PURPOSE: The incidence of hyperkalemia and the factors contributing the serum potassium level within 72 hours after birth in extremely preterm infants were determined. METHODS: The incidence of hyperkalemia and differences of clinical features between hyperkalemic(> OR =6.5mEq/L) and normokalemic(<6.5mEq/L) groups were determined by reviewing medical records of 53 extremely preterm infants born at less than 28 weeks gestation. RESULTS: The mean birth weight and gestational age were 912+/-186gram and 26.2+/-1.3weeks respectively. Thirty-six infants(67.9%) had at least one serum potassium level that exceeded 6.5mEq/L, and 15 infants with hyperkalemia(> OR =6.5mEq/L) had electrocardiographic abnormalities and eight infants had hyperkalemia-induced cardiac arrhythmias such as ven-tricular tachycardia, fibrillation and/or bradycardia. Serum potassium peaked in 13-36 hour postnatal age and the incidence of electrocadiographic abnormalities was highest in the 13-36 hour postnatal age(P<0.05). Urine flow rate during the first 48 hours after birth was only significantly lower for hyperkalemic infants(P<0.05). Six infants with hyperkalemia died as a direct result of hyperkalemia-induced cardiac arrhythmia. CONCLUSION: Hyperkalemia frequently occurred within the first 72 hours of life in extremely premature infants. Serum potassium should be monitored closely to avoid life-threatening cardiac arrhythmia in these infants.
Arrhythmias, Cardiac ; Birth Weight ; Bradycardia ; Electrocardiography ; Gestational Age ; Humans ; Hyperkalemia* ; Incidence ; Infant ; Infant, Extremely Premature* ; Infant, Newborn ; Medical Records ; Parturition* ; Potassium ; Pregnancy ; Tachycardia

Malformations of umbilicus are a feature of many dysmorphic syndromes and the measurement of periumbilical skin length should be considered as the basic step in the description of the umbilical malformations. So, we measured the periumbilical skin length in the 103 normal neonates and obtained the following results. 1) The means (+SD) of the periumbilical skin length were the 11.7mm (+3.0) in the cranial site and the 8.2mm (+2.5) in the caudal site, and the cranial length was 3.5mm longer than the caudal length. 2) No difference was observed between the male and female groups in the periumbilical skin length. 3) Age was the only statistically significant variable associated with the periumbilical skin length and it was observed that the periumbilical skin length decreased according to the advance of age (hour).
Female ; Humans ; Infant, Newborn ; Male ; Reference Values* ; Skin* ; Umbilicus

The pulmonary microvasculatures of rats were studied by injection replicas prepared from Mercox. This medium enabled us to easily obtain consistent, stable, and complete injected replicas of the pulmonary vasculature. In order to investigate the three dimensional structures of the tributaries of the bronchial artery, such as the capillary plexus and vasa vasorum, we performed a scanning electron microscopic(SEM) study of the vascular casts, using Mercox CL-2B as a media. The alveolar capillaries revealed hexagonal or pentagonal rings of vascular networks. In some areas, the vascular rings composed a square network, The bronchial tree was supplied by the bronchial arteries which form a coarse capillary extending as far as the terminal bronchioles. Occasionally the capillary plexus was connected with adjacent capillary networks in and around the alveolar walls. The walls of the pulmonary artery revealed only a single layer of the vasa vasorum, but those of the pulmonary vein were surrounded by more complicated and well developed vasa vasorum than the pulmonary arterial side. The mean diameters of the venous vasa vasorum are greater than the arterial vasa vasorum.
Rats ; Animals

This study was carried out to investigate the morphologic characteristics and localization of antigenic molecules of Pneumocystis carinii in experimentally induced P. carinii pneumonia in rats. After six weeks of administration of low protein diet and dexamethasone, Sprague-Dawley rats were sacrificed to submit lungs or bronchoalveolar lavage for the study. Monoclonal (092, 900, 902, and 904) and polyclonal (SP-D) antibodies were used for immunohistochemistry and immunoelectron microscopy (ITEM and ISEM). Immunohistochemically P. carinii organisms were well identified as clusters or separated forms in the alveolar spaces being frequently attached to the alveolar walls. Immunoelectron microscopically the adherences of gold particles were observed on the surface of all stages of the P. carinii. Occasionally positive immunogold labeling was observed in the cytoplasm of the trophozoites and on the pellicle of the intracystic bodies within the cysts. The monoclonal antibodies 092, 900, 902, and 904 reacted mainly with pellicles of P. carinii, whereas SP-D labeled on the pellicles, intracystic bodies, cytoplasms of the alveolar macrophages, and free floated surfactant material in the alveolar spaces. The immunogold particles were observed more diffusely and intensely in the cysts than in the trophozoites. These results indicate that antigen is mainly localized on the pellicles, and accumulated during development from the trophozoite to the cyst stages.
Animals ; Antibodies ; Antibodies, Monoclonal ; Bronchoalveolar Lavage ; Cytoplasm ; Dexamethasone ; Diet, Protein-Restricted ; Immunohistochemistry ; Lung ; Macrophages, Alveolar ; Microscopy, Electron ; Microscopy, Immunoelectron ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pulmonary Surfactant-Associated Protein D ; Rats ; Rats, Sprague-Dawley ; Trophozoites

No abstract available.
Cor Triatriatum*

Clothing dermatitis frequently goes unrecognized either becaue he clinical picture is mistaken for other disorders, such as seborrheic dermatitis, and prurius, or beacuse it is difficult to trace the causal agent. Contact dermatitis to disperse dyes, especially to azo dyes, has been well known and the most frequent sources of sensitization to dyes are dresses, stockings, and trousers made of synthetic fabrics We described a case of hat band contact dermatitis due to disperse dyes, proven by a patch test. Although chrome was not proven by the diphenylcirbizide method, many dyes known to be contact allergens were proved in different kinds of hat bands.
Allergens ; Clothing* ; Coloring Agents* ; Dermatitis ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Patch Tests

No abstract available.
HLA-DR Antigens*

PURPOSE: To observe the abnormal white matter findings on the magnetic resonance imaging (MRI) scans of very-low-birth-weight (VLBW) infant brains at term-equivalent age and to determine the clinical risk factors for the development of periventricular leukomalacia (PVL). METHODS: In all, MRI was performed in 98 VLBW infants and the white matter abnormalities were observed. Clinical risk factors for cystic and noncystic PVL were determined. RESULTS: MRI scans of 74 infants (75.5%) showed diffuse excessive high signal intensity (DEHSI) in the periventricular white matter, 17 (17.3%) lateral ventricle dilation, 5 (5.1%) and 11 (11.2%) focal punctate lesions and cystic changes in the periventricular white matter, respectively, 9 (9.1%), germinal layer hemorrhage (GLH) or subependymal cysts 3 (3.1%) intraventricular hemorrhage (>grade 2) 2 (2.0%) posthemorrhagic hydrocephalus and 2 (2.0%) periventricular hemorrhagic infarct. Gestational age (GA), 1-minute Apgar score, Clinical Risk Index for Babies-II (CRIB-II) score, and inotrope use, and GA, CRIB-II score, postnatal steroid administration, inotrope use, and abnormal white blood cell (WBC) count at admission were related to cystic PVL and noncystic PVL development, respectively (P<0.05). However, in logistic regression analysis, CRIB-II (odds ratio, 1.63, 295% confidence interval, 1.15-2.30 P=0.006) for cystic PVL, and GA (odds ratio 0.90, 95% confidence interval, 0.82-9.99 P=0.036) for noncystic PVL were only significant independently. CONCLUSION: White matter abnormalities could be observed on MRI scans of the VLBW infant brains at term-equivalent age, and CRIB-II and GA were only independently significant for cystic and noncystic PVL development, respectively.
Apgar Score ; Brain ; Gestational Age ; Hemorrhage ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Lateral Ventricles ; Leukocytes ; Leukomalacia, Periventricular ; Logistic Models ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Risk Factors

PURPOSE: The evaluation of pain in neonates is difficult due to their limited means of communication. The aim of this study was to determine whether the behavioral reactions of facial action and cry provoked by an invasive pain-induced procedure could be discriminated from the reactions to a noninvasive pain-induced procedure in normal full-term neonates. METHODS: Thirty-six healthy full-term neonates received three pain-induced procedures in counterbalanced order:intramuscular injection, tactile stimulus, and rubbing thigh with alcohol. The facial actions to the pain-induced procedures were measured and analysed by Neonatal Facial Action Coding System (NFACS) and the cry measures were analysed by the speech analysis after recording. RESULTS: 1) A cluster of facial actions comprised of brow bulging, eye squeezing, deepening of nasolabial furrow and open mouth was associated most frequently with the invasive procedure and the total facial action was the highest score in intramuscular injection. 2) Acoustic analysis of cry showed the shortest latency to the first cry and the lonegst duration of the first cry in intramuscular injection. 3) Two variables, total facial action and duration of the first cry, were most statistically significant in discriminating the invasive pain-induced procedure from the noninvasve pain-induced procedure. CONCLUSION: The facial actions and cry responses to the invasive pain-induced procedure were significantly different from the responses to the noninvasive pain-induced procedure in healthy full-term neonates.
Acoustics ; Clinical Coding ; Humans ; Infant, Newborn ; Injections, Intramuscular ; Mouth ; Thigh

PURPOSE: MgSO4 was used to evaluate the clinical effects in the treatment of severe persistent pulmonary hypertension of the newborn(PPHN). METHODS: Seven newborn infants with severe PPHN, and a persistent elevation of AaDO2(Alveolar-arterial oxygen tension difference) above 610 mmHg for more than 8 hours despite the aggressive conventional therapy were included. A loading dose of 200 mg/kg MgSO4 was given intravenously over 20-30 minutes, followed by continuous infusion of 20-50 mg/kg/hour. Vital signs, arterial blood gases, serum electrolytes, calcium and magnesium, and ventilatory setting were measured and recorded before MgSO4 was given and periodically thereafter. Severity of impairment of gas exchange was evaluated by AaDO2 and oxygenation index(OI). RESULTS: Mean gestational age and birth weight of seven infants were 38+5 weeks and 2,949844 grams, and one of them was a premature infant with gestational age of 27 weeks, and birth weight of 1,096 grams. There were six males and one female. Four infants were outborn. Four infants were presented with meconium aspiration syndrome, one with birth asphyxia, one with respiratory distress syndrome, and one with subdural hemorrhage. Before the start of the MgSO4 treatment, the mean AaDO2 and OI of seven infants were 638.8+/-10.8 mmHg and 43.811.2, respectively. During the treatment AaDO2 and OI significantly decreased to 538.4+/-114.5 mmHg and 13.4+/-9.4 within 24 hours(P< 0.05). Hypermagnesemia was noted in 7 infants, hypocalcemia in three, bradycardia in five, and hypotension in two. Only one infant was discharged against medical advice, and remaining six survived. CONCLUSION: MgSO4 may be considered as an alternative treatment of severe PPHN when other conventional treatments fail, are contraindicated, or not available.
Asphyxia ; Birth Weight ; Bradycardia ; Calcium ; Electrolytes ; Female ; Gases ; Gestational Age ; Hematoma, Subdural ; Humans ; Hypertension, Pulmonary* ; Hypocalcemia ; Hypotension ; Infant ; Infant, Newborn* ; Infant, Premature ; Magnesium* ; Male ; Meconium Aspiration Syndrome ; Oxygen ; Parturition ; Vital Signs