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Many factors are affecting intrauterine growth. The role of Wingless-type (Wnt) inducible signaling pathway protein-1 (WISP1), a novel adipokine and placental proteoglycans in intrauterine growth, is not known. We aimed to measure umbilical cord blood levels of glucose, insulin, leptin, WISP1, and placental proteoglycans [glypican-1 (GPC1), glypican-3 (GPC3), and syndecan-1 (SDC1)] which are thought to have an important role in fetal growth and investigate their relation with birth weight.Full-term neonates were included in this prospective, cross-sectional study and classified as appropriate for gestational age (AGA), small for gestational age (SGA), and large for gestational age (LGA) according to their birth weight. Umbilical cord blood levels of glucose, insulin, leptin, WISP1, GPC1, GPC3, and SDC1 were measured.Leptin levels were higher in LGA newborns compared to AGA and SGA newborns, while WISP1, GPC1, GPC3, and SDC1 levels were not different between the three groups. Leptin and GPC1 levels were higher in infants of mothers with gestational diabetes mellitus compared to infants of non-diabetic mothers, while WISP1, GPC3, and SDC1 were not different between the groups. Leptin was positively correlated with insulin, birth weight, and maternal weight. While there was a strong correlation between the WISP1, GPC1, GPC3, and SDC1 levels; there was no correlation between the birth weight, maternal weight, glucose, insulin, and WISP1, GPC1, GPC3, and SDC1 levels.Umbilical cord blood levels of GPC1, GPC3, SDC1, and WISP1 were not different between SGA, AGA, and LGA infants. The significance of serum levels of these adipokines and proteoglycans remains to be elucidated.

Akyuz-Unsal AI, Key O, Guler D, Bekmez S, Sagus M, Akcan AB, Kurt-Omurlu I, Anik A, Oruc-Dundar S, Turkmen M. Retinopathy of prematurity risk factors: Does human milk prevent retinopathy of prematurity? Turk J Pediatr 2019; 61: 13-19. The aim of this study was to investigate the risk factors for Retinopathy of Prematurity (ROP) development and the potential effect of human breast milk among these factors. For this purpose, infants admitted to a tertiary referral clinic for ROP screening and treatment between April 2013 and May 2015, were included in this retrospective study. The demographic data, accompanying diseases, previous surgery, type of feeding and duration of human breast milk intake were recorded. According to the ROP screening examination results, infants were divided into two groups as those with ROP (infants at any stage of ROP) and those without ROP. Relationship between the risk factors and ROP were evaluated. The comparison of 221 infants without ROP and 99 infants with ROP; revealed that gestational age at birth, birth weight, mechanical ventilation support, bronchopulmonary and cardiac diseases, hydrocephaly, any previous surgery, infections, steroid treatment percentages were high and human breast milk intake percentage was low among infants with ROP. Mean breast feeding time for infants with ROP (3.81 ± 2.33 month) was shorter than the infants without ROP (5.51 ± 1.43 month) (p < 0.001). In logistic regression analysis, the duration of breast feeding was inversely related with ROP (OR 0.744; 95% CI 0.621-0.891; p < 0,001). These results suggest that gestational age at birth and accompanying diseases are the main risk factors for the development of ROP. As the duration of the breast feeding of the infants without ROP was longer than the infants with ROP; breast feeding may have a preventive effect on ROP development.

BACKGROUND Twin-to-twin transfusion syndrome (TTTS) is a significant cause of perinatal morbidity and mortality. Fetoscopic laser photocoagulation (FLP) is the optimal treatment option for twin-to-twin transfusion syndrome; but can cause central nervous system, extremity and intestinal system injury. CASE We report the case report of ileal atresia and severe cerebral infarction co-occurrence after fetoscopic laser photocoagulation treatment. It is uncertain as to whether ileal atresia occurred due to ischemia associated with TTTS, the treatment with FLP, or a combination of both. CONCLUSIONS Cases with prenatal ultrasonographic abnormalities after FLP should have a close assessment to detect bowel complications. Despite many developments in its management, TTTS remains an important risk factor for cerebral injury.

Purpose Intravenous immunoglobulin (IVIG) therapy is used in inflammatory diseases but the use of immunoglobulin as a treatment for acute lung injury (ALI) has not been previously studied. Transforming growth factor beta (TGF-β) plays a critical role in the pathogenesis of of ALI. Therefore we examined the levels of TGF-β and lung inflammation scores in IVIG treated ALI models. Methods Intratracheal lipopolysacccharide was given to rats. Groups 1 and 3 received saline, whereas group 2 received IVIG. 24 h later saline was given to groups 1 and 2 and IVIG to group 3. Blood samples and bronchoalveolar lavage (BAL) fluids were obtained from each group and sacrificed for pathological evaluation. Results BAL TGF-β levels of groups 2 and 3 on day 30, were lower compared to their levels of day 2 (p = 0.01, p = 0.01). BAL TGF-β levels of groups 2 and 3 were lower than the levels of group 1 on day 30 (p = 0.002, p = 0.001). Pathological examination revealed that the inflammation scores of groups 2 and 3 on day 30, were lower than the scores of day 2 (p = 0.02, p = 0.01). Inflammation scores of group 2 were lower than group 1 on day 30 (p = 0.02). Moderate fibrosis was seen in half of the rats from group 1 and one rat from group 2. Conclusion High-dose IVIG decreased lung inflammation scores and BAL TGF-β1 levels and this therapy would give even better results if it is given earlier.

Since newborns are obligatory nasal breathers, upper respiratory tract problems may sometimes be life threatening. The most common pathology causing dyspnea and stridor in newborns is laryngomalacia. Nasal cavity pathologies that risk the neonatal airway are more rarely met. These anomalies may be seen either as solitary anomalies or as a part of a syndrome. While choanal atresia is one of the best-known nasal cavity anomalies, choanal stenosis, congenital nasal mid-line masses, congenital nasal pyriform aperture stenosis, and nasal tip anomalies are more rarely seen structural pathologies. Choanal atresia may be present either as an isolated congenital anomaly or as a part of CHARGE syndrome. Some rare chromosome anomalies may also cause significant problems during nasal respiration in newborns. With this study, we presented a case series of newborns with pathologies that affected nasal respiration. Although the diagnosis and treatment of choanal atresia and congenital dacryocystocele are well known, the information on the diagnosis and treatment of the other two uncommon cases are limited. With this study, we aimed to contribute to the literature by presenting our approach in six cases having congenital pathologies that cause nasal respiratory obstruction.

Alexander disease is a rare autosomal recessive disorder that is characterized by degeneration of the white matter in the central nervous system. Alexander disease is a leukodystrophy that is usually observed in early childhood but rarely in adults. It is characterized by megalencephaly, demyelinization and multiple Rosenthal fibers. Specific magnetic resonance imaging (MRI) findings and genetic investigations are necessary to diagnose the disorder. Signs of leukodystrophy were found in the bilateral white matter on a brain MRI of our four-year-old patient. He had megalencephaly since birth. We use this case to discuss Alexander disease.

Fraser syndrome is a rare autosomal recessive disorder comprising cryptophtalmus, syndactyly and genital abnormalities. The diagnosis is usually made at birth from the obvious malformations, occasionally made on prenatal ultrasound. It is rare and is associated with various types of laryngeal abnormalities such as subglottic stenosis, laryngeal webbing or atresia. We herein report an infant who presented with respiratory failure in neonatal intensive care unit and diagnosed as Fraser syndrome with laryngeal web that had not been recognized in prenatal period.

Trisomy 18 is the second most common autosomal trisomy in liveborn infants. Various congenital malformations, mental retardation, and high rate of infant mortality in the first year of life are characteristic features of trisomy 18. Congenital heart disease occurs in over 90% of these patients and the most common cardiac lesions are ventricular septal defect, patent ductus arteriosus and atrial septal defect. This is a case report of a baby born with trisomy 18 (postnatal diagnosis) in whom there was an unusual echocardiographic appearance of a mobile structure (“flap-like”) around the area of a VSD—which was imaged prenatally. (Echocardiography 2011;28:E191-E193)

Safra kesesi hidropsu, cocukluk caginda seyrek gorulen ve safra kesesinin tassiz asiri distansiyonu ile karakterizedir. Safra kesesi tasi,bakteriyel enfeksiyon veya safra sisteminin kongenital anomalilerinin yoklugu ile karakterizedir. Ates, kusma, karin agrisi, skleralarda ikter, hepatomegali ve sag hipokondriyumda hassasiyet ile basvuran yedi yasinda bir kiz cocugunu sunduk. Laboratuar incelemeleri, hiperbilirubinemi ve artmis karaciger enzim duzeylerini gostermekteydi. Bakteriyel veya parazitik enfeksiyon bulgusu yoktu. Viral hepatit serolojisi akut hepatit A enfeksiyonunu gostermekteydi. Abdominal ultrasonografi distandu, hidropik, tassiz safra kesesini gostermekteydi. Bu yazimizda, hepatit A virus enfeksiyonu nedeniyle gelisen akut viral tassiz kolesistitli yedi yasinda bir kiz cocugunu sunduk.

Trisomy 18 is the second most common autosomal trisomy in liveborn infants. Various congenital malformations, mental retardation, and high rate of infant mortality in the first year of life are characteristic features of trisomy 18. Congenital heart disease occurs in over 90% of these patients and the most common cardiac lesions are ventricular septal defect, patent ductus arteriosus and atrial septal defect. This is a case report of a baby born with trisomy 18 (postnatal diagnosis) in whom there was an unusual echocardiographic appearance of a mobile structure ("flap-like") around the area of a VSD-which was imaged prenatally.