• Child Health Nursing Research
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• v.22 no.4
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• pp.317-325
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• 2016

Purpose: Smoking during pregnancy contributes to the risk of negative health outcomes in mothers and babies. The purposes of this study were to review the harmful effects of maternal smoking during pregnancy on fetal and child development, to discuss if maternal smoking should be criminalized as a form of child abuse, and to explore advocating for fetal rights. Methods: A variety of published literature and legal documents including the Korean constitution, criminal laws, and children's welfare laws were reviewed and critically analyzed. Results: Women who smoke during pregnancy are more likely to experience abortion related to placental dysfunction. Their unborn risk premature birth, fetal growth restriction, low birth weight, neurobehavioral disturbances, and/or other complications and newborn babies are also at risk for complications. The advocates for fetal rights can assert that maternal smoking should be regarded as a crime. Conclusion: Findings show that maternal smoking during pregnancy is a major risk factor for many adverse pregnancy outcomes. Effective strategies and health policies for smoking cessation during pregnancy are required to protect pregnant women and their babies.

• Neonatal Medicine
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• v.16 no.2
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• pp.110-120
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• 2009

Mimicking fetal nutrition is the goal of early paretneral nutrition (PN) in very low birth weight infants, however the limited metabolic capacity of immature organs raises concern about the toxicity of metabolites to the developing brain. Starting parenteral amino acids from the first day of life, with a rate of 1.0 to 1.5 g/kg/day, is generally recommended to prevent endogenous protein breakdown by maintaining a positive nitrogen balance. A greater of amino acid infusion rate in the range of the fetal transfer rate (3.5-4.0 g/kg/day) is well tolerated during the early days after birth in VLBWI, however the influence on growth and long-term neurodevelopmental outcome remains unknown. Limited data are available from controlled trials regarding the effects of early supplementation with lipid emulsions on neonatal morbidity. Considering the role of long-chain polyunsaturated fatty acids in the neurodevelopment, the choice of an optimal lipid emulsion should be based on the quality as well as the quantity of the lipid contents. Little is known about the clinical benefit of higher rates of glucose infusion by permitting high serum glucose level or co-administration with insulin.

• Perinatology
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• v.29 no.4
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• pp.175-179
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• 2018

Pneumatocele (PC) is a thin-walled cyst of the lung that can occur at all ages and with various etiologies. However, there is no fully accepted consensus for the management of PC in a neonatal intensive care unit. Although the management of PC is generally expectant, it is difficult to decide how long conservative management should be maintained, especially under Korea's medical care environment and the parents' worry and anxiety. We report a male neonate, born at $27^{+5}weeks$ gestation, weighing 1,000 g, who had a post infectious PC caused by methicillin-resistant Staphylococcus aureus sepsis. We treated conservatively for about 100 days (roughly 14 weeks), but unfortunately after a few days of chest retraction, acute exacerbation occurred, video assisted thoracoscopic surgery (VATS) was deemed necessary and performed. The purpose of this publication is to describe the clinical course, aggravation and relief after VATS management with a review of the literature.

• Clinical and Experimental Pediatrics
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• v.62 no.7
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• pp.245-251
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• 2019

Hemodynamically significant preterm patent ductus arteriosus (PDA) affects mortality; comorbidities such as necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia; and adverse long-term neurodevelopmental outcomes in preterm infants, particularly in very low birth weight infants. However, recent studies have indicated that there is no consensus on the causal relationship between PDA and neonatal outcomes, the benefit of PDA treatment, the factors guiding the need for treatment, and optimal treatment strategies. Such uncertainty has resulted in wide variations in practice for treating preterm PDA between units, regions, and nations. Nowadays, there has been a paradigm shift to more conservative treatment for preterm PDA, and suggestions regarding selective management of preterm PDA considering risk factors and hemodynamic significance are increasing. Neonatologist-performed echocardiography and advances in modalities to assess hemodynamic significance such as biologic markers and near-infrared spectroscopy also help improve the efficacy of selective treatment of preterm PDA.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.3
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• pp.317-324
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• 2018

This study was performed to investigate changes in prenatal and delivery characteristics of married immigrant women and to provide basic data for developing maternal health care programs. Data collection was carried out for 6 weeks from September 7, 2016 through medical records, and it was divided into 5-year intervals (5 years before and after 2011 were compared). The survey records consisted of demographic, prenatal, and obstetrics characteristics, and the data were analyzed by frequency, percentage, Independent Sample T-test, and Chi-square test using the SPSS 23.0 program. The results were as follows. The prenatal and delivery characteristics of married immigrant women showed significantly increased inadequate weight gain during pregnancy, pregnancy complications, premature birth, low birth weight infants, and low apgar score. Therefore, based on these changes in married immigrant women, prenatal and postnatal health care programs are needed to prevent maternal and childbirth complications.

• Neonatal Medicine
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• v.16 no.2
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• pp.234-238
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• 2009

Posthemorrhagic hydrocephalus is a major problem in premature infants. We describe our experience with a neonate that was an extremely low birth weight infant with posthemorrhagic hydrocephalus, who was treated by repeated ventricular drainage through an Ommaya reservoir for more than two months until the placement of a ventriculoperitoneal shunt was possible. The Ommaya reservoir served as a bridge to definitive treatment. The patient required sodium supplements due to excessive salt loss from the repeated ventricular drainage procedures. Regular measurement of serum electrolytes in any infant requiring serial ventricular drainage is recommended.

• Kidney Research and Clinical Practice
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• v.37 no.4
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• pp.338-346
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• 2018

Background: The most common cause of acute kidney injury (AKI) in pregnancy is preeclampsia. Serum cystatin C (CysC) is a potential biomarker of early kidney damage as its levels are not disturbed by volume status changes in pregnancy, and serum CysC levels could serve as a replacement for conventionally used creatinine. In this study, we investigated the serum levels of CysC in severe preeclampsia cases and the associations between CysC levels and poor obstetric outcomes. Methods: Our cohort included severe preeclampsia patients with a normal serum creatinine level. Creatinine was measured to calculate estimated glomerular filtration rate (eGFR) based on the Cockcroft and Gault, Modification of Diet in Renal Disease Study (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, while CysC was measured to calculated eGFR based on a CysC-based equation. We then evaluated the correlations between serum CysC level, eGFR, and obstetric outcomes. Results: Twenty-six patients were evaluated of which 38.5% delivered preterm and 30.8% had low-birth weight babies. Unlike creatinine-based eGFR and CysC-based eGFR, serum CysC demonstrate significant negative correlation with gestational age. Receiver operating characteristic curve analysis indicated that serum CysC is a potential biomarker of preterm delivery with a cut-off serum level of 1.48 mg/L with 80% sensitivity and 75% specificity. Conclusion: GFR estimation using CysC is likely to be inaccurate in pregnancy. However, we found a significant correlation between preterm delivery and serum CysC level. Our results suggest that serum CysC level has the potential to predict preterm delivery in severe preeclampsia patients.

• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.991-998
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• 2009

Purpose : Thyroid hormone is essential for development of the brain in early life. Thyroid dysfunction is more common in the first 2-4 postnatal weeks of life in premature infants than in term infants. This study aimed to identify the prevalence and clinical course of thyroid dysfunction in prematurity. Methods : Premature infants admitted to and given neonatal screenings at Dankook University Hospital between April 1999 and March 2008 were included in this study. We retrospectively reviewed medical records and categorized subjects into six groups: normal, hypothyroidism, hyperthyrotropinemia, hypothyroxinemia, delayed onset of hypothyroidism, and delayed onset of hyperthyrotropinemia. Results : Among 599 subjects, 136 (23%) had initially abnormal thyroid function test (TFT); transient hypothyroxinemia was the most frequent condition (118, 20%). In addition, 8 (17%) of 46 subjects with initially normal TFT levels showed delayed onset of hyperthyrotropinemia with or without low free thyroxine ($fT_4$). Thyroxine was prescribed for 10 patients (1.7%) due to low $fT_4$ levels but was discontinued in 9 patients during follow-up. Thyroid scan confirmed ectopic thyroid in one patient. Conclusion : Thyroid dysfunction was frequently seen in premature infants, but most of the conditions were transient. In addition, some infants showed delayed TSH elevation on routine follow-up. Therefore, a recheck of the thyroid function of premature infants at 3-4 weeks is recommended, even if normal thyroid function is initially seen, especially in prematurity of less than 33 weeks of gestational age or birth weight of less than 2,500 grams.

• Journal of Korean Public Health Nursing
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• v.2 no.2
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• pp.81-98
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• 1988

The purpose of this study was to fine out the general physical status of the neonates, and to identify the risk factors of the mothers and the neonates which were significantly related to the neonatal diseases during hospitalization. The data were obtained from clinical records of 1098 neonates born in Seoul Red cross Hospital between January 1st of 1984 and December 31th of 1986. The results of this study were summarized as follows: 1. General characteristics of the maternal group. 1) The average of maternal age was 26.6 years, the $91.7\%$ of the mothers de liveried at the age of 20-34 years old. 2) The distribution of the types of delivey were as follows : spontaneous delivery $39.9\%$, cesarean section $32.4\%$, vaccum extraction $25.7\%$, and breech delivery$2.0\%$. 3) The $40.3\%$ of the total de liveried mother had experienced abortion. 4) The $42.3\%$ of the total deliveried mother had one or more obstetric risk factors. 2. General characteristics of the neonatal group. 1) In the distribution of sex, male was $49.4\%$, female $50.6\%$. 2) The average of birth weights was 3,020gm. The distribution of birth weight were as follows; nomal weight $85.5\%$, low birth weight $12.7\%$ and high birth weight $2.5\%$. 3) The average of gestational age was 39.2 weeks. The distribution of gestational age were as follows; full term $77.4\%$, preterm $13.7\%$, and postterm $8.9\%$. 4) The average of Apgar Score was 9.0 at one minute and 9.6 at five minutes. 5) The $5.7\%$ of the neonates had one or more neonatal risk symptoms and signs at birth. 3. Apgar Score by the maternal and neonatal factors. In Apgar Score at one minute, normal group was higher than that of abnormal group. Apgar Score at five minutes was slightly higher than that at one minute. 4. The distribution of the maternal risk factors and the neonatal risk factors. 1) The total numbers of the maternal risk factors were 1376. The distribution of the maternal risk factors were as follows: obstetric factor $33.7\%$, abortion $32.2\%$, breech and cesarean section delivery $27.5\%$ and maternal age under 19 years and over 35 years $6.6\%$. 2) The total numbers of the neonatal risk factors were 517. The distribution of the neonatal risk factors were as follows: gestational age under 37 weeks and over 42 weeks $48.0\%$, birth weight under 2500gm and over 4000gm $12.2\%$, Apgar score under 4 at one munute $6.4\%$ and Apgar score at five munutes $2.7\%$. 3) The total numbers of the obstetric risk factors were 661. The types of the obstetric risk factors were meconium stained amniotic fluid $22.0\%$, premature rupture of membrane $17.5\%$. absence prenatal care $14.1\%$, unmarried pregnancy $10.3\%$, placenta problem $9.0\%$, toxemia $8.0\%$. 4) The total numbers of the neonatal risk symptoms and signs at birth were 83. The types of the neonatal risk symptoms and signs were respiratory distress $65.1\%$, neonatal apnea $14.4\%$, convulsion $13.3%$, meconium aspiration syndrome $4.8\%$, cyanosis $2.4\%$. 5. The relationship between the maternal risk factors and the neonatal risk factors. 1) Maternal age under 19 years or over 35 years was significantly related to Apgar Score under 4 at 5 minutes. 2) Breech delivery or cesarean section was significantly related to neonatal risk factor at birth such as birth weight, gestational age, Apgar Score at one minute and at five minutes. and neonatal risk symptoms and signs. 3) Obstetric risk factors were significantly related to the neonatal risk factors at birth. 4) Abortion was not related to the neonatal risk factors. 6. The relationship between neonatal diseases during hosptalization and the maternal or the neonatal risk factors. 1) The total numbers of neonatal diseases during hospitalization were 281. The distribution of neonatal diseases were as follows: birth trauma $38.1\%$, infectious disease $31.3\%$, hematologic disease $21.4\%$, respiratory disease $6.0\%$, neurologic disease $2.5\%$. cardiovascular disease $0.7\%$. 3) Most maternal risk factors except abortion were significantly related to neonatal diseases. 4) Most neonatal risk factors at birth were significantly related to neonatal diseases.

• Journal of Yeungnam Medical Science
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• v.18 no.2
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• pp.287-292
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• 2001

Background: To determine mean clitoral and glans size of Korean female newborn. Materials and Methods: The size of glans and clitoris of 68 Korean female newborns born at Yeungnam University Medical Center were measured from May in 1999 to August in 1999. Results: The mean size of the 68 newborns were $2.38{\pm}1.14$ mm in glans length, $2.55{\pm}1.48$ mm in glans width and $4.66{\pm}1.93$ mm in clitoral length. In the premature infants the mean clitoral size was $1.92{\pm}1.58$ mm in glans length, $1.78{\pm}1.24$ mm in glans width and $3.86{\pm}2.16$ mm in clitoral length. In the full term infants $2.53{\pm}1.12$ mm in glans length, $2.75{\pm}1.58$ mm in glans width and $4.94{\pm}1.89$ mm in clitoral length. In low birth weight infants clitoral size was measured $1.55{\pm}1.10$ mm in glans length, $2.04{\pm}2.03$ mm in glans width and $3.29{\pm}1.87$ mm in clitoral length. In normal birth weight infants $2.53{\pm}1.13$ mm in glans length, $2.68{\pm}1.48$ mm in glans width and $4.92{\pm}1.91$ mm in clitoral length. In high birth weight infants $1.54{\pm}0.50$ mm in glans length, $1.63{\pm}0.53$ mm in glans width and $3.18{\pm}1.04$ mm in clitoral length. Conclusion: There was no significant correlation between gestational age and clitoral size or glans size, but significant negative correlation was found between birth weight and clitoral size or glans size.