No abstract available.
Biliary Atresia* ; Hepatitis*

No abstract available.
Humans ; Infant, Newborn* ; Ventilation*

PURPOSE: In premature, neurologic sequelae is most important long-term complication. So we investigated the relationship between brain ultrasonographic findings and neurologic outcome. METHODS: Infants weighting less than 2,000gm who were discharged from the Neonatal Intensive Care Unit of Seoul National University Children's Hospital from Jan 1, 1989 to Dec. 31 1992, were investigated. All ultrasound images were examined for evidence ICH/IVH, periventricular echogenicity, and cystic PVL. Infants were assessed neurodevelopmentally in the neonatal period and at least until 12 months corrected for gestation age. RESULTS: 1) Total 291 infants were discharged, but expired, against medical advice discharged, and lost follow-up infants were exculded, 187 infants were investigated for the realtionship between brain ultrasonographic findings and neurologic outcomes. 2) The proportion of infants with neurologic sequelae (cerebral palsy) according to birth weight was as follow: 4 cases (50%) of less than 1,000gm; 13 cases (24.5%) of between 1,001gm and 1,500gm; 11 cases (5.6%) of between 1,501gm and 2,000gm, 3) The proportion of infants with neurologic sequelae according to intraventricular hemorhage (IVH) was as follows : no IVH, 1 cases (1.4%) of 69 case; IVH gradeI, 9 cases (16.1%) of 56 cases; IVH grade II, 9 cases (17%) of 53 cases; grade III, 5 cases (55.6%) of 9 cases. 4) The proportion of infants with neurologic sequelae according to the degree of periventricular echogenisity (PVE) was as follows : normal PVE, none of 53 cases; transient increased PVE, 1 case (2.5%) of 40 cases; persistent increased PVE, 6 cases (8.3%) of 72 cases; cystic periventricular leukomalacia (PVL), 17 cases (77%) of 22 cases. 5) Mantel-Haenszel chi-square analysis for the relationship between IVH and PVE showed significant correlation (p<0.05). 6) Linear logistic regression analysis for risk factors of neurologic sequelae showed that low birth weight and PVE were significant factors (p<0.05), but IVH was not significant factor (p>0.05). 7) The severity and nature of neurologic sequelae correlated with the locations and the severity of cystic PVL. CONCLUSIONS: These data suggest that low birth weight and PVL are risk factors of neurologic sequelae, and location and extent of PVL correlate with severity and type of neurologic sequelae. So early detection and follow-up examination of PVL by brain ultrasonography are needed for early detection of neurologic sequelae and minimization of handicaps.
Birth Weight* ; Brain ; Follow-Up Studies ; Humans ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Leukomalacia, Periventricular ; Logistic Models ; Parturition* ; Pregnancy ; Risk Factors ; Seoul ; Ultrasonography

PURPOSE: In premature, neurologic sequelae is most important long-term complication. So we investigated the relationship between brain ultrasonographic findings and neurologic outcome. METHODS: Infants weighting less than 2,000gm who were discharged from the Neonatal Intensive Care Unit of Seoul National University Children's Hospital from Jan 1, 1989 to Dec. 31 1992, were investigated. All ultrasound images were examined for evidence ICH/IVH, periventricular echogenicity, and cystic PVL. Infants were assessed neurodevelopmentally in the neonatal period and at least until 12 months corrected for gestation age. RESULTS: 1) Total 291 infants were discharged, but expired, against medical advice discharged, and lost follow-up infants were exculded, 187 infants were investigated for the realtionship between brain ultrasonographic findings and neurologic outcomes. 2) The proportion of infants with neurologic sequelae (cerebral palsy) according to birth weight was as follow: 4 cases (50%) of less than 1,000gm; 13 cases (24.5%) of between 1,001gm and 1,500gm; 11 cases (5.6%) of between 1,501gm and 2,000gm, 3) The proportion of infants with neurologic sequelae according to intraventricular hemorhage (IVH) was as follows : no IVH, 1 cases (1.4%) of 69 case; IVH gradeI, 9 cases (16.1%) of 56 cases; IVH grade II, 9 cases (17%) of 53 cases; grade III, 5 cases (55.6%) of 9 cases. 4) The proportion of infants with neurologic sequelae according to the degree of periventricular echogenisity (PVE) was as follows : normal PVE, none of 53 cases; transient increased PVE, 1 case (2.5%) of 40 cases; persistent increased PVE, 6 cases (8.3%) of 72 cases; cystic periventricular leukomalacia (PVL), 17 cases (77%) of 22 cases. 5) Mantel-Haenszel chi-square analysis for the relationship between IVH and PVE showed significant correlation (p<0.05). 6) Linear logistic regression analysis for risk factors of neurologic sequelae showed that low birth weight and PVE were significant factors (p<0.05), but IVH was not significant factor (p>0.05). 7) The severity and nature of neurologic sequelae correlated with the locations and the severity of cystic PVL. CONCLUSIONS: These data suggest that low birth weight and PVL are risk factors of neurologic sequelae, and location and extent of PVL correlate with severity and type of neurologic sequelae. So early detection and follow-up examination of PVL by brain ultrasonography are needed for early detection of neurologic sequelae and minimization of handicaps.
Birth Weight* ; Brain ; Follow-Up Studies ; Humans ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Leukomalacia, Periventricular ; Logistic Models ; Parturition* ; Pregnancy ; Risk Factors ; Seoul ; Ultrasonography

The posterior fossa tumors were reviewed from January 1980 through September 1988. During that time, 72 tumors were diagnosed, with a male: female ratio of 1 : 1.8. The distribution of histopathologic types was; 17 acoustic neuromas(23%), 14 astrocytomas(19%), 8 hemangioblastomas(11%), 8 meningiomas(11%), 7 medulloblastomas(10%), 6 stem gliomas(8%), 4 metastatic tumors(5%), 3 granulomas(4%). The most common presenting symptoms were headache, nausea and vomiting, dizziness, diplopia and hearing diffrculty. Twenty-five patients(37%) showed hydrocephalus on CT scan. For the entire series of 60 patients operated on, results were: 31% excellent, 37% good, 8% fair, 13% poor and 10% Dead. Individuals with meningioma, acoustic neuroma or hemangioma were more favorable prognostically. With survival time should be further investigated for postoperative irradiation and chemotherapy.
Acoustics ; Diplopia ; Dizziness ; Drug Therapy ; Female ; Headache ; Hearing ; Hemangioma ; Humans ; Hydrocephalus ; Infratentorial Neoplasms ; Male ; Meningioma ; Nausea ; Neuroma, Acoustic ; Tomography, X-Ray Computed ; Vomiting

Five years ago, we made the cut-off value of Tsh by dry filter paper method as 15 microU/ml to sereening congenital hypothyroidism. Since then, 1,210 term neonates, who had no perinatal problems, were born in SNUCH between Aug. 1987 and Apr. 1992, had been performed this neonatal Tsh screening test with this cut-off point. Neonates had been recalled for measurement of serum T4/TSH to rule out congenital hypoothyroidism if their TSH value by screening tests reveal more than 15 microU/ml. Because there had been high false-positive rate during 5 years, we felt thiscut-off value of TSH should be set higher than 15 microU/ml with same method. Therefore, we analyzedthis TSH values to set a new cut-off point to recall the neonates. The results ars asbelow: 1) TSH value by dry filter paper method was 8.48+/-4.41 U/ml(mean+/-S.D.) 2) Assuming 15 microU/ml as a cut-off point for recall the neonates, the false positive fate is 8.01% 3) Tomake the false positive rates as 0.3%, it is reasonable to set the cut-off point at 22 microU/ml, whichis +/-3S.D.(99.7 percentile) of measured TSH level by dry filter paper method.
Congenital Hypothyroidism ; Humans ; Infant, Newborn* ; Mass Screening*

No abstract available.

No abstract available.
Humans ; Infant, Newborn* ; Oximetry* ; Oxygen*

No abstract available.
Hydrops Fetalis*

PURPOSE: In newborns from mothers with Graves' disease, neonatal transient hyperthyroidism or hypothyroidism may develop early in life. We evaluated the incidence and prognosis of neonatal thyroid dysfunction in neonates born to mothers with hyperthyroidism during pregnancy. METHODS: We measured blood T4, T3, TSH levels and TSH-R-Ab titer in 48 hyperthyroid mothers and their babies between 1988 and 1994. RESULTS: The mean birth weight was 3.21+/-0.49kg and gestational age was 39+5 weeks and three neonates(6%) were small for gestational age and two(4%) were premature whose mother had hyperthyroidism during pregnancy. Eight of the neonates showed high levels of thyroid hormone and four showed low levels of thyroid hormone but none had symptom or sign. The neonatal thyroid function was not affected by maternal antithyroid medication and maternal TSH-R-Ab level. The positive rate of TSH-R-Ab was 44 percent in neonates. In the neonates with low T4 level, the mean TSH-R-Ab was 38.1+/-19.6%, which was higher than those in euthyroid(14.7+/-9.7%) or hyperthyroid(8.4+/-6.2%) neonates(p<0.05). The neonatal blood TSH-R-Ab levels was correlated with maternal TSH-R-Ab levels(r=0.50, p<0.05). Neonatal T4 didn't show any correlation with maternal TSH-R-Ab but showed negative correlation with neonatal TSH-R-Ab(r=-0.43, p<0.05). Neonates with high T4 showed normal thyroid function within 35 days(10-54days) in average. Neonates with low T4 showed normal thyroid function within 29 days(7-61days) in average. One of neonate with low T4 was given thyroid hormone for 1 month. No one with initial abnoraml thyroid function showed clinical problem through follow-up. CONCLUSIONS: It is likely that hyperthyroid mothers have more tendency of small babies for gestational age or premature babies. Neonates born to hyperthyroid mothers should be closely monitored because of possible abnormal thyroid function, as shown by this study. It is likely that TSH-R-Ab from hyperthyroid mother usually consists of blocking antibody, rather than stimulating antibody, which might cause hypothyroidism in the neonates.
Birth Weight ; Follow-Up Studies ; Gestational Age ; Graves Disease ; Humans ; Hyperthyroidism* ; Hypothyroidism ; Incidence ; Infant, Newborn* ; Mothers* ; Pregnancy ; Prognosis ; Thyroid Gland*