• Pediatric Infection and Vaccine
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• 제28권3호
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• pp.149-159
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• 2021

목적: 산모의 산전 항생제 사용은 여러가지 면에서 태아 및 신생아에 영향을 미칠 수 있다. 본 연구에서는 극소 미숙아 또는 극소 저체중출생아에서 산모의 산전 항생제 투여 기간이 신생아 예후에 미치는 영향에 대해 조사하였다. 방법: 2015년 9월부터 2020년 12월까지 고려대학교 안암병원에서 출생한 재태주수 32주 미만 또는 출생 체중 1,500 gram 미만인 신생아 및 산모를 대상으로 의무기록을 후향적으로 분석하였다. 산모의 산전 항생제 투여 기간에 따라 미투여 군, 7일 이하 군, 7일 초과 군의 세 군으로 나누어 산모의 특성, 환아의 특성 및 합병증 등을 비교 분석하였다. 결과: 총 145명 중 93명의 환아가 산전 항생제에 노출되었으며, 그 중 35명(37.6%)는 7일 이하 군, 58명(62.4%)는 7일 초과 군이었다. 7일 초과 군은 미투여 군에 비해 재태 연령에 따른 출생체중의 Z-score가 교란변수 보정 후에도 유의미하게 높았다(beta, 0.258; standard error, 0.149; P<0.001). 다변량 로지스틱 회귀 분석에서 7일 초과 군은 사망(adjusted odds ratio [aOR], 8.926; 95% confidence interval [CI], 1.482-53.775), 그리고 사망, 괴사성 장염, 후기 패혈증의 복합 평가 결과와 연관이 있었다(aOR, 2.375; 95% CI, 1.027-5.492). 결론: 산모의 장기간 산전 항생제 투여는, 극소 미숙아 또는 극소 저체중출생아에서 재태 연령에 따른 출생체중의 Z score을 증가시키며, 사망 뿐 아니라 사망, 괴사성 장염, 후기 패혈증의 복합 평가 결과의 위험도를 증가시킬 수 있다.

• 대한약학회:학술대회논문집
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• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2-1
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• pp.104-105
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• 2003

Hypoxic-ischemic (H-I) encephalopathy in the prenatal and perinatal period is a major cause of morbidity and mortality and often results in cognitive impairment, seizures, and motor impairment (cerebral palsy). Many studies of neonatal H-I brain injury have utilized the well characterized Levine model in which unilateral carotid ligation is followed by exposure to hypoxia. (omitted)

• 대한간호학회지
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• 제2권1호
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• pp.131-140
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• 1971

Anions a total of 1,410 women who were taken in th the Ilshin Maternity Hospital in Pusan for child-bearing front January 1 to Hay 31, 1970, review and observation were made on 653 mothers and 661 babies delivered (including twin) who had received parental care, and on 757 mothers and 773 babies delivered (including twin) who had not received parental care. The results are: 1. Out of 1,410 women 653 received parental care, The number is 46.4% 2. Most of them are between 25 and 29 years of age, and it shows the highest percentage. 3. Twenty five % of them visited the hospital care for the first time in the tenth month of pregnancy It was the highest percentage. 4. Those who visited the clinic only once for parental care during the pregnancy were 25.7%, the highest percentage. 5. Those who got parental care among primiparae were 43.7%, and among multiphase were 48.5% The rates are similar to each other. 6. Maturity rate of the babies delivered after receiving prenatal care: mature 91%, Immature- 1% and premature- 8%. 7. It was found that among primiparae were the higher frequency of prematurity. 8. Among babies delivered by mothers after receiving parental care, 8.1% were premature, while 16.1% of babies delivered by those who han't received the care were premature. 9. Mothers between 25 and 29 years of age brought birth to premature. babies most. 10. Frequency of prematurity based on the times of parental care received was: once or twice -8.7% 3 or 4 time-8.9%, 5 or times-10.3%, 7 or 8 times-4.5%, 11 or 12 times-2.7%, 13 or 14 times-3.8%. 11. Percental death rate shows 2.9% among the mothers received prenatal care, and 7.3% among those without parental care. 12. Average weight of a baby boy was 3,114 gm, and that of a baby girl was 3,021 gm. 13. Obstetric complication rate was 63,2% in the babies delivered by mothers with prenatal care, and 85.6% in those delivered by mothers without parental care.

• Journal of mucopolysaccharidosis and rare diseases
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• 제2권1호
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• pp.19-22
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• 2016

Purpose: Mucolipidosis type II (ML II), also known as I-cell disease is an autosomal recessive inherited disorder of lysosomal enzyme transport caused by a deficiency of the uridine diphosphate (UDP)-N-acetylglucosamine:lysosomal enzyme N-acetylglucosamine-1-phosphotransferase (GlcNAc-phosphotransferase). Clinical manifestations are skeletal abnormalities, mental retardation, cardiac disease, and respiratory complications. A severely and rapidity progressive clinical course leads to death before 10 years of age. Methods/Results: In this study we diagnosed three cases of prenatal ML II in two different at-risk families. We compared two procedures -biochemical analysis and molecular analysis - for the prenatal diagnosis of ML II. Both methods require an invasive procedure to obtain specimens for the diagnosis. Biochemical analysis requires obtaining cell cultures from amniotic fluid for more than two weeks, and would result in a late diagnosis at 19 to 22 weeks of gestation. Molecular genetic testing by direct sequence analysis is usually possible when mutations are confirmed in the proband. Molecular analysis has an advantage in that it can be performed during the first-trimester. Conclusion: Molecular diagnosis is a preferable method when a prompt decision is necessary.

• Journal of Genetic Medicine
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• 제2권2호
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• pp.53-57
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• 1998

Spinal muscular atrophy (SMA) type I is a common severe autosomal recessive inherited neuromuscular disorder that has been mapped to chromosome 5q11.2-13.3. The survival motor neuron (SMN) gene, a candidate gene, is known to be deleted in 96% of patients with SMA type I. Presently, PCR and single strand conformation polymorphism (PCR-SSCP) analyses have been made possible for application to both archival slides and paraffin-embedded tissues. Archival materials represent valuable DNA resources for genetic diagnosis. We applied these methods for the identification of SMN gene of SMA type I in archival specimens for the prenatal diagnosis. In this study, we performed the prenatal diagnosis with chorionic villus sampling (CVS) cells on two women who had experienced neonatal death of SMA type I. DNA extraction was done from archival slide and tissue materials and PEP-PCR was performed using CVS cells. In order to identify common deletion region of SMN and neuronal apoptosis-inhibitory protein (NAIP) genes, cold PCR-SSCP and PCR-restriction site assay were carried out. Case 1 had deletions of the exons 7 and 8, and case 2 had exon 7 only on the telomeric SMN gene. Both cases were found to be normal on NAIP gene. These results were the same for both CVS and archival biopsied specimens. In both cases, the fetuses were, therefore, predicted to be at very high risk of being affected and the pregnancy were terminated. These data clearly demonstrate that archival slide and paraffin-embedded tissues can be a valuable source of DNA when the prenatal genetic diagnosis is needed in case any source for genetic analysis is not readily available due to previous death of the fetus or neonate.

• Journal of Microbiology and Biotechnology
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• 제18권9호
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• pp.1590-1598
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• 2008

Cell proliferation and differentiation are critical processes in a developing fetal rat brain, during which programmed cell death (PCD) also plays an important role. One of the decisive factors for PCD is Bcl-2 family proteins, where Bax induces cell death, whereas Bcl-2 acts as an inhibitor of PCD. As maternal drinking is known to cause fetal alcohol syndrome (FAS) or malformation of the fetal brain during pregnancy, the objective of the present study was to investigate whether maternal ethanol exposure alters the PCD-related Bax and Bcl-2 protein expression during fetal brain development. Pregnant female rats were orally treated with 10% ethanol and the subsequent expressions of the Bax and Bcl-2 proteins examined in the fetal brain, including the forebrain, midbrain, and hindbrain, from gestational day (GD) 15.5 to GD 19.5, using Western blots, in situ hybridization, and immunohistochemistry. With regard to the ratio of Bcl-2 to Bax proteins (Bcl-2/Bax), the Bax protein was dominant in the forebrain and midbrain of the control GD 15.5 fetuses, except for the hindbrain, when compared with the respective ethanol-treated groups. Moreover, Bcl-2 became dominant in the midbrain of the control GD 17.5 fetuses when compared with the ethanol-treated group, representing an alternation of the natural PCD process by ethanol. Furthermore, a differential expression of the Bcl-2 and Bax proteins was found in the differentiating and migrating zones of the cortex, hippocampus, thalamus, and cerebellum. Thus, when taken together, the present results suggest that ethanol affects PCD in the cell differentiation and migration zones of the prenatal rat brain by modulating Bax and Bcl-2 expression in an age- and area-dependent manner. Therefore, this is the first evidence that ethanol may alter FAS-associated embryonic brain development through the alteration of Bax and Bc1-2 expression.

• 한국환경성돌연변이발암원학회:학술대회논문집
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• 한국환경성돌연변이발암원학회 2002년도 Current Trends in Toxicological Sciences
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• pp.48-64
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• 2002

The primary recognized health risk from common deficiencies in glucose-6-phosphate dehydrogenase (G6PD), a cytoprotective enzyme for oxidative stress, is red blood cell hemolysis. Here we show that litters from untreated pregnant mutant mice with a hereditary G6PD deficiency had increased prenatal (fetal resorptions) and postnatal death. When treated with the anticonvulsant drug phenytoin, a human teratogen that is commonly used in pregnant women and causes embryonic oxidative stress, G6PD-deficient dams had higher embryonic DNA oxidation and more fetal death and birth defects. The reported G6PD gene mutation was confirmed and used to genotype fetal resorptions, which were primarily G6PD deficient. This is the first evidence that G6PD is a developmentally critical cytoprotective enzyme for both endogenous and xenobiotic-initiated embryopathic oxidative stress and DNA damage. G6PD deficiencies accordingly may have a broader biological relevance as important determinants of infertility, in utero and postnatal death, and teratogenesis.-Nicol, C. J., Zielenski, J., Tsui, L.-C., Wells, P. G. An embryoprotective role for glucose-6-phosphate dehydrogenase in developmental oxidative stress and chemical teratogenesis.

• Child Health Nursing Research
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• 제9권1호
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• pp.96-106
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• 2003

Advances in neonatal care system and research have resulted in an increased survival rate among low birth weight infants in the industrialized countries. Recent Korean neonatal mortality and morbidity statistics, and current status of Korean neonatal intensive care facilities were reviewed here for the sake of future improvement and research. Morbidity statistics revealed that perinatal diseases accounted for 80％ of the death of premature infants implying the possibility of its reduction by the vigorous prenatal care service in future.On the basis of extensive studies of nutritional support and growth rate of premature infants, commercial formulas for premature infants have been developed and various aspects of feeding techniques are standardized. However, problem of growth deficit of premature infants remains unsolved as medical problem. NICU specialists are challenged with the tasks of prenatal education or provision of care that minimizes the neurodevelopmental problems seen in preterm infants, various short-term outcome researches have been reported and those are reviewed here to promote research interest in the field of neonatal nursing. Systemic long-term outcome studies are also awaited in Korea for the formulation of welfare policy in future. Nursing science has to embrace all these interdisciplinary studies as their own research field in collaboration with neonatologist, nutritionist, rehabilitation therapist, social workers and teachers.

• Journal of Preventive Medicine and Public Health
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• 제4권1호
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• pp.19-30
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• 1971

A survey was couducted by the staff of the Dept. of Preventive Medicine, Kyung Hee University, School of Medicine, from April through May 1971, on such events as delivery, death, abortion and family planning. The survey directed to a total population 6,552 (Male 3,133; Female 3,419) residing in this area (1,262 households) led us to the following findings: 1) Two year averages of crude birth rate, crude death rate and natural increase rates were 24.9, 5.0 and 19.9 respectively. 2) Infant death rates for the years 1969 and 1970 were 13.2 and 5.8 respectively, mean for the two year period being 9.3. 3) Hospital deliveries rated 68.5 per cent, Home deliveries 28.4 per cent and deliveries at midwives' offices 2.7 per cent. 4) Deliveries other than hospital and midwives' office deliveries were found to be attended more often by mothers. 5) About 41.4 per cent of all pregnant women during last two years received prenatal care once or more. 6) The induced abortion rate was 6.7 per cent in 1969 and 7.5 per cent in 1970. 7) The spontaneous abortion rate was 1.1 per cent in 1969 and 1.4 per cent in 1970. 8) Hypertension was the most frequent cause of adult death(21.6%). 9) The rate of current practice in family planning was 43.3 percent of all women.

• Advances in pediatric surgery
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• 제12권2호
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• pp.137-146
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• 2006

Pediatric surgery could establish a definitive position in the medical field on the basis of a stable patient population. Neonatal surgery, the core of pediatric surgery, requires highly skilled surgeons. However, recent advancement of prenatal diagnosis followed by intervention and decreased birth rate has resulted in a significant decrease in the neonatal surgical population and the number of surgical operations. The purpose of this study is to examine the outcome of neonatal surgeries and to propose a guide for the future surgeries. A total of 359 neonatal surgical patients operated upon at the Department of Surgery, Ewha Medical Center, during past 21 years were studied. The study period hasbeen divided into two time periods: from 1983 to 1993 and from 1994 to 2004. Analysis was based on the Clinical Classification System and mortality pattern, frequency of disorders, occurrence and cause of death, and other changes. Neonatal surgery was 6.4 % of all pediatric surgery during the total 21 year period, 9.9 % in the first period and 4.8 % in the second. Male to female ratio increased from 2.7:1 to 2.1:1. The overall mortality was 6.7 %, and there was significant decrease from 7.4 % in the first period to 6.0 % in the second. The clinical classification system (CCS) for death cases included class II 2, III 4, and IV 7 during the first period and class III 3, and IV 8 during the second, respectively. According to the mortality pattern by Hazebroek, there were 6 preventable death cases during the first period, and only one in the second, and 2 non-preventable death cases during the first period and 8 in second, respectively. Although the patients in the second period had more serious diseases, surgical mortality has been decreased in the second period, which may be the result of improved surgery methods for newborns and advanced patient care.