BACKGROUND AND OBJECTIVES: Laboratory research was carried out to investigate the teratogenic effect of X-ray on chick embryos, especially with regard to cardiovascular malformation. MATERIALS AND METHODS: The chick embryos, 242, 242 and 215 eggs, were irradiated with X-ray at the dose of 500, 750 and 1000 cGy, respectively, during the incubation period between 0 and 9 days. A control group of 90 eggs received no irradiation. After 2 weeks of incubation, the embryos were sacrificed and examined. RESULTS: The survival rate of irradiated group was significantly lower than that of control group (62.5 vs. 87.8%, p<0.0001). The incidence rate of cardiovascular malformation was significantly higher in the irradiated than the control group (16.2 vs. 2.5%, p<0.005). The rate of cardiovascular malformation in the irradiated group increased from 9.4% with 500 cGy to 24.5% with 1000 cGy (p<0.05). There were a total of 33 cases of cardiac malformation, of which 24 were ventricular septal defects and 9 were complex congenital heart diseases. The higher the administered dose of radiation, the higher the observed incidence rate of cardiac malformation and the more complex the cardiac anomaly. Also, the rates of exocardia, exencephaly, beak anomalies and anopia were all increased in the irradiated group. CONCLUSION: X-ray irradiation of chick embryos increased the rates of death and cardiovascular malformation. The highest dose resulted in greater complexity of the cardiovascular malformation.
Animals ; Beak ; Cardiovascular System* ; Chick Embryo* ; Eggs ; Embryonic Structures ; Heart ; Heart Diseases ; Heart Septal Defects, Ventricular ; Incidence ; Neural Tube Defects ; Ovum ; Survival Rate

Parvovirus B19, a member of the Erythrovirus genus, is the only member of the Parvoviridae family known to be pathogenic in humans. Haematological consequences of B19 infection arise due to a direct cytotoxic effect on erythroid progenitors in bone marrow, resulting in interruption of erythrocyte production. The physiology of host haematopoiesis and competence of the immune response each determines clinical manifestations of B19 infection. A search of the literature revealed that neutropenia and thrombocytopenia due to B19 have been rarely reported in healthy individuals. In Korea, B19 infection has been reported among individuals with underlying disorders such as leukemia or congenital spherocytosis. Among otherwise healthy persons, there have been few reported cases of B19 infection which resulted in anemia, leukopenia, and thrombocytopenia. We herein report, for the first time in Korea, of two children who experienced leukopenia and thrombocytopenia, but not anemia, after B19 infection and recovered uneventfully.
Anemia ; Bone Marrow ; Child ; Erythrocytes ; Erythrovirus ; Hematologic Diseases ; Hematopoiesis ; Humans ; Korea ; Leukemia ; Leukopenia ; Mental Competency ; Neutropenia* ; Parvoviridae ; Parvovirus* ; Physiology ; Thrombocytopenia*

PURPOSE: The 2000-2001 measles epidemic resulted in more than 50,000 cases with the highest attack rate occuring in infants less than one year of age, indicating the necessity of measles immunization before 12 months of age when a measles outbreak occurs again. The study was conducted to measure maternal measles antibody in infants by plaque reduction neutralization test(PRN), for the first time in Korea, to assess the optimal age for measles vaccination before the first birthday, when necessary. METHODS: Sera were obtained from 95 infants younger than 12 months of age who were healthy or recovered from mild llnesses, and had not had measles vaccination, measles infection, or blood transfusion. Measles antibodies were measured by PRN. RESULTS: Geometric mean titers and seropositive rates of measles antibody measured by PRN were 879.7 mIU/mL(100.0%), 690.0 mIU/mL(83.3%), 182.7 mIU/mL(50.0%), 91.3 mIU/mL(50.0%), 32.2 mIU/ mL(0.0)%, 25.1 mIU/mL(0.0%), 18.1 mIU/mL(0.0%), 38.4 mIU/mL(25.0%), 27.1 mIU/mL(0.0%), 31.2 mIU/mL(0.0%), 54.3 mIU/mL(0.0%), and 27.1 mIU/mL(0.0%) from 0 to 11 months respectively. CONCLUSION: By PRN, which was used for the first time to measure the measles antibody in Korea, placentally transferred measles antibody was detected in all newborns tested and decreased reciprocally to the age of infants, leaving almost all infants older than four months seronegative. These results indicate that measles vaccination at six months of age or older, which is the current recommendation during the period of epidemic issued by the Korean Society of Pediatrics, should not cause the primary vaccine failure. It seems advisable to utilize PRN further in order to find the optimal schedule for measles vaccination to infants born to women who were vaccinated.
Antibodies* ; Appointments and Schedules ; Blood Transfusion ; Female ; Humans ; Immunization ; Infant* ; Infant, Newborn ; Korea ; Measles* ; Neutralization Tests* ; Pediatrics ; Vaccination

PURPOSE: To investigate the teratogenic effect of gamma-ray on the heart of chick embryo. METHODS: 50 rad, 100 rad, 150 rad, 200 rad, 250 rad, and 300 rad of gamma-ray were used to irradiate three days old chick embryos. The control group was not irradiated. After three weeks, the embryos were sacrificed and examined for cardiovascular malformation. RESULTS: The survival rate of the gamma-ray irradiated group was significantly lower than that of the control group(33.3-63.3% vs 76.4%, P=0.001). The cardiac malformation rate of the experimental group was 11.0%. In the control group, no congenital cardiac malformations were observed. The experimental groups had a significantly higher malformation rate(P=0.001). The types of malformation were ventricular septal defect, tricuspid atresia, Ebstein anomaly and aortic arch anomaly. In the gamma-ray irradiated group, the cardiac malformations were : 14 small ventricular septal defects (VSDs), five large VSDs, two tricuspid atresias, and one Ebstein anomaly. The higher the dose of radiation applied, the higher the incidence of cardiac malformation was noted. CONCLUSION: Gamma-ray irradiation of 3 days old chick embryos increased the rate of death and the rate of cardiac malformation significantly.
Animals ; Aorta, Thoracic ; Chick Embryo* ; Ebstein Anomaly ; Embryonic Structures ; Heart Septal Defects, Ventricular ; Heart* ; Incidence ; Survival Rate ; Tricuspid Atresia

Autologous stem cell transplantation (ASCT) for the treatment of high-risk neuroblastoma (NBL) is an accepted method for restoring bone marrow depression after high dose chemotherapy. We retrospectively analyzed eighty eight cases of NBL that underwent ASCT following marrow ablative therapy at 12 transplant centers of the Korean Society of Pediatric Hematology-Oncology between January 1996 and September 2000. Seventy nine children were of stage IV NBL and 9 were of stage III with N-myc amplification. Various cytoreductive regimens were used. However, the main regimen was 'CEM' consisting of carboplatin, etoposide and melphalan, and this was used in 66 patients. Total body irradiation was also added in 36 patients for myeloablation. To reduce tumor cell contamination, stem cell infusions after CD34+ cell selection were performed in 16 patients. Post-transplantation therapies included the second transplantation in 18 patients, interleukin2 therapy in 45, 13-cis retinoic acid in 40, 131-meta-iodobenzylguanidine in 4, conventional chemotherapy in 11, and local radiotherapy in 8. Twenty two patients died, sixty six patients are surviving 1 to 46 months after ASCT (median followup duration, 14.5 months). Although the follow-up period was short and the number of patients small, we believe that ASCT might improve the survival rate in high-risk NBL.
Adolescent ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Human ; Korea ; Male ; Myeloablative Agonists/therapeutic use ; Neuroblastoma/mortality ; Neuroblastoma/pathology ; Neuroblastoma/therapy* ; Retrospective Studies ; Stem Cell Transplantation* ; Survival Rate ; Transplantation Conditioning ; Transplantation, Autologous ; Treatment Outcome

We report a first korean case of anaphylactic response to factor lX replacement therapy in 22-month-old male hemophilia B patient. He was admitted to our hospital via emergency room due to anaphylactic response after factor lX infusion. Immediately after the infusion, he became dyspneic and cyanotic. The symptoms completely resolved after sleep. He represented same symptoms after next factor lX infusion, which completely resolved by the administration of oxygen. At the time of anaphylaxis, inhibitors of factor lX was demonstrated(8.8 Bethesda Unit). We planned him to treat with recombinant factor Vll or diluted factor lX at bleeding episode.
Anaphylaxis ; Emergency Service, Hospital ; Hemophilia A* ; Hemophilia B* ; Hemorrhage ; Humans ; Infant ; Male ; Oxygen

PURPOSE: This report is an analysis of our experience with surgery, multi-agent chemotherapy and radiotherapy, in pediatric germ cell tumors(GCTs). METHODS: This report included all children(age <15 years) who were registered between November 1985 and May 2001 with a histologically confirmed diagnosis of GCTand received surgery, chemotherapy and radiotherapy. Retrospective analysis of the medical records of these patients was performed. In addition to the clinicopathological features, the response rate, survival rate, and toxicity were analyzed. RESULTS: Among were a total of 19 patients, 6 had an ovarian tumor and 3 had a testicular tumor. Histologically immature teratoma was the most common type(11/19; 57.9%). Tumor markers were increased in 13/17(76.5%). Complete responses were observed in 17/19(89.5%) of the evaluable patients. Five year actuarial survival was 79.4% and event free survival was 84.2%. Median follow up was 46 months. CONCLUSION: From the present report, it is apparent that chemotherapy is very effective and well tolerated in children with GCTs. The data probably suggests that conservative surgery, when combined with effective chemotherapy, can result in cure of the majority of children with GCTs.
Child ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Germ Cells* ; Humans ; Medical Records ; Neoplasms, Germ Cell and Embryonal* ; Radiotherapy ; Retrospective Studies ; Survival Rate ; Teratoma ; Biomarkers, Tumor

Ewing sarcoma is an uncommon bone malignancy of childhood. Although Ewing sarcoma is mostly a tumor of bone, it may also arise from soft tissues (extraskeletal Ewing sarcoma). We report a case of extraskeletal Ewing sarcoma that arose in the retroperitoneum of a 18-month-old girl and presented with right leg pain and gait disturbance. A brief review of related literatures was also made.
Female ; Gait ; Humans ; Infant ; Leg ; Sarcoma, Ewing*

PURPOSE: Acute lymphoblastic leukemia (ALL) accounts for approximately 75% of all cases of childhood leukemia. We investigated epidemiology, clinical and laboratory features and treatment outcome of the children with ALL in Korea during recent 5 years. METHODS: One thousand forty nine patients were enrolled between January 1994 and December 1998 from 37 major hospitals in Korea. The data regarding the clinical and laboratory features including age, WBC counts at diagnosis, immunophenotype, morphology, cytogenetics and treatment outcome of patients were analyzed retrospectively by review of patient's medical records. Kaplan-Meier survival curves were constructed. The differences between groups analyzed by log-rank test. RESULTS: There were 597 males and 452 females. The distribution between the age 2 and 5 years is most common in 46.1%. The annual incidence rate per 100,000 population varied from 1.6 to 2.2. The 5 year event free survival (EFS) rates according to good prognostic factors were as follows: 67% bet ween 1-9 year of age at diagnosis, 69% in under 10,000/mm3of initial WBC count, 74% in early pre-B cell CALLA ( ) immunophenotype, 65% in L3 morphology, 68% in no CNS invasion. Most of patients were treated by CCG treatment protocol. The 5 year EFS was 63%. Main complications were sepsis (21.8%) and hemorrhage (12.5%). The relapse rate was 15.6%. The common causes of death were sepsis, DIC, pneumonia, relapse. CONCLUSION: Our results could provide the most recent and important information about acute lymphoblastic leukemia of children in Korea.
Cause of Death ; Child ; Clinical Protocols ; Cytogenetics ; Dacarbazine ; Diagnosis ; Disease-Free Survival ; Epidemiology* ; Female ; Hemorrhage ; Humans ; Incidence ; Kaplan-Meier Estimate ; Korea* ; Leukemia ; Male ; Medical Records ; Pneumonia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Precursor Cells, B-Lymphoid ; Recurrence ; Retrospective Studies ; Sepsis ; Treatment Outcome

Gastrointestinal involvement occurs in two thirds of children with Henoch-Schonlein purpura (HSP) and intussusception is by far the most common abdominal complication. Intussusception in HSP almost originates in the small bowel, which is in contrast with idiopathic intussusception. Earlier diagnosis and prompt treatment of intra-abdominal complications can reduce the mortality and ultrasound is the imaging modality of choice in evaluation the bowel manifestations of HSP. We report a case of jejuno-jejunal intussusception associated with HSP in a 5-year-old boy who presented with diffuse abdominal pain and vomiting after a few days of HSP onset. Abdominal ultrasound demonstrated intussusception in the jejunum with well defined target appearance because of the thickened intussusceptum, which disappeared on the computerized tomographic examination checked approximately 24 hours later. A brief review of literature was made.
Abdominal Pain ; Child ; Child, Preschool ; Diagnosis ; Humans ; Intussusception* ; Jejunum ; Male ; Mortality ; Purpura, Schoenlein-Henoch* ; Ultrasonography ; Vomiting