• Neonatal Medicine
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• v.15 no.2
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• pp.151-159
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• 2008

Purpose : This study determined the prenatal and postnatal factors associated with complications and prognosis in premature infants with leukemoid reaction. Methods : We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and low birth weights (<2,500 g) who were admitted immediately after birth to the neonatal intensive care unit at the Dongguk University Ilsan Hospital between June 2005 and July 2006. A leukemoid reaction was defined as an absolute neutrophil count (ANC) >30,000/$mm^3$. The infants who had leukemoid reaction comprised the study group, while the remainder of infants made up the control group. The relationships between maternal and neonatal variables and ANC were studied. Results : Leukemoid reaction was detected in 3.1% of the study infants (8 of 252). Factors more frequently associated with infants with leukemoid reaction were as follows: maternal chorioamnionitis, high levels of maternal and infant C-reactive protein, gestational age <37 weeks, birth weight <2,500 g, low Apgar score, prolonged ventilator support, and a high incidence of bronchopulmonary dysplasia (BPD). However, there were no significant differences with respect to the antenatal usage of steroids, the incidences of patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, and mortality between the two groups. Conclusion : Leukemoid reaction in premature infants was associated with chorioamnionitis and high levels of serum C-reactive protein in mothers and infants, and BPD in infants. These findings suggest that leukemoid reaction is secondary to inflammation caused by infection.

• Women's Health Nursing
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• v.5 no.1
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• pp.111-132
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• 1999

This correlational descriptive study sought to define the relationship between the experience of Sanhujori, Korean tradition non-professional postpartal care after delivery and abortion and present physical symptom distress of arthritis female who visited to outpatient clinic of rheumatic internal medicine at three hospital located in Seoul, Pusan, Chongju, Korea. Data from a convenience sample of 98 women who orally agreed to be respondent were collected from September 1, 1998 to October 31, 1998 for two months by way of interview with semi-structured questionnaire. Data analysis consisted of frequency, percentage, mean, S. D., Pearson Correlation Coefficient, t-test, ANOVA and Scheffe test as a post hoc by SPSS. The results of the study were as follows ; Mean age of participants as 52.8 years and mean number of children 3.3. Mean frequency of child birth was 3.1 times per woman, 67.4% of respondents had menopause, 57.0% did not have Sunhujori after abortion. The health status implies the subjective health status women perceived, which came from the three points of view of the present, comparative with other of same age and changed after delivery. The respondents of 76.1% perceived them as unhealthy and the main sites of physical symptom distress were upper & lower extremities including knee and hand 34.8%, shoulder 26.5%, waist 22.4%. Women perceived the etiology of the arthritis as 'did Sanhujori wrongly' 36.7%, 'aging process' 24.5%, 'stress' 16.3%, 'overwork' 15.3%, 'Immunocompromize' & 'physical constitution' 7.1% respectively, 'character' 3.1%, 'genetic' 2.0%, 'malnutrition' 1.0%. The mean period of Sanhujori after delivery was 20.4 at the first child and 18.1 at the second child. The higher frequency of child birth, the shorter period of Sanhujori. For the subjective evaluation of whether the women did Sanhujori well or not, the rate of 'did Sanhujori well' was the highest rank in the first child and the rate of 'did not particularly Sanhujori well' was the highest rank in the last child. There was a significant positive correlation between physical function disability and rheumatoid arthritis symptom at the level of 1% of significance statistically(r=.406). And a positive correlation between physical function disability and Sanhubyung symptom at the level of 5% of significance statistically(r=.224). There was a significant positive correlation among rheumatoid arthritis symptom, Sanhubyung symptom and menopause symptom at the level of 1%-5% of significance statistically. Most of all, the correlation between Sanhubyung symptom and menopause symptom was the higher than others. There was a negative correlation between the present physical symptom distress and experience of Sanhujori(r=.-130), however it was not significant statistically. However, there was a positive correlation between subjective health status and experience of Sanhujori at the level of 1% of significance statistically(r=.328). In conclusion, this finding reconfirmed the positive relationship between the perceived health status and experience of Sanhujori after delivery among women of arthritis. It provides a challenge to the professional care givers to study further on the effects of Sanhuiori after abortion or delivery on the physical symptom distress from the variouis aspects through the cross-sectional and longitudinal research. The strategy for the development of the appropriate intervention for primary prevention of sequele after childbirth and quality of care for desirable health outcomes for postpartal women with considering deeply on the relationship between women's health and postapartal care.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.227-236
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• 2002

Purpose : A study was done to assess the incidence and classification of congenital urinary tract anomalies detected by antenatal ultrasonogram. Methods : We reviewed 558 cases of urinary tract anomaly which were detected by antenatal ultrasonogram and postnatally confirmed between June 1989 and May 2002. We investigated the incidence and classified congenital urinary tract anomalies by review of medical records, antenatal and postnatal radiologic studies retrospectively. Results : In 558 cases of congenital urinary tract anomalies, 292 cases of hydronephrosis were found and the most common. Another anomalies were composed of 65 cases of multicystic dysplastic kidney, 32 cases of hydroureteronephrosis, 31 cases of duplication of kidney, 25 cases of renal agenesis, 21 cases of simple renal cyst, 20 cases of polycystic disease, 13 cases of ureterocele, 11 cases of renal hypoplasia, 10 cases of horseshoe kidney, 9 cases of vesicoureteral reflux, 8 cases of posterior urethral valve, 7 cases of bladder diverticulum, 6 casts of megaureter, 5 cases of ectopia, 2 cases of megacystis, and 1 case of medullary cystic disease. In 82 of the 558 cases, there were two or more combined urinary tract anomalies. Associated diseases other than urinary tract were observed in 13 cases, of which the congenital heart disease was the most common. Conclusion : The congenital urinary tract anomaly is frequently found and diverse during the antenatal ultrasonography. The multicenter study is needed to investigate precise incidence and distribution of each anomalies in general population.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.60-66
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• 2003

Purpose : Neonatal hydronephrosis has been detected with increasing frequency with the widespread use of prenatal ultrasonography, but the consensus about its postnatal management has not yet been reached, especially about surgical intervention. We attempted to determine the guideline of follow-up study and surgical intervention of hydronephrosis by analyzing clinical outcomes of neonates with hydronephrosis. Materials and Methods : Between 1994 and 2000, 128 hydronephrotic kidneys were postnatally confirmed. Cases associated with other urologic anomalies were excluded and 90 unilateral hydronephrotic kidneys with a minimum follow-up of 12 months were enrolled in this study. We classified the patients into 6 groups according to the anterior posterior pelvic diameter(APPD) at initial ultrasonography(USG) within 1 month after birth. Renal USG and $Tc^{99m}-mercaptoacetyl$ triglycerine(MAG3) scan were done according to a set protocol, and pyeloplasty was performed when indicated according to our protocol. Results : Most cases whose APPD were below 10 mm improved or resolved. Only few cases with APPD above 20 mm showed spontaneous improvement and most(88%) had undergone operation. Those with initial APPD within 10-19 mm showed variable outcomes. When the risk factors for irreversible renal functional deterioration were analyzed, the age at pyeloplasty and pre-operative functional deficit were significant. Conclusion : We concluded that in infants with initial APPD below 10 mm, consideration of surgery is not needed, and in those with initial APPD above 20 mm, early operation is recommended. Our set protocol based on initial USG is useful, but the cut-off value of relative renal function(RRF) for operation might be increased to 40% to improve post operative RRF.

• Neonatal Medicine
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• v.17 no.1
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• pp.21-33
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• 2010

Purpose : The increased survival of preterm infants in the neonatal intensive care unit recently has resulted in an increased frequency of bronchopulmonary dysplasia (BPD), especially with atypical forms. However, there have been few studies compairing classic and atypical BPD. The aim of this study was to investigate the differences between these two types of BPD. Methods : Infants with a gestational age less than 32 weeks born at the Seoul National University Hospital and Bundang Seoul National University Hospital from May 2004 to April 2007 were included. The data were categorized in 2 groups, classic and atypical BPD. We determined the incidence of BPD, and compared perinatal factors and postnatal managements between two groups. Results : Among 260 study subjects, 141 (54.2%) infants had BPD. Classic BPD infants were 64 and atypical BPD infants were 77. Comparison of differences between 2 groups, classic BPD infants were associated with respiratory distress syndrome, patent ductus arteriosus, intrauterine growth restriction, more high-frequency ventilator (HFV) use, low 1 and 5 minute Apgar scores. Atypical BPD infants were associated with antenatal steroid use, maternal premature rupture of membrane and chorioamnionitis (CAM). In multivariate analysis, more HFV use was associated with classic BPD. Antenatal steroid use, clinical CAM and histological CAM were associated with atypical BPD. Conclusion : The results of this study showed that antenatal factors (antenatal steroid use, clinical CAM, histological CAM) were associated with atypical BPD and postnatal factors (HFV used more) were associated with classic BPD. Further studies are needed for prevention and treatment of BPD.

• Journal of Genetic Medicine
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• v.8 no.1
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• pp.1-16
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• 2011

Owing to the risk of fetal loss associated with prenatal diagnostic procedures (amniocentesis, chorionic villus sampling), noninvasive prenatal diagnosis (NIPD) is ultimate goal of prenatal diagnosis. The discovery of circulating cell-free fetal DNA (cffDNA) in maternal plasma in 1997 has opened up new probabilities for NIPD by Dr. Lo et al. The last decade has seen great development in NIPD. Fetal sex and fetal RhD status determination by cffDNA analysis is already in clinical use in certain countries. For routine use, this test is limited by the amount of cell-free maternal DNA in blood sample, the lack of universal fetal markers, and appropriate reference materials. To improve the accuracy of detection of fetal specific sequences in maternal plasma, internal positive controls to confirm to presence of fetal DNA should be analyzed. We have developed strategies for noninvasive determination of fetal gender, and fetal RhD genotyping using cffDNA in maternal plasma, using real-time quantitative polymerase chain reaction (RT-PCR) including RASSF1A epigenetic fetal DNA marker (gender-independent) as internal positive controls, which is to be first successful study of this kind in Korea. In our study, accurate detection of fetal gender through gestational age, and fetal RhD genotyping in RhD-negative pregnant women was achieved. In this assay, we show that the assay is sensitive, easy, fast, and reliable. These developments improve the reliability of the applications of circulating fetal DNA when used in clinical practice to manage sex-linked disorders (e.g., hemophilia, Duchenne muscular dystrophy), congenital adrenal hyperplasia (CAH), RhD incompatibility, and the other noninvasive pregnant diagnostic tests on the coming soon. The study was the first successful case in Korea using cffDNA in maternal plasma, which has created a new avenue for clinical applications of NIPD.

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