No abstract available.
Evoked Potentials, Auditory, Brain Stem* ; Hearing* ; Humans ; Infant*

No abstract available.
Diagnosis* ; Sepsis*

No abstract available.
Septo-Optic Dysplasia*

The thirty eight newborn infants with periventricular leukomalacia who were admitted to the neonatal intensive care unit of Gil General Hospital from March 1, 1988 to June 30, 1991, were investigated for ultrasonographic findings, risk factors and neurological outcome. The results were as follows: 1) There were 38 cases of PVL including 21 echogenic flarings and 17 cystic PVL's. 2) Mean birth weight was 2,250 gm and mean gestational age was 35 week. 3) Mean detection timing was 4th day in echogenic flarings and 18th day in cystic PVL's. 4) PVL's were located in the parietal region in 1 case and fronto-parieto-occipital in 3 cases. 5) Mean cyst size was 6 mm. 6) Multiple logistic regression analysis for the risk factors of PVL showed that low birth weight, apnea and seizure were the most significant contributing factors (p<0.05). 7) In the follow-up study of cystic PVL's, 7 cases showed improvement, 7 cases developed into multicystic encephalomalacia and 3 cases developed into atrophy. 8) Neurodevelopmental outcome of cystic PVL's showed nomal; 6.2%, minor neurodevelopmental defect; 43.8%, major neurodevelopmental defect; 31.2% and death; 18.8%. 9) Neurosonographic predictability for neurodevelopemental sequelae by cystic PVL's showed sensitivity; 63.6%%, specificity; 98.0%, positive predictive value; 92.8% and accuracy; 88.2%. 10) Major neurodevelopmental defect was more frequent, cyst size being larger and location being more extensive (p<0.05).
Apnea ; Atrophy ; Birth Weight ; Encephalomalacia ; Follow-Up Studies ; Gestational Age ; Hospitals, General ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Leukomalacia, Periventricular* ; Logistic Models ; Rabeprazole ; Risk Factors* ; Seizures ; Sensitivity and Specificity

PURPOSE: Aim of this study is to obtain the normal values of pulmonary function test (PFT) in newborn babies according to their postconceptional age and to detect changes in PFT values of neonatal lung diseases including respiratory distress syndrome and meconium aspiration pneumonia. METHODS: PFT was performed in 60 newborn babies who were admitted in the neonatal intensive care unit and newborn nurseries of Inje University Sanggye Paik Hospital from 2002. 11. 1. to 2003. 10. 31. The PFT data of 20 respiratory distress syndrome (RDS) and 20 meconium aspiration pneumonia patients during the same period were analyzed and compared with normal values of similar postconceptional age group to find what kind of changes in PFT values occur in patient groups. PFT values including compliance (C), resistance (R), functional residual capacity (FRC), tidal volume (TV), percent volume to peak flow (%V-PF) were measured. RESULTS: 1) In PCA 30-32 week newborns, C:1.22+/-0.43 (mL/cmH2O), R:0.12+/-0.07 (cmH2O/mL/sec), FRC:20.9+/-12.7 (mL/kg), TV:7.1+/-3.6 (mL/kg), In PCA 33-36 week newborns, C:1.81+/-0.76 (mL/cmH2O), R:0.09+/-0.04 (cmH2O/mL/sec), FRC:23.3+/-14.1 (mL/ kg), TV:7.3+/-4.3 (mL/kg). In PCA 37-42 week newborns, C:2.08+/-0.57 (mL/cmH2O), R:0.08+/-0.06 (cmH2O/mL/sec), 28.3+/-13.4 (mL/kg), TV:8.5+/-4.1 (mL/kg). 2) In RDS patients of PCA 30-36 week, C:0.08+/-0.02 (mL/cmH2O), FRC:12.3+/-4.3 (mL/kg), %V-PF:0.27+/-0.11. These values were significantly decreased comparing with normal PFT values of newborns with similar postconceptional age (P<0.05). CONCLUSIONS: Lung compliance and FRC of normal newborns increased with increase of their postconceptional age. In RDS patients compliance, FRC and %V-PF were significantly decreased comparing with normal newborns with similar postconceptional age.
Compliance ; Functional Residual Capacity ; Humans ; Infant, Newborn* ; Intensive Care, Neonatal ; Lung Compliance ; Lung Diseases ; Meconium Aspiration Syndrome ; Nurseries ; Passive Cutaneous Anaphylaxis ; Pneumonia ; Reference Values* ; Respiratory Function Tests* ; Tidal Volume

No abstract available.
Apoptosis* ; Lung*

We retrospectively evaluated datas on 61 cases of neonatal sepsis confirmed by clinical symptoms and blood cultures at the NICU of Gil general hospital From Mar. 1989, to Fed. 1992. The results obtained were as follows: 1) The mean gestational age was 32.7+/-2.6 Weeks in preterm infants, and 39+/-1.5 weels on term infants. The mean birth weight was 1,701.4+/-422.4 g in preterm infants, and 3,232+/-581.7 g in term infants. 2) There were 61 infants with neonatal sepsis identified among 13, 486 live births, resulting in an incidence of 0.45%. The sex ratio of male to female was 1.2:1. The incidencdence was higher in preterm infants (2.21%) than in term infants (0.27%). 3) The most commom presenting symptoms of neonatal sepsis were apnea and bradycardia (53.6%) in preterm infants, jaundice (33.3%) in term infants 4) The concurrent diseases in neonatal sepsis were urinary tract infection (UT)(25%), pneumonia (21%), hyaline membrane disease (21%) in the order of frequency. Hyaline membrane disease (33.3%) was the most frequently associated disease in preterm infants, UTI (41.4%) in term infants 5) Gram positive organisms were isolated in 33 casess (52%), gram negative organisms in 30 cases (48%). The most common ortanism isolated from blood cultures was CONS (28.6%). The more common organisms in preterm infants were CONS (26.7%), Enterococcus (23.3%) and Klebsiella (10%). CONS (30.3%), E. Coli (27.3%) and Staphylococcus aureus (12%) were more frequent in term infants. 6) The significant diagnostic laboratory findings for neonatal sepsis were leukopenia ( < or =5000), I:T 0.16, thrombocytopenia ( <150,000/mm3), CRP> or =1+.2 or more of abnormal hematologic values were significantly more frequent in preterm infants (P< 0.05). 7) The risk factors associated with neonatal sepsis were endotracheal intubation (57%), birth ashyxia (Apgar score< or =6 at 5 min.)(39%) and umbilical catheterization (35.7%) in preterm infants, while endotrachial intubation (12.1%), birth ashyxia (12.1%) and premature rupture of membrane ( > or =24hrs)(9.0%) in term infants. 8) Early onset neonatal sepsis (72< or =hr of age) was found in 40 cases (65.6%). 9) The overall mortality rate of neonatal sepsis was 26.0%(39,3% in preterm infants, 15.2% in term infants). The mortality rate was significantly high in pseudomonas infection. 10) In low birth weight infants, the susceptibility to neonatal sepsis was greatest in the infants of lowest birth weight (1,00-1,500 gm) and the mortality rate was inversely proportional to birth weight. 11) Sensitivity to antibiotics in gram postitive organisms were chlorampjenicol (37%), Erythromycin (29%), ampicillin (26%) and cephalothin (26%). It clearly showed that newer antibiotics such as vancomycin is neccessary. In cases of gram negative organisms, sensitivity to antibiotics were amikacin (85%), gentamicin (65%), tobramycin (58%) and cephalothin (54%).
Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Apnea ; Birth Weight ; Bradycardia ; Catheterization ; Catheters ; Cephalothin ; Enterococcus ; Erythromycin ; Female ; Gentamicins ; Gestational Age ; Hospitals, General ; Humans ; Hyaline Membrane Disease ; Incidence ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Intubation ; Intubation, Intratracheal ; Jaundice ; Klebsiella ; Leukopenia ; Live Birth ; Male ; Membranes ; Mortality ; Parturition ; Pneumonia ; Pseudomonas Infections ; Retrospective Studies ; Risk Factors ; Rupture ; Sepsis* ; Sex Ratio ; Staphylococcus aureus ; Thrombocytopenia ; Tobramycin ; Urinary Tract Infections ; Vancomycin

Newborn premature babies have lwo levels of transplacentally acquired maternal immunoglobulin which is mostly transferred after 32~34 weeks gestaton, therefore they may have IgG deficiencies that increase their susceptibility to bacterial infection. We performed this study to determine whether intravenous immunoglobulin (IVIG) therapy improves mortality or infection occurrance rate. From 1 october 1991 to 31 July 1992, 73premature newborn infants with gestational age< or =34weeks were enrolled: the theatment group, consisting of 43infants who received prophylactic intravenous immunoglobulin therapy (500mg/kg/week) and the control group, consisting of 30infants who did not receive. prophylactic intravenous administration of immunoglobulin to preterm infants with a gestational ageage< or =34week, at a dose of 500mg/kg/week, results in maintenance of a satisfactory serum IgG level throughout the high-risk period for infection. But the incidence rates of proven or very probable sepsis, mortality for sepsis and total mortality in the infants receiving intravenous immunoglobulin were not significant differences when compared with those in the control infants. No adverse effects were noted after immunoglobulin transfusions in our subjects. In conclusion, our study does not show any decrease in bacterial infection rate or in mortality rate, and no study in the literature has shown absolute proof of the prophylactic efficacy of IVIG in premature newborns. Larger studies are necessary to confirm these observations and to determine more effective dosing schedules and the optimal levels of orhanism-spectific antibodies. And specific hyperimmnue of monoclonal antibody preparations may be required to provide reliable sources of effective prophylactic to premature neonate with high risk in bacterial sepsis.
Administration, Intravenous ; Antibodies ; Appointments and Schedules ; Bacterial Infections ; Humans ; IgG Deficiency ; Immunization, Passive ; Immunoglobulin G ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Mortality ; Sepsis*

Neonatal lupus(NL) is characterized by typical clinical features and the presence of maternal auto- antibodies. The principal serologic markers of NL are anti-Ro/SSA or anti-La/SSB maternal auto- antibodies, which are transferred across the placenta and can be detected for the first few months of the affected child. The major clinical manifestations are cardiac disease, notably congenital heart block, and cutaneous lupus lesions. Hepatobiliary disease is relatively rare clinical manifestation of NL. We experienced a case of NL with abnormal liver function test and skin lesion.
Antibodies ; Child ; Heart Block ; Heart Diseases ; Humans ; Infant, Newborn ; Liver Function Tests* ; Liver* ; Placenta ; Skin*

Neonatal hyperbilirubinemia is a significant risk factor for the developemtn of otoneurologic disorder. Hyperbilirubinemia resulting in kernicterus produces widespread neuronal damage with the most common sites of staining and destruction involving the hippocampus, basal ganglia and the brainstem nuclei in the floor of the fourth ventricle, including the dorsal cochlear nucleus. ABR may be a useful tool for the monitoring early bilirubin toxicity and postcteric sequelae in infants. This study attempts to evaluate the clinical neurodevelopmental outcome in hyperbilirubnemic infants requiring exchange transfusion through the assessment of ABR. Eight hyperbilirubinemic neonates with severely abnormal ABR findings and twelve hyperbilirubinemic neonates with normal ABR findings were studied to assess their neurodevelopemental outcome. The results were as follows; 1) There were 8 severely abnormal ABR cases, including 5 cases of bilateral flat wave and 3 cases of unilateraly elevated hearing throeshold. 2) The major cause of hyperbilirubinemia was ABO incompatibility(65%) 3) Significant clinical finding associated with severely abnormal ABR was kernicterus(p<0.05) 4) Significant laboratory findings associated with severely abnormal ABR were lower levels of hemoglobin and hematocrit(p<0.05) 5) 2 cases of bilateraly flat ABR and 3 cases of unilaterally elevated hearing threshold could be classified into sensorineural type hearing defect by latency-intensity function curve. 6) At the follow up tests of 3 cases of bilaterally flat ABR, 2 cases showed no change and 1 case showed mild improvement. 7) Among 5 follow up cases of severely abnormal BR, only 1 case showed normal neurodevelopmental outcome, 3 cases showed major neurodevelopmental defect and 1 case showed minor neurodeveoplemental defect. Among them, 1 case has had definite hearing disability.
Basal Ganglia ; Bilirubin ; Brain Stem ; Cochlear Nucleus ; Evoked Potentials, Auditory, Brain Stem* ; Follow-Up Studies ; Fourth Ventricle ; Hearing ; Hippocampus ; Humans ; Hyperbilirubinemia* ; Hyperbilirubinemia, Neonatal ; Infant ; Infant, Newborn* ; Kernicterus ; Neurons ; Risk Factors