• Clinical and Experimental Pediatrics
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• 제56권3호
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• pp.112-115
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• 2013

Purpose: To investigate the association between necrotizing enterocolitis (NEC) and red blood cell transfusions in very low birth weight (VLBW) preterm infants. Methods: We studied were 180 VLBW preterm infants who were admitted to the neonatal intensive care unit of CHA Gangnam Hospital from January of 2006 to December of 2009. The subjects were divided into 2 groups: an NEC group (greater than stage II on the modified Bell's criteria) and a control group (less than stage II on the modified Bell's critieria). We defined red blood cell transfusion before NEC diagnosis as the frequency of transfusion until NEC diagnosis (mean day at NEC diagnosis, day 18) in the NEC group and the frequency of transfusion until 18 days after birth in the control group. Results: Of the 180 subjects, 18 (10%) belonged to the NEC group, and 14 (78%) of these 18 patients had a history of transfusion before NEC diagnosis. The NEC group received $3.1{\pm}2.9$ transfusions, and the control group received $1.0{\pm}1.1$ transfusions before the NEC diagnosis (P=0.005). In a multivariate logistic regression corrected for gestational age, Apgar score at 1 minute, the presence of respiratory distress syndrome, patent ductus arteriosus, premature rupture of membrane, disseminated intravascular coagulopathy and death were confounding factors. The risk of NEC increased 1.63 times (95% confidence interval, 1.145 to 2.305; P=0.007) with transfusion before the NEC diagnosis. Conclusion: The risk for NEC increased significantly with increased transfusion frequency before the NEC diagnosis.

• Clinical and Experimental Pediatrics
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• 제62권8호
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• pp.307-311
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• 2019

Purpose: Necrotizing enterocolitis (NEC) is one of the most serious complications of prematurity. Many risk factors can contribute to the development of NEC. The epidermal growth factor (EGF) plays a major role in intestinal barrier function, increases intestinal enzyme activity, and improves nutrient transport. The aim of this study was to assess the role of epidermal growth factor in the development of NEC in preterm neonates. Methods: In this study, 130 preterm neonates were included and divided into 3 groups, as follows: group 1, 40 preterm neonates with NEC; group 2, 50 preterm neonates with sepsis; and group 3, 40 healthy preterm neonates as controls. The NEC group was then subdivided into medical and surgical NEC subgroups. The serum EGF level was measured using enzyme-linked immunosorbent assay. Results: Serum EGF levels (pg/dL) were significantly lower in the NEC group (median [interquartile range, IQR], 9.6 [2-14]) than in the sepsis (10.1 [8-14]) and control groups (11.2 [8-14], P<0.001), with no significant difference between the sepsis and control groups, and were positively correlated with gestational age (r=0.7, P<0.001). A binary logistic regression test revealed that low EGF levels and gestational ages could significantly predict the development of NEC. The receiver-operating characteristic curve for EGF showed an optimal cutoff value of 8 pg/mL, with 73.3% sensitivity, 98% specificity, and an area under the curve of 0.92. Conclusion: The patients with NEC in this study had significantly lower serum EGF levels (P<0.001), which indicated that EGF could be a reliable marker of NEC in preterm neonates.

• Clinical and Experimental Pediatrics
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• 제52권1호
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• pp.56-60
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• 2009

목적 : 본 연구에서는 로타바이러스와 관련된 신생아 괴사성 장염(RV+NEC)이 로타바이러스와 연관되지 않은 신생아 괴사성 장염(RV-NEC)과 서로 다른 경과 및 예후를 보이는지 알아보고자 하였다. 방 법 : modified Bell stage II 이상의 환아들을 monoclonal antibody-based enzyme immunoassay (EIA) 결과를 통해 8명의 RV+NEC군과 22명의 RV-NEC군으로 분류하였고 이 두군의 임상양상과 방사선소견 및 치료 결과를 후향적으로 조사하여 비교하였다. 결 과 : RV+NEC군에서 RV-NEC군보다 재태주령과 출생체중이 통계적으로 유의하게 더 높았다($33.5{\pm}3.3$ 주 vs $29.3{\pm}4.4$ 주; P=0.01). 두 군간의 C-반응성 단백질의 최고치, 혈소판 감소증, 장벽 내 공기와 장 천공의 비교에서는 차이가 없었으나 문맥 정맥 내 공기의 빈도는 RV+NEC군에서 유의하게 많았다(88% vs 9%; P<0.01). III 이상의 병기와 수술율 그리고 합병증과 사망률을 비교한 결과에서는 두 군 간에 차이를 보이지 않았다. 결 론 : 로타바이러스와 관련된 신생아 괴사성 장염은 로타바이러스와 연관되지 않은 신생아 괴사성 장염에 비해 더 높은 재태주령과 출생체중을 가지나 질환의 중증도와 결과 면에서는 차이가 없었다.

• Neonatal Medicine
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• 제25권2호
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• pp.78-84
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• 2018

Purpose: To investigate the hemodynamic risk factors for necrotizing enterocolitis (NEC), we analyzed the characteristics of descending aorta (DA) blood flow in preterm neonates, who later developed NEC. Methods: This was an observational case-control study on 53 preterm neonates at a tertiary referral center. Clinical and echocardiographic data were collected from 23 preterm neonates with NEC (NEC group), and compared with those of 30 preterm neonates without NEC (control group). Echocardiography was done at a median (interquartile range) of 5 (3-9) days after birth and 2 (1-2.5) days before the diagnosis of NEC. Results: Basic clinical characteristics including gestational age, birth weight, Apgar score, breast feeding status, use of umbilical catheters, and mode of invasive ventilator care were similar between the groups. Compared with the control group, the lowest diastolic velocity of DA was significantly decreased, whereas the diastolic reverse flow and the ratio of diastolic reverse to systolic forward flows were significantly increased in the NEC group. In addition, the resistive index (RI) of DA was significantly increased in the NEC group and showed a positive association with the development of NEC. Multivariate logistic regression analysis showed that increasing RI of DA was an independent risk factor for the development of NEC (P=0.008). Conclusion: Significant changes in DA flow characteristics including decreased diastolic velocity and increased diastolic reverse flow along with increased peripheral vascular resistance were observed before the development of NEC in preterm neonates. These findings may help clinicians stratify in advance neonates at a risk of developing NEC and may help improve outcomes in these neonates.

• Clinical and Experimental Pediatrics
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• 제57권8호
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• pp.351-356
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• 2014

Purpose: Among the many factors associated with acute intestinal mucosal infection, numerous studies have proposed the usefulness of fecal calprotectin. The aim of this study was to evaluate the usefulness of fecal calprotectin in the diagnosis of necrotizing enterocolitis (NEC). Methods: We collected 154 stool samples from 16 very low birth weight and premature newborns at the Konyang University Hospital neonatal intensive care unit or neonatal nursery. The stool samples were collected using the Calprest device, and the fecal calprotectin level was measured with the $B\ddot{U}HLMANN$ Calprotectin enzyme-linked immunosorbent assay kit. Results: Fecal calprotectin levels were significantly higher in the NEC group than in the non-NEC group (P=0.02). There was a significant positive linear relationship between the fecal calprotectin level and number of days after birth (P=0.00) in the gestational age <26 weeks group. There was a significant negative linear relationship between the calprotectin level and number of days after birth (P=0.03) in the gestational age ${\geq}26$ weeks and <30 weeks group. There was no difference in the calprotectin levels according to the type and method of feeding between the NEC and non-NEC groups. Conclusion: Fecal calprotectin levels were significantly increased in premature infants with NEC. The fecal calprotectin test is a noninvasive, easy, and useful tool for the diagnosis of NEC.

• 한국마이크로전자및패키징학회:학술대회논문집
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• 한국마이크로전자및패키징학회 2000년도 2nd Korea-Japan Advanceed Semiconductor Packaging Technology Seminar
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• pp.105-129
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• 2000

• 대한후두음성언어의학회지
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• 제16권1호
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• pp.76-80
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• 2005

Although primary neuroendocrine carcinomas(NEC) are uncommon tumors of the larynx, they represent the most common nonepidermoid malignancy of this organ. Whereas typical carcinoid tumors and small-cell carcinomas occur very rarely in the larynx, the majority of laryngeal NEC belong to a broad intermediate group between these two extremes of NEC. Through many case studies, a major protion of clinicopathologic characteristics of laryngeal NEC have been revealed; however, the gistogenesis of laryngeal NEC is still unknown. The only well-documented normal neuroendocrine structures of the larynx are paraganglions, but the incidence of laryngeal paragangliomas are much lower than that of NEC. Here, we report on three cases of NEC affecting the larynx and the results of searching for neuroendocriene cells in non-neoplastic larynx tissue.

• Clinical and Experimental Pediatrics
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• 제63권6호
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• pp.226-231
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• 2020

Background: Probiotics and prebiotics have strain-specific effects on the host. Synbiotics, a mixture of probiotics and prebiotics, are proposed to have more beneficial effects on the host than either agent has alone. Purpose: We performed a randomized controlled trial to investigate the effect of Lactobacillus and Bifidobacterium together with oligosaccharides and lactoferrin on the development of necrotizing enterocolitis (NEC) or sepsis in very low birth weight neonates. Methods: Neonates with a gestational age ≤32 weeks and birth weight ≤1,500 g were enrolled. The study group received a combination of synbiotics and lactoferrin, whereas the control group received 1 mL of distilled water as placebo starting with the first feed until discharge. The outcome measures were the incidence of NEC stage ≥2 or late-onset cultureproven sepsis and NEC stage ≥2 or death. Results: Mean birth weight and gestational age of the study (n=104) and the control (n=104) groups were 1,197±235 g vs. 1,151±269 g and 29±1.9 vs. 28±2.2 weeks, respectively (P>0.05). Neither the incidence of NEC stage ≥2 or death, nor the incidence of NEC stage ≥2 or late-onset culture-proven sepsis differed between the study and control groups (5.8% vs. 5.9%, P=1; 26% vs. 21.2%, P=0.51). The only significant difference was the incidence of all stages of NEC (1.9% vs. 10.6%, P=0.019). Conclusion: The combination of synbiotics and lactoferrin did not reduce NEC severity, sepsis, or mortality.

• Neonatal Medicine
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• 제18권2호
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• pp.337-344
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• 2011

목적: 신생아 시기에 수술적 치료를 한 위장관계 질환과 저체중 출생아에서 발생 빈도가 높은 위장관계 질환에 대한 이해를 높이고자 한다. 방법: 2008년 1월부터 2010년 12월까지 부산대학교병원과 부산대학교 어린이병원 신생아실에 입원한 환아 중 위장관계 질환으로 진단되고 외과적 치료를 받은 125명과 괴사성 장염과 서혜부 탈장으로 진단받은 환아 40명을 대상으로 원인 질환 및 빈도, 출생력, 성별, 동반 기형과 혈청학적 결과를 살펴보았다. 결과: 괴사성 장염과 서혜부 탈장을 제외한 총 125명 환아 중에서 항문 직장 기형이 가장 흔하였고, 남성이 우세하였다. 24명(19.2%)에서 타기형이 동반되었고 수신증, 선천성 심장 기형이 많았으며, 항문 직장 기형에서는 43.9%에서 동반 기형이 있었다. 출생체중을 보면 괴사성 장염의 경우 76.0%가 1,500 g 미만으로 대부분을 차지하였다. 술 후 완전 장관 영양까지의 기간은 괴사성 장염이 평균 30.8일로 가장 길었다. 술 후 합병증은 담즙정체증, 패혈증과 유착 등이 있었다. 괴사성 장염을 제외한 위장관계 질환으로 수술적 치료를 받았던 환자들은 1.6%의 사망률을 보였으며 수술적 치료를 받은 괴사성 장염의 사망률은 18.8%였다. 괴사성 장염의 수술군에서 보존적 치료군보다 직접 빌리루빈이 의미있게 더 높았다. 결론: 수술적 치료를 받은 위장관 질환의 생존율은 높고 수술적 치료의 성과도 우수하였다. 괴사성 장염 환아 중 수술군에서 직접 빌리루빈이 유의하게 더 높았다.

• Bulletin of the Korean Chemical Society
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• 제16권4호
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• pp.305-309
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• 1995

The enantiomeric separation of several amino acid derivatives by reversed-phase liquid chromatography using two (R)-and (S)-naphthylethylcarbamate-β-cyclodextrin(NEC-β-CD) bonded stationary phases was studied to illustrate the chiral recognition model of the enantiomeric separation. The retention and enantioselectivity of the chiral separations with (R)-and (S)-NEC-β-CD bonded phases were compared with similar separations with the native β-CD stationary phases. Especially, the enantioselectivity and elution orders between the derivatized amino acid enantiomers are carefully examined. These results can be illustrated by the chiral recognition models involving inclusion complexation, π-π interaction, and/or hydrophobic interaction. Inclusion complexation and hydrophobic interaction of the naphthyl group of the NEC moiety seem to be major chiral recognition components in the enantiomeric separation of 2,4-dinitrophenyl amino acids and dabsyl amino acids on (R)-and (S)-NEC-β-CD columns. For dansyl amino acids, only the inclusion complexation is the dominant factor. Three different chiral recognition models containing π-π interaction, inclusion complexation and hydrogen bonding were proposed for the separation of the 3,5-dinitrobenzoyl amino acid enantiomers, depending on the size and shape of amino acids.