• Journal of The Korean Society of Inherited Metabolic disease
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• v.16 no.1
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• pp.18-23
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• 2016

Objective: Newborn screening leads to improved treatment and disease outcomes, but false-positive newborn screening results may impact include parental stress and anxiety, perception of child as unhealthy, parent-child relationship dysfunction, and increased infant hospitalizations. The purpose of this study was to investigate of the false positive rates and the causative factors of false positive results in Tandem Mass Spectrometry (TMS) in single center. Methods: Records were reviewed for all 18,872 subjects who were born in Cheill General Hospital, during January 1st, 2012 to December 31st, 2014. 17,292 neonates (91.62%) were tested for tandem mass screening almost in 2-5th day of life. Newborn babies whose first results were abnormal had been tested repeatedly by same methods in 7-14 day. If the results were abnormal again, further evaluation was performed. TMS analysis included data for the 43 disorders screened for using TMS broken down into three categories: fatty acid oxidation disorders, organic acidurias, and aminoacidopathies. The impact of several factors on increased false positive rates was analyzed using a multivariate analysis: time from birth to sample collection, birth weight, birth height, BMI, gender, gestational age, delivery type. Results: Males of the subjects were 8942 (51.7%), female 8350 (48.3%), the mean gestational age was $38.6{\pm}1.7$ weeks, the average birth weight $3,155.6{\pm}502.4g$, the average birth height $49.1{\pm}2.9cm$, and the average BMI $13.0{\pm}3.8(kg/m^2)$. Vaginal delivery cases were 9713 (56.2%), caesarean section 7,579 (43.8%). The average date of the inspection was $2.8{\pm}1.1$ days. 224 cases were identified as TMS positive. All the subjects were false positive (222/17,292, 1.30%) except 2 cases (1 male; benign phenylketonuria and 1 female; Short chain acyl-CoA dehydrogenase deficiency). The false positive rates were 0.61% in fatty acid oxidation disorders, 0.25% in organic acidurias, and 0.45% in aminoacidopathies. In our study, the date of inspection got late, the false positive rates got higher. Because almost the cases of late test date were in treatment in neonatal intensive care unit so their test date was affected by their medical conditions. False positive rate was higher in extreme immaturity${\leq}27$ weeks than newborns of gestational age >27 weeks [OR=6.957 (CI=1.273-38.008), p<0.025] and extremely low birth weight<1,000 g than newborns of birthweight ${\geq}1,000g$ [OR=5.616 (CI=1.134-27.820), p<0.035]. Conclusion: False positive rate of TMS was 1.30% in Cheil General Hospital. Lower gestational age and birth weight impacted on increased false positive rates. Better understanding of factors that influence the reporting of screening tests, and the ability to modify these important factors, may improve the screening process and reduce the need for retesting. of screening tests, and the ability to modify these important factors, may improve the screening process and reduce the need for retesting.

• Neonatal Medicine
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• v.18 no.1
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• pp.117-123
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• 2011

Purpose: Congenital intrahepatic portosystemic shunts are rare disease and clinically asymptomatic shunts may be detected by chance on ultrasonogram before and after birth. We studied clinical course, treatment and prognosis of congenital intrahepatic portosystemic shunt at prenatal or neonatal period. Methods: Medical records of 8 patients which were diagnosed in intrahepatic portosystemic shunt in Cheil General Hospital from 2006 through 2010 were reviewed retrospectively. Results: Eight patients with congenital intrahepatic portosystemic shunts were identified. Six patients were diagnosed at prenatal radiological screening, including three cases of intrauterine growth restriction and two cases of preterm baby. One case with increased serum ammonia underwent coil embolization. In four cases including one case that presented elevated direct bilirubin, shunts were closed spontaneously within 11th month after birth. Two patients were diagnosed on abdominal sonogram after birth because of elevated direct hyperbilirubinemia, all of whom presented intrauterine growth restriction. Closure of shunts was confirmed during 4th month to 6th month. Conclusion: Congenital intrahepatic portosystemic shunts are clinically asymptomatic mostly and spontaneous closure is expected within 2 years age. But occasionally they have severe complication, so clinical and radiological observation is needed. Specially in cases of intrauterine growth retardation without evident cause, the possible diagnosis of congenital intrahepatic portosystemic shunts should be considered and prenatal and postnatal examination should be performed. When prenatal diagnosis is made, fetal wellbeing should be monitored periodically until spontaneous closure of shunts.

• Journal of the Korean Society of Food Science and Nutrition
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• v.29 no.4
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• pp.691-700
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• 2000

The purpose of this study was to estimate food intakes of the long-lived elderly and to obtain the data for establishing dietary guidelines that may be recommended for the general population for the sake of longvity. The subjects of the study were 224 elderly people of age over 85 years living in Kyungpook Sung-Ju area who have no problem in daily living. The food consumption survey was carried out seasonally by the repeated 24-hr recall method for one year. The subject group for this study was composed of 58 males and 166 females, the average age being 87 years old. Food intakes of the winter were more than any other seasons. The mean daily total food intake per capita was 594.4g, 513.5 g (86.4%) from plant foods and 79.3 g(13.3%) from animal foods. The sequence of high intakes of food groups were cereals, vegetables, fruits, fishes, legumes and meats. Boiled white rice, beef soup, soybean paste soup, soybean paste stew, broiled yellow croaker, kimchi, ra myon and broiled noodles were consumed most frequently. In conclusion, the subjects consumed much more plants foods than animal foods and consumed more natural and seasonal foods than processed foods and also showed food habits of eating small meals. Dietary habits of eating small meals containing abundant amount of fresh plant foods might partially contribute to the longevity of the subjects.

• Clinical and Experimental Pediatrics
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• v.50 no.10
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• pp.959-964
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• 2007

Purpose : The purpose was to investigate the clinical considerations of patients affected by meconium aspiration syndrome (MAS) and the effect of suctioning through endotracheal intubation immediately after delivery on the prognosis of MAS. Methods : A total of 44 inpatients diagnosed as MAS in the Neonatal Intensive Care Unit (NICU) at Cheil Hospital were selected from January 2004 to June 2006. They were divided into two groups. In the early aspiration group (12 patients), suctioning through endotracheal intubation was performed according to the neonatal resuscitation program of the American Academy of Pediatrics and the American Heart Association because infants born through meconium-stained amniotic fluid (MSAF) were not vigorous after birth. In the early non-aspiration group (32 patients), endotracheal intubation was not performed because the infants born through MSAF were vigorous after birth. These two groups were analyzed retrospectively by medical records in the fields of clinical features, obstetric risk factors, complications, treatment, and duration of hospitalization. Results : There was no significant difference in mean gestational age, mean birth weight, sex, and delivery mode between the early aspiration group and the early non-aspiration group. Mean Apgar score of the early aspiration group both in 1 and 5 minute score was significantly lower than in the early non-aspiration group. Lengths of hospitalization and duration of mechanical ventilator care were longer in the early non-aspiration group, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group than in the early aspiration group. Conclusion : In this study, the early non-aspiration group used surfactant more and had a longer duration of mechanical ventilator and hospitalization, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group. Therefore, more detailed guidelines for vigorous infants born through MSAF are needed and we should study and follow up the long term prognosis of neurological complications of MAS.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1172-1178
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• 2008

Purpose : Congenital chylothorax is an accumulation of lymphatic fluid within the pleural space. It is a common cause of unidentified hydrops fetalis. We examined the perinatal history, clinical manifestation, diagnosis, treatment, and outcome in 6 newborns diagnosed to have congenital chylothorax with hydrops fetalis. We also studied the effect of octreotide therapy for congenital chylothorax in relation to conservative treatment. Methods : We retrospectively reviewed the medical records of 6 patients diagnosed to have congenital chylothorax with hydrops fetalis among 27,907 newborns who were born at the Cheil General Hospital and Womens Healthcare Center between January 2004 and July 2007. The diagnosis of chylothorax is based on the analysis of pleural fluid before and after milk feeding. Results : Incidence of congenital chylothorax in this study was 0.021%. All 6 cases were noted in over the 92% lymphocyte in pleural analysis. Transudate was changed into chyle with increasing triglyceride levels above 200 mg/dL after milk feeding. Three of 6 infants improved with conservative treatment, including thoracostomy and assisted ventilation. The others had persistent symptoms despite conservative treatment and responded to octreotide therapy. A complication, specifically vomiting was noted in 1 case during octreotide therapy. Conclusion : In this study, octreotide therapy resulted in a safe and excellent outcome. Therefore, octreotide therapy is considered in severe refractory congenital chylothorax in conservative treatment. Further studies are required to determine appropriate guidelines for octreotide therapy.

• Clinical and Experimental Pediatrics
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• v.51 no.12
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• pp.1315-1319
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• 2008

Purpose : We aimed to examine the effect of rooming-in care on newborn infants emotional stability by comparing them with those cared for in a nursery. Methods : Forty-eight full-term newborn infants born at Cheil General Hospital between July 1 and October 31, 2007, were enrolled. Twenty-four newborn infants were roomed-in in their mothers rooms (rooming-in group), and 24 newborns were cared for in the hospital nursery (the nursery group) for the first 3 days of their lives. Those with perinatal problems that required medical treatment were excluded. By using Brazeltons neonatal behavior assessment scale, we measured irritability and self-quieting as well as the duration of crying after heel-stick puncture for the newborn metabolic screening test. Results : The rooming-in group had a higher irritability score than the nursery group ($6.8{\pm}1.7$ vs. $4.2{\pm}2.1$, P<0.001), thereby suggesting stable behavior against external irritation; the former also had a higher self-quieting activity score ($5.9{\pm}0.3$ vs. $4.5{\pm}1.8$, P=0.001), thereby suggesting that stability was reached quickly from the irritated state. Time taken to stop crying after the heel-stick puncture was significantly shorter in the rooming-in group than in the nursery group ($17{\pm}15.1$ seconds vs. $115.3{\pm}98.5$ seconds, P<0.001). Conclusion : These results show that newborn infants in the rooming-in group exhibit more stable behavior against external irritation and can be stabilized from an irritated state more quickly than infants cared for in the nursery, even after a few days of rooming-in care.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.134-140
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• 2017

Purpose: Severe combined immunodeficiency (SCID) is the most serious form of primary immunodeficiency. Infants with SCID are susceptible to life-threatening infections. To establish newborn screening for SCID in Korea, we performed a screening test for T-cell receptor excision circle (TREC) and ${\kappa}$-deleting recombination excision circle (KREC) in neonates and investigated the awareness of SCID among their parents. Methods: Collections of dried blood spots from neonates and parent surveys were performed at the Samsung Medical Center and Cheil General Hospital & Women's Healthcare Center in Korea. The amplification crossing point (Cp) value <37.0 was defined as TREC/KRECpositive based on cutoff values from measuring multiplex real-time polymerase chain reaction. A Cp value >39.0 was defined as negative. Results: For TREC/KREC screening, 141 neonates were enrolled; 63 (44.7%) were male. One hundred forty neonates (99.3%) had positive TREC/KREC results at the time of the initial test; 82.3% and 75.9% were positive and 17.0% and 23.4% were weakly positive for TREC and KREC, respectively. In one neonate (0.7%), the initial TREC/KREC test result was negative. However, repeated tests obtained and confirmed a positive result. For an awareness survey, 168 parents were engaged. Only 2% of parents (3/168) knew that the newborn screening test for SCID had been introduced and performed in other countries. Eighty-four percent of parents (141/168) replied that nationwide newborn SCID screening should be performed in Korean newborns. Conclusions: In this study, newborn SCID screening was performed along with assessment of public awareness of the SCID test in Korea. The study results showed that newborn SCID screening can be readily applied for clinical use at a relatively low cost in Korea.

• Journal of dental hygiene science
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• v.12 no.3
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• pp.189-195
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• 2012

The subjects in this study were 281 elderly people in some regions. After they were respectively interviewed, the following findings were given: The group of elderly people who brushed their teeth three times or more and who did toothbrushing in an arbitrary way were more concerned about oral health, and the gap between them and the others (p<.05). The group who paid a regular visit to dental clinics had more interest in oral health than the other (p<.01). The group who brushed their teeth in an arbitrary way had more remaining teeth, and the gap between them and the others(p<.05). The group who did toothbrushing for about two minutes had more remaining teeth, and more edentulous jaws were found in the group who brushed their teeth once (p<.01). The group who did toothbrushing three times or more scored higher in oral health knowledge, and the gap between them and the others(p<.01). And the group who paid a regular visit to dental clinics scored higher in oral health knowledge, and the gap between them and the other (p<.01). In the future, the development of a wide variety of oral health programs and prolonged oral health education are both required. Diverse oral health programs and education are expected to stir up elderly people's interest in oral health, to improve their oral health knowledge and to give a positive change to their oral health behavior.

• Journal of the Korean Society of Food Science and Nutrition
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• v.35 no.8
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• pp.1016-1024
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• 2006

The purpose of this study was to investigate students' and parents' perceptions of nutrition education. In this survey, 7,577 elementary school students and 6,003 of their parents across the country were surveyed about the necessity of implementing nutrition education, its present status and problems and future methods for nutrition education implementation. The results showed that 96.6% of the parents and 62.8% of the students responded that nutrition education was urgently needed, at least once per week in the lower grades of elementary school, and that it should be related to and coordinated with special activities class. In addition, the survey showed that students and their parents wanted nutrition teachers to establish a nutrition counseling room, a practical cooking class, a special activity class, and/or dietary camp during school breaks. With regard to the status of nutrition education at home, there was statistical evidence that suggests significant differences between urban and rural schools. Approximately 63% of the parents indicated that they had difficulty teaching nutrition education in their own homes, because it was difficult to determine the dietary habits and nutritional status of their children. When asked about attending a dietary class for parents, 74% expressed their intent to attend. Parents were most interested in learning about cooking practices, diet therapy, and food information in that order. The results showed that the most effective method of dietary education was to teach appropriate nutritional practices in school and at home simultaneously. Hence, necessary information and education should be provided through special lectures, special cooking classes, and dietary classes for parents. The conclusions of this study suggest that a variety of education programs should be developed to achieve effective nutrition education for students and their parents.

• Journal of the Korean Society of Food Science and Nutrition
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• v.36 no.7
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• pp.944-954
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• 2007

The Purpose of this study was to investigate overall sanitation levels of restaurants in Korea by examining sanitation management. Sanitation inspections were carried out in 200 large Korean, Western, Chinese, and Japanese restaurants and in buffet-style restaurants of over 100 pyeong in size located in Daegu and Gyeongbuk province. This survey of sanitation management practices found that in large restaurants employing many workers, sanitation management was good in the areas of the kitchen environment, equipment and utensils, food handling, and worker's personal hygiene. Restaurants having relatively large kitchens showed significantly high scores in these sanitation areas. Furthermore, open-kitchen-type restaurants showed significantly higher scores in kitchen sanitation compared with closed-kitchen-type restaurants. Survey results of sanitation management show that, in all restaurants surveyed, sanitation management was good in dining hall sanitation and in providing a safe drinking water supply, but poor in food handling sanitation. Kitchen environment sanitation was poor in Korean, Chinese, and Japanese restaurants. Equipment and utensils sanitation was unsatisfactory in Western and buffet-style restaurants. In the food handling area, especially food sanitation and temperature, checks were rarely made, and pasteurization and temperature records were not kept. Therefore, it is recommended that, in planning a kitchen facility in the future, the floor area should be as large as Possible and open. In terms of management, more attention should be paid to food pasteurization, sanitation of cooking equipment and utensils, and checking of food temperature.