Vascular endothelial growth factor levels in newborns with meconium stained amniotic fluid

Objective  The effects of meconium-stained amniotic fluid (MSAF) on cord blood vascular endothelial growth factor (VEGF) levels have not been explored. The aim of this study was to verify whether MSAF influences cord blood VEGF levels in healthy term neonates and we can use cord blood VEGF levels in infants with MSAF as an indicator of fetal distress. Methods  Using an enzyme-linked immunosorbent assay double sandwich method, plasma VEGF levels were determined in 18 healthy term neonates with MSAF and in 16 healthy term neonates without MSAF. Results  VEGF plasma levels were not significantly different between healthy term neonates with or without MSAF. Conclusion  Intrauterine meconium passage could not affect VEGF levels on cord blood in term newborn infants and VEGF level may not be used as an indicator of fetal distress in infants with MSAF.     

Successful Implantation of an Intracardiac Defibrillator in an Infant With Long QT Syndrome and Isolated Noncompaction of the Ventricular Myocardium

Congenital long QT syndrome (LQTS) is an inherited disorder characterized by QT prolongation and polymorphic ventricular tachycardia known as torsade de pointes. The underlying cellular mechanism is prolonged ventricular repolarization caused by mutations in genes encoding cardiac ion channels or membrane adaptors. The disease can be diagnosed at any age and, very rarely, it can be diagnosed prenatally or in the neonatal period. Isolated noncompaction of the ventricular myocardium (INCVM) is defined as the presence of prominent ventricular trabeculations and deep intertrabecular recesses within the endomyocardium. This report describes a newborn baby presenting with polymorphic ventricular tachycardia whose diagnosis was LQTS and INCVM. Ventricular tachycardia did not respond to medical treatment, and a transient epicardial pacemaker was inserted surgically on his 30th day of life for atrioventricular block and bradycardia. The transient epicardial pacemaker was upgraded to an epicardial intracardiac defibrillator on his 40th day. The concomitant occurrence of INCVM, LQTS, and atrioventricular block needs to be evaluated further.     

Persistent hypoglycemia caused by umbilical arterial catheterization

Hypoglycemia as an umbilical artery catheter (UAC) complication is rare. We present a neonate with hyperinsulinemic hypoglycemia due to a high-positioned UAC used inadvertently for parenteral nutrition. The aim of this report is to increase physicians' awareness of the possibility of this rare complication.     

Long-term optional retrievability of a new inferior vena cava filter in an ovine model

Long-term retrievability of a new optional retrieval inferior vena cava (IVC) filter composed of a modified square stent and a modified Günther Tulip filter was tested in eight sheep. Eleven filters were placed into the IVC and eight were successfully retrieved 3-5 months after implantation. Incorporation of the filter struts into the IVC wall prevented its retrieval in three sheep at 3, 4, and 5 months after placement.     

An analysis of HELLP syndrome cases: does platelet count predict adverse maternal and fetal outcomes in women with HELLP syndrome?

Purpose  

To evaluate the maternal and fetal outcome in 44 pregnancies complicated with HELLP syndrome and to investigate the role of platelet counts in its prognosis.     

Primary malignant melanoma of the cervix: report of a case

Background  To present a case of primary malignant melanoma of the cervix. Case   The patient was admitted with the complaint of vaginal bleeding. Gynecological examination revealed a dark, papillary mass on the posterior lip of the cervix. Histopathology showed a malignant neoplasm with increased vascularity, indicating the possibility of a primary uterine cervical melanoma. Diagnosis of malignant melanoma was confirmed with immunohistochemistry, which showed diffuse positive reactions for S-100 protein and HBM-45, with no reaction for epithelial markers, namely cytokeratin AE1/AE3 and epithelial membrane antigen. An extensive search for a melanotic lesion in skin and in uveal tract was performed to verify the distinct site of melanoma. The tumor was stage IB1 according to the International Federation of Gynecology and Obstetrics classification.The patient underwent radical Wertheim–Meigs hysterectomy, bilateral salpingo-oopherectomy, and retroperitoneal pelvic lympadenectomy. Radiotherapy or chemotherapy was not performed in the postoperative period. She is now free of the disease 10 months after the operation. Conclusion  Primary malignant melanoma of the cervix is a rare cervical malignancy.     

Association of <Emphasis Type="Italic">Escherichia</Emphasis><Emphasis Type="Italic">coli</Emphasis> O157:H7 with necrotizing enterocolitis in a full-term infant

Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency of the neonate. NEC is predominantly seen in premature infants; however, in rare instances it can affect full-term infants as well. Although the pathogenesis of NEC remains elusive, it is well established that bacterial colonization is required for development of this disease. In this report, we present a case of a full-term infant, who developed a very aggressive form of NEC and was found to have Escherichia coli (E. coli) O157:H7 both in stool and blood cultures. Unfortunately, despite aggressive surgical and intensive care management, this infant suffered pan-intestinal necrosis and expired. We were not able to establish the route of transmission. To our knowledge, this is the first report of the association of E. coli O157:H7 with NEC.