• Pediatric Infection and Vaccine
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• v.14 no.2
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• pp.145-154
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• 2007

Purpose : Rotavirus is one of the most important etiologic agents of nosocomial infections among the neonates. This study was designed to investigate nosocomial rotavirus infection in neonates who were admitted to a postpartum-care center after birth. Methods : From March 2005 to September 2006, 957 healthy neonates were examined for rotavirus antigen in stool by immunochromatographic method and 216 neonates were rotavirus antigen positive within 24 hours after admitted to a postpartum-care center. We reviewed the nursing charts retrospectively such as characteristics, monthly distribution, birth hospitals, delivery methods, feeding types and clinical manifestations. Results : Among 957 neonates, 216 neonates (22.6%) were rotavirus antigen positive and there were no differences in sex, birth weight, gestational age. Monthly positive rate of rotavirus antigen showed diversity from 10% to 36%. According to birth hospitals, positive rate showed diversity from 3.5% to 53.6%. Out of 957 neonates, 655 cases (68.4%) were born of vaginal delivery and mean hospitalized duration was 2.4 days, 302 cases (31.6%) were born of cesarean section and mean hospitalized duration was 5.7 days. 17.6% of vaginal delivery and 33.4% of cesarean section were rotavirus antigen positive. The positive rate was higher in neonates by cesarean section than vaginal delivery (P<0.001). According to feeding types, positive rate of rotavirus antigen was lower in breast-fed group than formula-fed group (P<0.001). Proportion of symptomatic case among rotavirus antigen positive was 34.7%. Most common clinical manifestation was diarrhea (61.3%), following poor feeding (45.3%), fever (40.0%), vomiting (25.3%), delayed weight gain (12.0%), and decreased urine amount (5.3%). Conclusion : Some neonates were already infected before admission to a postpartum-care center. Without meticulous management, nosocomial rotavirus infection would transmit rapidly in a postpartum-care center spreading to the community. Recommendation of breast-feeding, routine rotavirus screeing test with or without symptom, and isolation of all rotavirus antigen positive neonates in a postpartum-care center seem to be necessary. Also attentive hygiene education and further investigations of rotavirus infection in a postpartum-care center would be needed.

• Clinical and Experimental Pediatrics
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• v.48 no.4
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• pp.376-379
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• 2005

Purpose : Mycoplasama pneumoniae is a leading cause of pneumonia and exacerbates other respiratory conditions such as asthma. Surfactant protein A(SP-A) is involved in surfactant physiology and surfactant structure, and plays a major role in innate host defense and inflammatory processes in the lung. In this study, SP-A mediated mycoplasma cidal activity. The candidate-gene approach was used to study the association between the SP-A gene locus and Mycoplasama pneumoniae pneumonia in the genetically homogeneous Korean population. Methods : PCR-cRFLP-based methodology was used to detect SP-A genotype. The forty nine children with Mycoplasama pneumoniae pneumonia were matched to 50 nomal neonates. Results : The specific frequencies for the alleles of the SP-A1 and SP-A2 gene in the study population were : $6A^2=21$ percent, $6A^3=45$ percent, $6A^4=11$ percent, $6A^8=9$ percent, $6A^{14}=8$ percent, 1A=11.3 percent, $1A^0=38$ percent, $1A^1=12.7$ percent, $1A^2=9.2$ percent, $1A^5=15.5$ percent, $1A^7=2.9$ percent, $1A^8=4.9$ percent, $1A^9=2.2$ percent, others=3.3 percent. The frequencies of specific genotypes such as $1A^2$ was higher than control group, significantly. Conclusion : $1A^2$ are susceptible factors for Mycoplasama pneumoniae pneumonia. We conclude that the SP-A gene locus($1A^2$) is an important determinant for predisposition to Mycoplasama pneumoniae pneumonia in children.

• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.388-393
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• 2006

Purpose : We compared the pain reducing effect of orally administered glucose solution with EMLA cream and pacifiers during venipuncture in newborn infants. Methods : Fifty newborn infants(30 prematures) were enrolled in this study. We performed these four pain-reducing methods to all infants in serial order. Group A(control) did not receive any treatment; to group B, EMLA cream was applied on the skin for 1 hour; group C(or D) received 10 percent(or 30 percent) glucose solution orally; group E used pacifiers. Symptoms and signs associated with pain at venipuncture were measured with the Premature Infants Pain Profile(PIPP) scale. Results : There was no significant difference in the PIPP scores between preterm and fullterm infants. The mean PIPP scores of groups were A : $12.5{\pm}2.5$, B : $10.1{\pm}2.6$, C : $9.4{\pm}2.0$, D : $6.5{\pm}2.1$ and E : $8.7{\pm}2.3$; the mean scores of groups B, C, D and E were significantly lower than that of group A(all, P<0.001 except B(P<0.05)), and the mean score of D was significantly lower than those of B, C and E(P<0.001, P<0.005, P<0.05, respectively). The percentages of patients with PIPP scores above 6, which means pain, were A : 100 percent, B : 82 percent, C : 56 percent, D : 40 percent and E : 70 percent. The percentages of patients with PIPP scores above 12, which means severe pain, were A : 72 percent, B : 30 percent, C : 22 percent, D : 0 percent and E : 14 percent; that of group D was clearly lowest. Conclusion : These results support the use of oral glucose solution, EMLA, and pacifiers for pain reduction as effective intervention at venipuncture in newborn infants. The most effective method was a 30 percent oral glucose solution.

• Clinical and Experimental Pediatrics
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• v.46 no.4
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• pp.340-344
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• 2003

Purpose : We evaluated allele frequencies and distribution of surfactant protein A2(SP-A2) in Korean neonates in order to estimate the prevalence of RDS, to find out new SP-A alleles, and to establish new steroid therapy. Methods : Genomic DNA was extracted from 71 neonates and served as a template in PCR for genotype analysis. SP-A gene-specific amplications and gene-specific allele determinations were performed using PCR-cRFLP methods. Results : The distribution for the alleles of the SP-A2 gene in the study population was 1A, $1A^0$, $1A^1$, $1A^2$, $1A^3$, $1A^5$, $1A^6$, $1A^7$, $1A^8$, $1A^9$, $1A^{11}$, $1A^{12}$. The specific frequencies for the alleles of the SP-A2 gene in the study population were : 1A=11.3%, $1A^0=38%$, $1A^1=12.7%$, $1A^2=9.2%$, $1A^5=15.5%$, $1A^7=2.9%$, $1A^8=4.9%$, $1A^9=2.2%$, others=3.3%. Conclusion : The frequency of $1A^0$ was higher than the other SP-A2 alleles in Korean neonates. This finding suggests that the prevalence of RDS in Korea may be low compared with other countries. However, this finding also suggests that Korean neonates have a high risk of infection.

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.362-366
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• 2008

Purpose :The purpose of this study is to investigate the predisposing factors for nipple confusion by using questionnaires. Methods :From October, 2005 to October, 2006, we performed a survey on guardians of neonates who had been admitted to the nursery at Dongguk University Medical Center and were discharged 10 to 14 days before the survey. We reviewed their medical records retrospectively. The neonates were categorized into two groups; nipple-unconfused group and nipple-confused group. Results :There were 71 neonates in the nipple-unconfused group and 29 neonates in the nipple-confused group. In the nipple-confused group, 12 neonates (41.4%) had nipple-suckling experience before admission, whereas in the nipple-unconfused group, 54 neonates (76.1%) had nipple-suckling experience before admission; showing a difference that was statistically significant (P=0.001). Regarding to breast-feeding experience before admission, 11 neonates (37.9%) had experience in the nipple-confused group, whereas 49 neonates (69.0%) had in the nipple-unconfused group. This also showed a statistically significant difference (P=0.004). However, the relationship between the duration of breast-feeding prior to hospitalization was not different (P=0.151). Conclusion :In this study, we believe that the suckling experience and the breast-feeding of neonates before admission may be factors affecting the development of nipple confusion. This study particularly revealed that neonates who had only nipple suckling experience, regardless of breast-feeding, had less nipple confusion. Thus, allowing neonates enough time to make an attempt at nipple suckling may be helpful to prevent nipple confusion.

• Clinical and Experimental Pediatrics
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• v.45 no.12
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• pp.1497-1502
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• 2002

Purpose : We evaluated allele frequencies and distribution of surfactant protein A1(SP-A1) in Korean neonates in order to estimate prevalence of RDS to find out new SP-A alleles, and to establish new steroid therapy. Methods : Genomic DNA was extracted from 100 neonates and served as a template in PCR for genotype analysis. SP-A gene-specific amplications and gene-specific allele determinations were performed using PCR-RFLP methods. Results : The distribution for the alleles of the SP-A1 gene in the study population were 6A, $6A^2$, $6A^3$, $6A^4$, $6A^8$, $6A^9$, $6A^{10}$, $6A^{11}$, $6A^{12}$, $6A^{13}$, $6A^{14}$, $6A^{15}$, $6A^{16}$, $6A^{17}$, $6A^{18}$, $6A^{20}$. The specific frequencies for the alleles of the SP-A1 gene in the study population were : $6A^2=21%$, $6A^3=45%$, $6A^4=11%$, $6A^8=9%$, $6A^{14}=8%$. Conclusion : The frequency of $6A^3$ was higher than the other SP-A1 alleles in Korean neonates. This finding suggests that the prevalence of RDS in Korea may be low compared with other countries. However, this finding also suggests that Korean neonates have a high risk of infection.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.130-136
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• 2006

Purpose : The purpose of this study is to confirm the epidemiologic change of the causative organisms of neonatal and pediatric bacterial meningitis in Korea. And we tried to evaluate the risk factors correlated with prognosis which was available on the day of admission. Methods : Retrospectively, we reviewed the medical records of 57 patients admitted for bacterial meningitis at six hospitals affiliated with Catholic Medical Center for 6 years(Jan. 2000~Dec. 2005). Results : 22 cases(38.6%) of them were neonates under 28 days and 35 cases were infants and children ; 16 cases(28.1%), under 1 year ; 6 cases(10.5%), under 5 years ; 13 cases (22.8%), under 15 years. In neonates, 16 cases(72.7%) were caused by group B streptococcus (GBS). In infants and children, S. pneumoniae(25.7%), H. influenzae type b(Hib)(22.8%) and N. meningitidis(22.8%) were common cause of bacterial meningitis in order. In the informations available on the day of admission, weight deficit for age under 3 percentile, increased CRP level and decreased glucose level of CSF were related to poor prognosis(P<0.05). Conclusion : GBS became a leading cause of neonatal bacterial meningitis. Though, pneumoccocal, Hib and meningococcal meningitis were confirmed as major causes of bacterial meningitis. The routine immunization of pneumococcal and Hib vaccines will be considered, and it is necessary to introduce meningococcal vaccines to our country in the future.

• Tuberculosis and Respiratory Diseases
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• v.60 no.6
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• pp.638-644
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• 2006

Backgrounds: This study investigated whether or not a polymorphism in the gene encoding the surfactant protein A(SP-A) has any bearing on the individual susceptibility to the development of chronic obstructive pulmonary disease(COPD) in a genetically homogenous Korean population. Methods: The genotypes of 19 COPD patients and 20 healthy neonates as controls were tested using a polymerase chain reaction followed by restriction fragment length polymorphism analysis for the SP-A gene. Results: The specific frequencies of the 6A2 and 6A18 alleles of SP-A1 and the 1A2 allele of SP-A2 were much higher in the COPD group than control group (p<0.05). However, the frequencies of the 6A3 and 6A4 alleles of SP-A1 and the 1A0 allele of SP-A2 in the COPD group were significantly lower than the control group. In the COPD group, the frequencies of the +50 locus genotypes GG of SP-A1 and the +9 locus genotypes CC of SP-A2 were 85.0% and 60.6%, respectively, and 19.7% and 24.8% in the control group, respectively. The frequencies of the polymorphic genotypes or alleles showed a statistically significant difference between the COPD group and the control group (P<0.05). Conclusion: A genetic polymorphism in SP-A is associated with the development of COPD in the Korean population.

• Clinical and Experimental Pediatrics
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• v.52 no.1
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• pp.44-49
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• 2009

Purpose : Early surfactant treatment and minimal ventilation, bronchopulmonary dysplasia needed prolonged oxygen supplement is a problem. This study aimed to report the effects of early surfactant treatment and minimal ventilation on the prevention of bronchopulmonary dysplasia in respiratory distress syndrome. Methods : We retrospectively studied 139 premature newborn infants (gestational age, 36 weeks; birth weight, 1,500 gm) admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 2001 and December 2006. We analyzed the occurrence of bronchopulmonary dysplasia with respect to ventilator care and surfactant treatment. Results : The incidence of bronchopulmonary dysplasia was significantly higher with prolonged ventilator care, moderate to severe respiratory distress syndrome, and low Apgar score (P<0.001). Despite early surfactant treatment and minimal ventilation, mild bronchopulmonary dysplasia occurs in a considerable number of patients with mild respiratory distress syndrome. The patient group with low Apgar scores required ventilator care for a prolonged period (P=0.020). Conclusion : Early surfactant treatment and minimal ventilation shortens the duration of ventilator care; however, the preventive effects on bronchopulmonary dysplasia are limited. Therefore, not only early surfactant treatment and minimal ventilation but also appropriate management in the delivery room is essential.

• Clinical and Experimental Pediatrics
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• v.51 no.12
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• pp.1320-1323
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• 2008

Purpose : The aim of this study was to investigate the epidemiologic status of Kawasaki disease (KD) in infants ${\leq}6months$ of age. Methods : For the epidemiologic study of KD in Korea, data from 22,674 KD patients were collected from 1997 to 2005 on a 3-year basis by a retrospective survey. From this survey, data of 1,739 KD patients ${\leq}6months$ of age were analyzed and compared with those of KD patients >6 months of age. Results : A total of 1,739 patients ${\leq}6months$ of age, including 1,088 males and 651 females, represented 7.7% of total KD patients. These subjects included 22 patients aged <1 month, 171 patients aged 1-2 months, 304 patients aged 2-3 months, 407 patients aged 3-4 months, 372 patients aged 4-5 months, and 463 patients aged 5-6 months. Their mean age of onset was 4.3 months, and the male-to-female ratio was 1.67:1. Incidences of coronary arterial (CA) abnormalities (21.0% versus 18.7%) and CA aneurysms (4.7% versus 3.1%) detected by echocardiography showed differences between patients with KD younger and older than 6 months, respectively. Conclusion : Comparison of data from KD patients >6 months old with data from 1,739 KD patients ${\leq}6months$ old showed significantly higher incidences of CA abnormalities and CA aneurysms in the younger patients.