Eight neonates with transient tricuspid insufficiency are presented which was confirmed clinical and two dimensional echocardiographic assessment. We found that two dimensional Doppler echocardiography was very useful in the detection of transient tricuspid insufficiency during neonatal age as noninvasive method. Transient tricuspid insufficiency is a clinical disorder in the newborn period caused by myocardial dysfunction, secondary to asphyxia with or without hypoglycemia and associated with right ventricular overloading caused by pulmonary hypertention. The clinical diagnosis was based on a history of perinatal distress, distinctive murmur, ECG changes, biochemical abnormalities and myocardial imaging. 1) The sex ratio of TTI was 1:1. 2) The average gestational age was 34 weeks and mean body weight was 2.06 Kg, respectably. 3) Major symptoms were dyspnea, cyanosis, and tachypnea. 4) Tricuspid regurgitation was detected from the lst day to the 4th day of the life and was improved from the 7th day to the 30th day of the life. 5) The peak velocity through tricuspid valve ranged from the 2.7 m/sec to 4.0 m/sec and the estimated right ventricular pressure ranged from 39 mmHg to 74 mmHg. 6) Associated diseases were neonatal hyperbilirubinemia (100%), prematurity (87.5%), atrial right to left shunt (87.5%), patent ductus arteriosus (75%), hyaline membrane disease (25%), and transient tachypnea of newborn (12.5%).
Asphyxia ; Body Weight ; Cyanosis ; Diagnosis ; Ductus Arteriosus, Patent ; Dyspnea ; Echocardiography* ; Echocardiography, Doppler ; Electrocardiography ; Gestational Age ; Humans ; Hyaline Membrane Disease ; Hyperbilirubinemia, Neonatal ; Hypoglycemia ; Infant, Newborn ; Sex Ratio ; Tachypnea ; Transient Tachypnea of the Newborn ; Tricuspid Valve ; Tricuspid Valve Insufficiency ; Ventricular Pressure

The case of a cyanotic infant with a rare combination of atypical pulmonary artery sling, imperforate anus, absence of the left kidney, interruption of the inferior vena cava, left side hemihypertrophy and diffuse-type pulmonary arteriovenous fistula is described. The clinical features were confusing, because of compounding abnormalities involving the respiratory tract and pulmonary circulation. The diagnostic approach to the etiology of cyanosis is discussed and the embryonic origin of pulmonary artery sling is reviewed.
Arteriovenous Fistula/ultrasonography ; Arteriovenous Fistula/pathology* ; Case Report ; Human ; Infant ; Male ; Pulmonary Artery/pathology*

PURPOSE: This study was undertaken to investigate changes in cardiac performance in early neo-natal life by observing the changes of left ventricular(LV) function and volume according to the size of ductus arteriosus. METHODS: The study group consisted of 21 full-term Cesarean section neonates who were admitted to the nursery of Korea University Hospital. We serially investigated the patency and size of the ductus at 2, 24, 120 hours after birth by two-dimensional echocardiography. The standard two-dimensional tracings of LV volume were obtained under the guidance of apical two- and four-chamber views. LV end-diastolic and end-systolic volumes were calculated using a biplanar Simpson's method. RESULTS: LV end-diastolic volume was highest(3.44>0.4mm) at 2 hours of age(P<0.01), being constant from 24 to 120 hours. LV contractility, indicated by the mean normalized systolic ejection rate, remained constant during the whole period of investigation. The size of the ductus arteriosus was maximal at 2 hours after birth, and decreased significantly at 24 hours of age (P<0.01). The size of ductus arteriosus demonstrated a close linear correlation with the left ventricular end-diastolic volume(y=0.17x+2.92, r=0.59: P<0.01). CONCLUSION: Changes in LV end-diastolic volume soon after birth depend on changes in ductus arteriosus flow, which in turn is affected by ductal diameter. Upon patency of the ductus arteriosus, the newborn left ventricle operates at maximal performance with only a limited capacity to increase contractility.
Cesarean Section ; Ductus Arteriosus ; Ductus Arteriosus, Patent ; Echocardiography ; Female ; Heart Ventricles ; Humans ; Infant, Newborn ; Korea ; Nurseries ; Parturition ; Pregnancy ; Ventricular Function, Left

Little is known about the prevalence of naturally acquired IgG antibodies to the capsular polysaccharides of Streptococcus pneumoniae (pneumococcal IgG) in Korea. In the present study, we investigated transplacental transfer and age-related levels of pneumococcal IgG to provide background seroepidemiologic data for S. pneumoniae in Korea. One hundred thirty eight sera were assayed by ELISA for IgG to pneumococcal polysaccharide capsular serotypes 14 and 19, the predominant serotypes for under 15 yr of age in Korea. The subjects were divided into 7 subgroups according to age. The cord/maternal geometric mean titer of pneumococcal were 4.47+/-5.88/5.21 +/- 5.88 for serotype 14, and 4.68 +/- 5.55/6.55 +/- 6.92 for serotype 1 9 (mean +/- standard deviation, microg/mL). After birth, the geometric mean titers of pneumococcal IgG for serotypes 14 and 19 expressed in microg/mL were 1.18+/-2.12 and 1.41+/-2.17 in the 0-6 months group, 0.27+/-0.19 and 0.69+/-0.93 in 7-12 months, 0.21+/-0.22 and 0.64+/-1.32 in 1-2 yr, 0.69+/-0.78 and 2.65+/-2.46 in 3-6 yr, 2.52+/-2.72 and 8.29+/-4.24 in 7-10 yr, respectively. In conclusion, reduced transplacental transfer and very low serum concentrations of pneumococcal IgG may contribute to the susceptibility of neonates, infants, and young children to S. pneumoniae infection.
Age Factors ; Antibodies, Bacterial/metabolism* ; Bacterial Capsules/immunology* ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; IgG/metabolism* ; IgG/blood ; Infant ; Infant, Newborn ; Male ; Maternal-Fetal Exchange* ; Pneumococcal Vaccines/immunology ; Pregnancy ; Streptococcus pneumoniae/immunology* ; Vaccines, Conjugate/immunology