• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.160-166
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• 1994

Mid-arm circumference and mid-arm circumference/head circumference ratio(MAC/HC) were measured in 207 AGA(appropriate for gestational age) infants delivered at 26 to 42 weeks of gestation from January 1990 to December 1993 in Yeungnam University Hospital, Taegu, Korea. There were linear relationships between MACs and MAC/HC ratios and gestational age(MAC : y=0.3181x - 2.2069, r=0.81, p<0.001 ; MAC/HC ratio : y=0.0049x+0.1128, r=0.62, ; < 0.001). Using standard curves of MAC and MAC/HC ratio according to the gestational age, measurement of MAC or MAC/HC ratio can be a noninvasive, simple method to evaluate the intrauterine growth of newborn infants and the nutritional status of growing premature infants.

• Clinical and Experimental Pediatrics
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• v.63 no.8
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• pp.284-290
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• 2020

Korea currently has the world's lowest birth rate but a rapidly inreasing number of preterm infants. The Korean Neonatal Network (KNN), launched by the Korean Society of Neonatology under the support of Korea Centers for Disease Control, has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. In terms of the short-term outcomes of VLBWIs born from 2013 to 2016 registered in the KNN, the survival rate of all VLBWIs was 86%. Respiratory distress syndrome and bronchopulmonary dysplasia were observed in 78% and 30% of all VLBWIs, respectively. Necrotizing enterocolitis occurred in 7%, while 8% of the VLBWIs needed therapy for retinopathy of prematurity in the neonatal intensive care unit (NICU). Sepsis occurred in 21% during their NICU stay. Intraventricular hemorrhage (grade ≥III) was diagnosed in 10%. In terms of the long-term outcomes for VLBWIs born from 2013 to 2014 registered in the KNN, the post-discharge mortality rate was approximately 1.2%-1.5%, mainly owing to their underlying illness. Nearly half of the VLBWIs were readmitted to the hospital at least once in their first 1-2 years of life, mostly as a result of respiratory diseases. The overall prevalence of cerebral palsy was 6.2%-6.6% in Korea. Bilateral blindness was reported in 0.2%-0.3% of VLBWIs, while bilateral hearing loss was found in 0.8%-1.9%. Since its establishment, the KNN has published annual reports and papers that facilitate the improvement of VLBWI outcome and the formulation of essential healthcare policies in Korea.

• Neonatal Medicine
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• v.28 no.1
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• pp.29-35
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• 2021

Purpose: Intussusception is the most common cause of bowel obstruction in children; however, it is rarely diagnosed in newborn infants. This study aimed to describe the clinical features of intussusception in newborn infants. Methods: Medical records of eight patients diagnosed with intussusception during the newborn period at Ulsan University Hospital between March 2007 and March 2020 were retrospectively reviewed. Results: Among the eight cases, two occurred in the intrauterine period and six occurred in the postnatal period. Intrauterine intussusception presented with symptoms of bowel obstruction within 1 to 2 days after birth, and ileal atresia was diagnosed simultaneously through exploratory laparotomy. All the postnatal patients were extremely low birth weight infants (median gestational age and birth weight: 25⁺⁶ weeks and 745 g, respectively). Four cases were diagnosed preoperatively using abdominal ultrasonography. One patient was diagnosed by exploratory laparotomy because the clinical symptoms were nonspecific and difficult to differentiate from those of necrotizing enterocolitis, a more prevalent complication in preterm infants. The site of intussusception in all six patients was the small bowel. Meckel's diverticulum (one case) and meconium obstruction (two cases) were found to be the lead point. Conclusion: Neonatal intussusception tends to show different clinical features according to its period of occurrence. Intussusception, especially in preterm infants, has nonspecific clinical features; therefore, clinicians should always be cautious of this disease for its early diagnosis.

• Neonatal Medicine
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• v.17 no.2
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• pp.193-200
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• 2010

Purpose: Feeding desaturation is a common problem among preterm infants which can result in prolonged hospital stays, longterm feeding difficulties and growth delay. The purpose of this study was to identify the characteristics of premature infants with feeding desaturation and to examine the effect of orocutaneous stimulation on oral feeding. Methods: During the first phase of this study, 125 extremely low birth weight infants were reviewed retrospectively. Characteristics between infants with feeding desaturation (n=34) and those without feeding desaturation (n=91) were examined. During the second phase, 29 infants recruited from March, 2009 to May, 2010 were subjected to orocutaneous stimulation. The results of orocutaneous stimulation were compared to a control group (n=81). Results: The first phase of the study revealed that extremely low birth weight infants with feeding desaturation were significantly lower in gestational ages at birth, and had lower 5 minute apgar scores, more gastroesophageal refluxes and bronchopulmonary dysplasia. Infants without feeding desaturation reached full enteral feeding significantly earlier and showed shorter duration of hospital stay. At the second phase, infants in the intervention group showed shorter days to achieve initiation of bottle feeding, shorter days in achievement of full bottle feeding, last episodes of feeding desaturation and length of hospital stay compared to the control group of similar characteristics. Conclusion: Orocutaneous stimulation among extremely low birth weight infants results in earlier achievement of full bottle feedings without episodes of feeding desaturation hence shortens the length of hospital stay.

• Neonatal Medicine
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• v.16 no.1
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• pp.47-54
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• 2009

Purpose: Present evidences suggest that Ureaplasma urealyticum is a cause of pneumonia, septicemia, and bronchopulmonary dysplasia (BPD) in newborn infants, particularly those born prematurely. The purpose of this work was to examine the relationship between Ureaplasma urealyticum in the tracheal aspirates and adverse outcomes, such as BPD and early onset neonatal sepsis in premature infants. Methods: A polymerase chain reaction (PCR) was performed on tracheal aspirates collected within 24 hour after birth in 176 premature infants less than 35 weeks of gestation and admitted to the neonatal intensive care unit of Bundang CHA Hospital. Results: U. urealyticum was detected in 37 of 176 preterm infants (21.0%). Gestational age ($29^{+5}{\pm}2^{+5}$ wk vs. $30^{+6}{\pm}2^+{-5}$ wk, P=0.0l3) and birth weight (1.39${\pm}$0.44 kg vs. 1.59${\pm}$0.55 kg, P=0.037) were lower in the U urealyticum-positive group compared to the control group. The incidence of early onset neonatal sepsis (16.2% vs. 6.5%, P=0.045) and BPD (45.9% vs. 29.5%, P=0.047) was higher in the U urealyticum-positive group compared to the control group, but the severity of BPD was not different between two groups. However, multiple logistic regression analysis revealed that the presence of U. urealyticum was not independently related to the development of early onset neonatal sepsis and BPD. Conclusion: The results suggest that colonization of the lower respiratory tract by U. urealyticum might not be related to the development of neonatal sepsis and BPD directly in preterm infants.

• Journal of Yeungnam Medical Science
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• v.16 no.1
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• pp.52-59
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• 1999

This study was conducted to evaluate the effect of the antenatal ambroxol administration to mothers who were in danger of imminent preterm delivery in preventing the neonatal respiratory distress syndrome(RDS). Forty-two preterm newborn infants who were delivered at Yeungnam University Hospital from January 1996 to December 1997 were divided into two groups, 21 in ambroxol-treated group and 21 in control group. Six cases of the respiratory distress syndrome were developed from 21 ambroxol-treated infants, but 13 cases of RDS, from 21 control infants. This result indicated a significant reduction of the occurrence of RDS by antenatal administration o[ ambroxol (p<0.05). There were no differences in the occurrence of adverse effects of ambroxol in mothers between the two groups. There was also no difference between pre- and post-treatment hematologic and biochemical parameters in ambroxol-treated group. In conclusion, when premature delivery is expected, the administration of ambroxol before delivery enhances lung maturation in premature newborn infants and prevents the occurrence of respiratory distress syndrome without significant adverse effects.

• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.354-362
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• 2001

Objectives : The aim of this study was to estimate the burden of disease through an analysis of Years of Life Lost due to premature deaths, one component of the Disability-Adjusted Life years (DALY). In addition, the cause of death statistics were adjusted to improve validity, and the results were compared with those of the Global Burden of Disease (GBD). Methods : In closely fellowing the approach taken in the original GBD study, most of the explicit assumptions and the value judgments were not changed. However, the statistics for some problematic concerns such as deaths of infants or those due to senility, were adjusted. Deaths, standard expected years of life lost (SEYLL), and potential years of life lost (PYLL) were computed using vital registration data compiled by the National Statistical Office. Results : The burden for males is 1.8 and 2.3 times higher than that for females, according to SEYLL and PYLL, respectively. The proportions of deaths due to Group I, II, and III causes are 5.4%, 80.4%, and 14.3%, respectively, for PYLL, but in a major shift from Group II to III they are 6.3%, 66.2%, and 27.5%, respectively, for SEYLL. The proportion of Group III causes in Korea, 27.5%, is extremely high when compared to 10.1% for the world, 7.6% for developed countries, and 10.7% for developing countries. Conclusions : Estimation results showed that the total burden due to premature deaths is smaller than that for the entire world but larger than that for developed countries. The disease structure of Korea has changed to resemble that of developed countries. Also, an overly large portion of the total burden in Korea stems from injuries arising from car accidents.

• Advances in pediatric surgery
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• v.16 no.2
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• pp.101-107
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• 2010

Herniorrhaphy of Indirect inguinal hernia (IIH) is one of the most frequently performed surgical procedures in children. The overall incidence of inguinal hernias in childhood ranges from 0.8 to 4.4 %. The incidence is up to 10 times higher in boys than girls, especially much higher in premature infants. IIHs in children are basically an arrest of embryologic development rather than an acquired weakness, which explains the increased incidence in premature infants. In normal development, the processus vaginalis closes, obliterating the peritoneal opening of the internal ring between 36th and 40th week of gestation. This process is often incomplete, leaving a small patent processus in many newborns. However, closure continues postnatally, and the rate of patency is inversely proportional to age of the child. The presence of a patent processus vaginalis is a necessary but not sufficient variable in developing a congenital IIH. In other words, all congenital IIHs are preceded by a patent processus vaginalis, but not all patent processus vaginalis go on to become IIHs. The overall incidence of IIH in population is approximately 1 to 2 % and the incidence of a processus vaginalis is approximately 12 to 14%, clinically appreciable IIH should develop in approximately 8 to 12 % of patients with a patent processus vaginalis. Although the classic open inguinal hernia repair remains the gold standard for most pediatric surgeons, laparoscopic repair is being performed in many centers. Like open technique, laparoscopic technique is fundamentally a high ligation of the indirect hernia sac with or without internal ring ligation. The advantages of laparoscopic approach include the ease of examining the contralateral internal ring, the avoidance of access damage to vas and vessels during mobilization of cord, decreased operative time, and an ability to identify unsuspected direct or femoral hernias. Almost all groin hernias in children are IIHs and occur as a result of incomplete closure of processus vaginalis. The treatment is repair by high ligation of hernia sac, which can be done by an open or laparoscopic technique. The contralateral side can be explored by laparoscopy or left alone, open exploration is no longer indicated due to potential risk of infertility.

• Journal of Nutrition and Health
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• v.27 no.3
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• pp.215-227
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• 1994

Changes in total lipid content, total cholesterol content and fatty acid composition of preterm milk were investigated during early lactation. Milk samples were collected from Korean mothers of 16 premature(34 to 36 weeks gestation age) infants on day 2 to 5(colostrum) and at 6 weeks(mature) postpartum. We estimated the lipid nutrition of preterm milk by comparing with the lipids of term milk. The total lipid content of preterm colostrum was significantly lower than the lipid content of preterm mature milk(p<0.001). Lipid content, determined gravimetrically in colostrum and matured milk, was 1.50g/이 and 3.2g/dl, respectively. Also the total cholesterol content(mg/dl) in preterm milk tends to increase from 14.16mg/dl to 15.20mg/dl, while the total cholesterol(mg/g lipid) concentration higher significantly in colostrum(12.36mg/g) than in mature(5.73mg/g)(p<0.001). The total unsaturated fatty acid contents in preterm milk were higher in colostrum than in mature milk and the total saturated fatty acids were higher in mature milk. The average DHA contents of colostrum and matured milk was 0.64%, 0.53% and the P/M/S ratio of preterm milk were 0.63 : 1.05 : 1.00, 0.47 : 0.79 : 1.00, respectively. Also, $\omega$6/$\omega$3 ratio of preterm milk were 2.35 in colostrum and 5.81 in mature. Therefore, colostrum in preterm milk contained higher amounts of $\omega$3 PUFA than mature milk. The levels of total lipid in preterm milk were higher than term milk. Also, preterm milk is richer in cholesterol, and long chain polyunsaturated fatty acid than term. It appears that the milk secreted by mothers who delivered prematurely differs from milk in several important respect. These components may serve as precursors for membrane, myelin development in the preterm infants. Therefore, it would be necessary to study further into the machanism of how the gestation age might affect to the lipid composition in human milk. These data may provide a basis for better construction of infant formaulas to provide more adequately for the lipid requirements of the Korean premature infant.

• Clinical and Experimental Pediatrics
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• v.54 no.2
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• pp.69-78
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• 2011

Purpose: The aim of this study was conducted to investigate the mean nRBC count in very low births weight infants (VLBWIs) and to determine the usefulness of the nRBC as an independent prognostic factors of perinatal complications in VLBWIs. Methods: This study was conducted on 112 VLBWIs who were hospitalized in the neonatal intensive care unit (NICU) of the author's hospital within the period from March 2003 to and May 2008. Based on the infants' nucleated red blood cells (nRBC) counts at birth, on the third day after birth, on the seventh day after birth, in the second week after birth, and in the fourth week after birth in the medical records, the correlation between nRBC or absolute nRBC counts with birth weight, gestational age, and other perinatal outcomes were retrospectively investigated. Results: In VLBWIs, their mean nRBC and absolute nRBC counts were showing a gradual decrease after birth, and they were consisteantly kept at low values since one week after and inversely proportional to the birth weights. The mean nRBC counts based on the stage after birth showed a significant correlation with perinatal death, necrotizing enterocolitis, and severe intraventricular hemorrhage. Conclusion: The increase in the nRBC count showed a significant correlation with having a severe intraventricular hemorrhage, necrotizing enterocolitis, and perinatal death in VLBWIs. If an increase or no decrease in the nRBC count after birth is observed, newborninfant care precautions should be required.