ; however, some patient do experience progressive disease and ultimately die of neuroblastoma. We experienced a case of stage IVS neuroblastoma with N-myc amplification and coagulopathy. This patient has treated with combination chemotherapy and radiation therapy, then remained disease free for 1 year on the follow up till March, 1997.
Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Neuroblastoma* ; Remission, Spontaneous ; Research Personnel ; Survival Rate

Prader-Willi syndrome is characterized by infantile hypotonia, mental retardation, hyperhagia, hypogonadism and obesity. Approximately 60% of all PLW syndrome show an interstitial deletion of chromosome 15, 37% have apparently normal chromosome, and 3.6% have a variety of other abnormalities involving chromosome 15. Diabetes mellitus has been considered a component of PLW syndrome and the incidence is about 7%. We experienced a 17-year-old female who revealed mental retardation, hypogonadism, obesity, and non-insulin dependent type DM, compatible with Prader-Willi syndrome.
Adolescent ; Chromosomes, Human, Pair 15 ; Diabetes Mellitus* ; Female ; Humans ; Hypogonadism ; Incidence ; Intellectual Disability ; Muscle Hypotonia ; Obesity ; Prader-Willi Syndrome*

This is a report of clinical study on the 63 patients of symptomatic urinary tract infection who were hospitalized at the Department of Pediatrics in Kangnam General Hospital during the period between the May of 1989 and the September of 1992. The observation results were as follows: 1) The frequency of urinary tract infection (UTI) was the highest in children under the age of one year (66.7%). 35 patients were male, while the other 28 were female. The ratio of male and female patients was 1.25:1. 2) Fever was observed in most of the cases. Systemic nonspecific manifestation was predominant in the infancy and early childhood, whereas local symptom of UTI was predominant in the late childhood. Among the 35 male patients, 32 cases were phimoses. As for the other 3 cases, Phimoses were not identified. 3) E. coli had the most frequency (65.3%), followed by Klebsiella, Enterobacter, Pseudomonas in descending order. 4) In the vitro antimicrobial susceptibility test, Gram negative organisms such as E. coli Klebsiella, Enterobacter were sensitive to cefotaxime, amikacin, and ampicillin/sulbactam. Meanwhile, Gram positive organisms such as Staphylococcus, Enterococcus were sensitive to vancomycin and cephradine. 5) The renal ultrasonography test was performed for 59 patients, 13 cases of whom showed abnormal findings. 6 cases out of the 13 abnormal patients had hydronephrosis. 6) DMSA renal scan was performed for 40 patients within 2 months of an acute pyelonephritic attack. Signs of pyelonephritic change were found in 18 patients. DMSA scan was repeated 4~12 months later in 4 of these patients. This showed renal cortical scarring in all patients. 7) Voiding cystourethrographic findings in 38 patients showed vesicoureteral reflux in 13 patients. 8) We performed urine culture again after 48 hours from the beginning of therapy and 85.5% of the cases became sterile. 9) The recurrent percentage of UTI was 23.8% with the ratio of 1:1.5 between male and female. Most of the patients were clildren under the age of one year. 10) Operations were made on two cases showing the increase of reflux during the follow-up of unilateral Grade ll and Grade 3 reflux, respectively. Operations were also performed on other two cases with bilateral Grade IV reflux. All the cases were good after the operations. In the meantime, as for another two cases having the right reflux of Grade lland the bilateral reflux of Grade lll, the refluxes were able to be reduced by prophylaxis only, in the course of following up.
Amikacin ; Cefotaxime ; Cephradine ; Child* ; Cicatrix ; Enterobacter ; Enterococcus ; Female ; Fever ; Follow-Up Studies ; Hospitals, General ; Humans ; Hydronephrosis ; Infant* ; Klebsiella ; Male ; Pediatrics ; Phimosis ; Pseudomonas ; Staphylococcus ; Succimer ; Ultrasonography ; Urinary Tract Infections* ; Urinary Tract* ; Vancomycin ; Vesico-Ureteral Reflux

BACKGROUND: It is now thought that the earliest manifestation of idiopathic pulmonary fibrosis is alveolitis, that is, an accumulation of inflammatory and immune effector cells within alveolar walls and spaces. Inflammatory cells including alveolar macrophages and resident normal pulmonary tissue cells participate through the release of many variable mediators such as inflammatory growth factors and cytokines, which contribute to tissue damage and finally cause chronic pulmonary inflammation and fibrosis. This study was performed to investigate the source and distribution pattern of transforming growth factor-beta1(TGF-beta1), platelet derived growth factor(PDGF), basic fibroblast growth factor(bFGF), interleukin 1(IL-1), interleukin 6(IL-6), tumor necrosis factor-alpha(TNF-alpha) and the role of these mediators on bleomycin(BLM)-induced pulmonary injury and fibrosis in rats. METHOD: Wistar rats were divided into three groups(control group, BML treated group, BML and vitamine E treated group). Animals were sacrifices periodically at 1, 2, 3, 4, 5, 7, 14, 21, 28 days after saline or BLM administration. The effects were compared to the results of bronchoalveolar lavage fluid analysis, light microscopic findings, immunohistochemical stains for six defferent mediators(TGF-beta1, PDGF, bFGF, IL-1, IL-6 and TNF-alpha) and mRNA in situ hybridization for TGF-beta1. RESULTS: IL-1 and IL-6 are maximally expressed at postbleomycin 1~7th day which are mainly produced by neutrophils and bronchiolar epithelium. It is thought that they induce recruitment of inflammatory cells at the injury site. The expression of IL-1 and IL-6 at the bronchiolar epithelium within 7th day is an indirect evidence of contribution of bronchiolar epithelial cells to promote and maintain the inflammatory and immune responses adjacent to the airways. TNF-alpha is mainly produced by neutrophils and bronchiolar epithelial cells during 1~5th day, alveolar macrophages during 7~28th day. At the earlier period, TNF-alpha causes recruitment of inflammatory cells at the injury site and later stimulates pulmonary fibrosis. The main secreting cells of TGF-beta1 are alveolar macrophages and bronchiolar epithelium and the target is pulmonary fibroblasts and extracellular matrix. TGF-beta1 and PDGF stimulate proliferation of pulmonary fibroblasts and TGF-beta1 and bFGF incite the fibroblasts to produce extracellular matrix. The vitamine E and BLM treated group shows few positive cells(p<0.05). CONCLUSION: After endothelial and epithelial injury, the neutrophils and bronchiolar epithelium secrete IL-1, IL-6, TNF-alpha which induce infiltration of many neutrophils. It is thought that variable enzymes and O2 radicals released by these neutrophils cause destruction of normal lung architecture and progression of pulmonary fibrosis. At the 7~28th day, TGF-beta1, PDGF, bFGF, TNF-alpha secreted by alveolar macrophages sting pulmonary fibroblasts into proliferating with increased production of extracellular matrix and finally, they make progression of pulmonary fibrosis. TNF-alpha compares quite important with TGF-beta1 to cause pulmonary fibrosis. Vitamine E seems to decrease the extent of BLM induced pulmonary fibrosis.
Animals ; Bites and Stings ; Bleomycin* ; Blood Platelets ; Bronchoalveolar Lavage Fluid ; Coloring Agents ; Cytokines* ; Epithelial Cells ; Epithelium ; Extracellular Matrix ; Fibroblasts ; Fibrosis ; Idiopathic Pulmonary Fibrosis ; In Situ Hybridization ; Intercellular Signaling Peptides and Proteins* ; Interleukin-1 ; Interleukin-6 ; Interleukins ; Lung ; Lung Injury ; Macrophages, Alveolar ; Necrosis ; Neutrophils ; Pneumonia ; Pulmonary Fibrosis* ; Rats ; Rats, Wistar ; RNA, Messenger ; Transforming Growth Factor beta ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha ; Vitamins

Effectiveness of flubendazole, a newly introduced as an anthelmintic in Korea, was evaluated in 28 ascariasis, 28 whipworm infections and 17 pinworm infections in primary school children. All patients were orally given by flubendazole of 500 mg once. Stools for roundworm and whipworm and anal swabs for pinworm infections were examined both before and 25 days after treatment. After flubendazole treatment, all ascariasis and pinworm infected cases were cured. On the other hand, in whipworm infections, the cure rate was 82.1 percent (23 cured of 28 infected), and the egg reduction rate was 67.1 percent, respectively. Headache (one case), dizziness (2 cases) and abdominal pain (3 cases) were noticed as untoward effects, but they were mild and disappeared within 24 hours. These results demonstrate the excellent effectiveness of flubendazole in treating these helminth infections.
parasitology-helminth-nematoda ; Ascaris lumbricoides ; Trichocephalus trichiurus ; Enterobius vermicularis ; chemotherapy ; flubendazole

The Diego blood group system consists of two pairs of antigens, Dia and Dib The incidence of Dia is low among pure Caucasian, Blacks, Polynesian and Eskimo, however, the rnongolians and American indians have both Dia and Dib. We report a case of two days old male who was admitted on first day of life for jaundice and subsquently exchange transfusion was performed on second day of life for bilirubin of 20 mg/dl. The blood groups of patient and his mother were both Rh D positive 0 type. Direct and indirect Coombstest were strong positive in the patient and indirect Coombstest was positive in his mother. We found anti-Dib antibody in his rnother's serum. The phenotype of Diego blood group system of the patient and his mother were Di (a+b+) and Di (a+b- ), respectively and hemolytic anemia in this case was due to anti-Dib antibody.
African Continental Ancestry Group ; Anemia, Hemolytic ; Bilirubin ; Blood Group Antigens ; Humans ; Incidence ; Indians, North American ; Inuits ; Jaundice ; Male ; Mothers ; Phenotype

This experiment was focused on the characterization of anti-Toxoplasma monoclonal antibodies (mAbs) and the effect of mAbs on the parasite invasion of mouse peritoneal macrophages. Twenty eight mAbs including M110, M556, R7A6 and M621 were characterized by Ab titer, immunoglobulin isotyping and western blot pattern. Antibody titer (optical density) of 4 mAbs, M110, M556, R7A6 and M621, were 0.53, 0.67, 0.45 and 0.39 (normal mouse serum; 0.19) with the same IgG1 isotypes shown by Enzyme-linked immunosorbent assay (ELISA). Western blot analysis showed that M110, M556, R7A6 and M621 reacted with the 33 kDa (p30), 31 kDa (p28), 43 kDa and 36 kDa protein. Immunogold labelling of mAbs M110, M556, R7A6 and M621 reacted with the surface membrane, dense granules and parasitophorous vacuolar membrane (PVM), rhoptries and cytoplasm of tachyzoite, respectively. For in vitro assay, preincubation of tachyzoites with four mAbs, M110, M556, R7A6 and M621 resulted in the decrease of the number of infected macrophages (P < 0.05) and the suppression of parasite multiplication at 18 h post-infection. Four monoclonal antibodies including M110 (SAG1) were found to have an important role in the inhibition of macrophage invasion and T. gondii multiplication in vitro, and these mAbs may be suitable for vaccine candidates, diagnostic kit and for chemotherapy.
Animals ; *Antibodies, Monoclonal/pharmacology ; *Antibodies, Protozoan/pharmacology ; Antigens, Protozoan/*analysis/immunology ; Cells, Cultured ; Depression, Chemical ; Macrophages, Peritoneal/parasitology ; Mice ; Mice, Inbred ICR ; Support, Non-U.S. Gov't ; Toxoplasma/growth & development/*immunology

Nutrition is thought to be much more important to the handicapped for their growth and development and successful management of their disease because they have much more complexed problems in physical, emotional, familial, and socioeconomic aspects. The authors determined number of erythrocytes and leukocytes, quantity of hemoglobin, hematocrit, reticulocyte, number of platelets for the survey of anemia to evaluate the nutritional status in mental and physical handicapped. Mean Corpuscular volume, Mean Corpuscular Hemoglobin and Mean Corpuscular Hemoglobin Concentration were calculated as usual according to wintrobe. Total iron binding capacity and serum iron were also measured in the hadicapped. The study group consists of total III handicapped children, who were composed of 13 first visitors to Out Patient Department, 51 hopsitalized patients in Rehabilitation Hospital, and 47 patients attending a Special Elementary School for the handicapped. Of the III subjects, 58 had cerebral plasies, 49 poliomyelitises and 4 had other orthopedic problems. Results. 1. Anemia were seen in 14 subjects, composed of 4 first visitors to O.P.D.(28.6% of all the anemias, 30.8% of all the O.P.C. subjects), 7 hospitalized subjects(50% of all the anemias, 13.7% of all the hospitalized subjects) and 3 Special School subjects(21.4% of all the anemias, 6.4% of Special School subjects). Incidence of anemia was higher in O.P.D. subjects than in the subjects of other groups. 2. Incidence of anemia by the disease entities was higher in the indivisuals with cerebral palsy, 7 in number(50% of all the anemias, 11.1% of all the cerebral palsy subjects) than in 5 those with poliomyelitis (35.7% of all the anemias, 10.2% of all the poliomyelitis subjects), or in 2 other subjects. 3. Incidence of anemia by the age was higher in the subjects below 6 years of age whose number was 5(35.7% of all the anemias, 45.5% of all the subjects below 6 years of age) than in the subjects above 9 years of age whose number was 9(64.3% of all the anemias, 11.1% of all the subjects above 9 years of age). The incidence of anemia in the subjects above 12 years of age was 17.7%(seven of the nine anemias above 9 years of age). 4. Five of the seven cerebral palsy patients with anemia were below 6 yeas of age(45.5% of all the cerebral palsy subjects below 6 years of age). All of the five poliomyelitis patients with anemia were above 9 years of age(11.1% of all the poliomyelitis subjects above 9 years of age). 5. Iron deficiency anemia was noted in 6 of 14 anemia patients(43% of all the anemias), which were composed of 2 cerebral palsy patients below 6 years of age, 3 poliomyelitises and one patients with congenital hip dislocation above 9 years of age.
Anemia* ; Anemia, Iron-Deficiency ; Cerebral Palsy ; Disabled Children ; Disabled Persons* ; Erythrocyte Indices ; Erythrocytes ; Growth and Development ; Hematocrit ; Hip Dislocation, Congenital ; Humans ; Incidence ; Iron ; Leukocytes ; Nutritional Status ; Orthopedics ; Poliomyelitis ; Rehabilitation ; Reticulocytes