• Neonatal Medicine
• /
• v.18 no.1
• /
• pp.104-110
• /
• 2011

Purpose: The unique nutrient requirements of premature infants necessitate knowledge of the composition of human milk produced by mothers of such infants. We investigated longitudinal changes in iron concentration of preterm human milk and compared to those observed in human milk of mothers of 1-week old term infants to determine optimal iron supplementation guidelines when preterm infants are nourished exclusively by breast feeding. Methods: Human milk samples were collected at 1, 2, 4, 6, 8 and 12 weeks postpartum from 103 mothers who delivered infants of gestational age <34 weeks or weighing <1,800 g. Term human milk samples were collected at 1 week postpartum from 24 mothers. Results: There were no significant differences in the iron concentrations of preterm human milk obtained at 2 to 8 weeks postpartum (36.3${\pm}$23.1 to 45.8${\pm}$26.0 $\mu$g/dL), but these concentrations were higher than those noted at 1 week in preterm (23.1${\pm}$14.6 $\mu$g/ dL) and term (25.2${\pm}$7.55 $\mu$g/dL) infants. The iron concentration in preterm human milk obtained at corrected term age (42.2${\pm}$19.4 $\mu$g/dL) was significantly higher than that of mature term human milk (25.2${\pm}$7.55 $\mu$g/dL). Conclusion: The concentration of iron in preterm human milk was consistently low during the first 3 months of lactation. Supplementation with iron of at least 2 mg/kg/day should be considered for preterm infants who are exclusively breastfed and who have low body iron stores, to meet the minimum enteral iron requirements recommended by AAP-CON (2004).

• Clinical and Experimental Pediatrics
• /
• v.51 no.7
• /
• pp.729-735
• /
• 2008

Purpose : Chlamydia trachomatis is one of the most common sexually transmitted diseases and is also a cause of pneumonia in infants. Respiratory infections by respiratory viruses are also common for infants. The objectives of this study were to identify the clinical manifestations and to determine the prevalence of C. trachomatis respiratory infections and coinfections by respiratory viruses in infants younger than 6 months of age. Methods : For this study, we enrolled 6 months or younger infants who were admitted to the Dankook University Hospital between January 2002 and July 2007, with respiratory symptoms. Nasopharyngeal aspirates or throat swabs were collected within s d of hospitalization and C. trachomatis was detected using polymerase chain reaction (PCR). Patients who tested positive underwent multiplex PCR for respiratory viruses. Results : A total of 690 patients underwent chlamydial PCR testing and 36 (5.2%) had positive results. Of the 36, 28 (78%) were male; 30 were vaginally delivered. From the 36 patients positive for C. trachomatis, 26 underwent multiplex respiratory viral PCR; 12 were coinfected with viruses. Respiratory syncytial virus (RSV) was the most frequent pathogen that was detected in 6 patients. Increased C-reactive protein and fever were significant in patients coinfected with respiratory viruses. Conclusion : C. trachomatis can infected in infants delivered by cesarean section as well as in 6 months old or younger infants. Infant with C. trachomatis respiratory infections can also be coinfected with respiratory infection also coinfected with respiratory viruses. Further studies are needed to better understand the prevalence rates of the this infection and its coinfection rate with respiratory viruses.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.8 no.1
• /
• pp.50-56
• /
• 1997

The objective of this study was to compare the family environment and developmental history of three groups of children classified by their temperament. The parents of 484 Korean children aged between 3 and 7 years completed the Korean version of Parental Temperamental Questionnaire developed by Thomas and Chess and Developmental Questionnaire created by Division of Child and Adolescent Psychiatry, Samsung Medical Center. After clustering these children into 5 temperamental groups according to the method proposed by Fullard et al, 98 Easy, 36 Difficult, and 21 Slow-To-Warm-Up children were included in the analysis. Statistically meaningful differences observed among three groups were as follow：1) Marital conflict of parents was more frequent in Difficult and Slow-To-Warm-Up children than in Easy children. 2) Parentchild conflict was more frequent in Difficult children than in Easy children. 3) Conflict among siblings was more frequent in Difficult children than in Easy children. 4) Average monthly income of family was less in Difficult children than in Easy children. 5) Toilet training was achieved later in Difficult children than in Easy children. 6) Motor development was slower, between 2 and 5 years old, in Slow-To-Warm-Up children than in Easy children. 7) Fear of stranger started earlier in Slow-To-Warm-Up children than in easy children. 8) Physical health was poorer in Difficult and Slow-To-Warm-Up children than in easy children. The findings indicate that Difficult child or Slow-To-Warm-Up child group have unfavorable family environment, different developmental milestone and poorer physical health in comparison with Easy child group.

• Journal of Genetic Medicine
• /
• v.5 no.1
• /
• pp.47-54
• /
• 2008

Purpose : Fluorescence in situ hybridization (FISH) on uncultured amniotic fluid cells offers the opportunity for rapid screening of aneuploidies and has become an integral part of the current practice in many clinical cytogenetics laboratories. Here, we retrospectively analyzed the results of interphase FISH in 943 amniotic fluid samples and assessed the efficiency of FISH for rapid detection of aneuploidies. Methods : Interphase FISH for chromosome 13, 18, and 21 was performed in 943 consecutive amniotic fluid samples for rapid diagnosis of aneuploidies referred from 2004 to 2006. Karyotypes from standard cytogenetic analysis were compared to the FISH results. Results : A total of 45 chromosomal rearrangements (4.8%) were found after conventional cytogenetic analysis of the 943 amniotic fluid. After exclusion of known familiar chromosomal rearrangements and inversions (2.1%, 20/943), 2.7% (25/943) were found to have chromosomal abnormalities. Of this group, 0.7% (6/943) were chromosomal abnormalities not detectable by FISH and 2.0% (19/943) were numerical abnormalities detectable by FISH. All 14 cases of Down syndrome (Classic type, 13 cases; Robertsonian type, 1 case) and 5 cases of trisomy 18 were diagnosed and detected by FISH and there were no false-positive or -negative results (specificity and sensitivity=100%). Conclusion : The present study demonstrates that FISH can provide a rapid and sensitive clinical method for prenatal identification of chromosome aneuploidies. However, careful genetic counseling is essential to explain the limitations of FISH, including the inability to detect all chromosomal abnormalities and the possibilities of uninformative or false-negative results in some cases.

• Neonatal Medicine
• /
• v.15 no.2
• /
• pp.142-151
• /
• 2008

Purpose : The aim of this study was to compare the clinical effects of modified porcine (Curosurf$^{(R)}$) and bovine (Newfactan$^{(R)}$) surfactants in the treatment of neonatal respiratory distress syndrome. Methods : Between April 2004 and December 2006, 65 neonates (birth weight ${\leq}$2,500 g and gestational age ${\leq}$35 weeks) with neonatal respiratory distress syndrome were treated in our neonatal intensive care unit with surfactant. Thirty-one neonates received Curosurf$^{(R)}$ and 34 neonates received Newfactan$^{(R)}$. The neonates were not enrolled if they had major congenital anomalies or meconium aspiration syndrome. We compared the changes in respiratory parameters after surfactant instillation, the incidences of acute and chronic complications, and the mortality between the two treatment groups. Results : Neonatal and maternal demographic characteristics were not different between the groups. The patterns of change in the respiratory parameters after surfactant instillation were not statistically different between the groups. The incidences of surfactant reinstillation and acute complications, such as pneumothorax, patent ductus arteriosus, pulmonary hemorrhage, and grade 3-4 intraventricular hemorrhage, were not different between the neonates who received Curosurf$^{(R)}$ and the neonates who received Newfactan$^{(R)}$. There were no statistically significant differences in the duration of mechanical ventilation, oxygen therapy, hospitalization, prevalence of bronchopulmonary dysplasia, periventricular leukomalacia, retinopathy of prematurity, necrotizing enterocolitis, and mortality between the groups. Conclusion : In the present comparative study, no significant differences in the clinical effects of Curosurf$^{(R)}$ and Newfactan$^{(R)}$ were observed.

• Journal of Nutrition and Health
• /
• v.48 no.6
• /
• pp.476-487
• /
• 2015

Purpose: This study was conducted to examine the concentration of nutrients in transitional breast milk from Korean lactating mothers and to evaluate daily intakes of their infants based on the Dietary Reference Intakes for Koreans 2010 (KDRIs 2010). Methods: Breast milk samples were collected at 5~15 days postpartum from 100 healthy lactating Korean mothers. Macro- and micro-nutrients, and immunoglobulin (Igs) concentrations in breast milk were analyzed. Results: The mean energy, protein, fat, and carbohydrate concentrations in breast milk were $59.99{\pm}8.01kcal/dL$, $1.47{\pm}0.27g/dL$, $2.88{\pm}0.89g/dL$, and $6.72{\pm}0.22g/dL$. The mean linoleic acid (LA), a-linolenic acid (ALA), arachidonic acid (AA), and docosahexaenoic acid (DHA) concentrations were $181.44{\pm}96.41mg/dL$, $28.15{\pm}8.89mg/dL$, $5.67{\pm}1.86mg/dL$, and $5.74{\pm}2.57mg/dL$. The mean vitamin A, vitamin D, vitamin E, vitamin $B_1$, vitamin $B_2$, vitamin $B_{12}$, and folate concentrations were $2.75{\pm}1.75{\mu}g/dL$, $2.31{\pm}1.12ng/dL$, $0.74{\pm}1.54mg/dL$, $3.02{\pm}1.84mg/dL$, $7.51{\pm}20.96{\mu}g/dL$, $61.78{\pm}26.78{\mu}g/dL$, $63.71{\pm}27.19ng/dL$, and $0.52{\pm}0.26{\mu}g/dL$. The mean concentrations of calcium, iron, potassium, sodium, zinc, and copper were $20.71{\pm}3.34mg/dL$, $0.59{\pm}0.86mg/dL$, $66.71{\pm}10.35mg/dL$, $27.72{\pm}10.16mg/dL$, $0.44{\pm}0.41mg/dL$, and $70.48{\pm}30.41{\mu}g/dL$. The mean IgA and total IgE concentrations were $61.85{\pm}31.97mg/dL$ and $235.00{\pm}93.00IU/dL$. The estimated daily intakes of infants for protein, vitamin D, vitamin E, vitamin $B_2$, vitamin $B_{12}$, iron, potassium, sodium, zinc, and copper were sufficient compared to KDRIs 2010 adjusted by transitory milk intakes. The estimated infants' intakes of energy, fat, carbohydrate, vitamin A, vitamin C, vitamin $B_1$, folate, and calcium did not meet KDRIs 2010 adjusted by transitory milk intakes. Conclusion: In general most estimated nutrient intakes of Korean breast-fed infants in transitory breast milk were sufficient, however some nutrient intakes were not sufficient based on KDRIs 2010. These results warrant conduct of future studies for investigation of important dietary factors associated with nutrients in breast milk to improve the quality of breast milk, which may contribute to understanding nutrition in early life and promoting growth and development of breast-fed infants.