• Neonatal Medicine
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• 제25권1호
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• pp.16-22
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• 2018

Purpose: This study investigated predictive factors for severe neonatal thrombocytopenia, which greatly increases the need for intensive care and is associated with a high mortality rate in premature infants. Factors adopted for prompt identification of at-risk newborns include blood test results and birth history. This study analyzed the relationship between the presence of severe neonatal thrombocytopenia and the mortality rate. The causes of thrombocytopenia in premature infants were also examined. Methods: This retrospective study evaluated 625 premature infants admitted to the neonatal intensive care unit (NICU) at Chung-Ang University Medical Center. The neonates were classified into 3 groups according to the severity of thrombocytopenia: mild ($100{\times}10^9/L{\leq}platelet<150{\times}10^9/L$), moderate ($50{\times}10^9/L{\leq}platelet<100{\times}10^9/L$), or severe (platelet<$50{\times}10^9/L$). Analysis of blood samples obtained at the onset of thrombocytopenia included platelet count, white blood cell (WBC) count, hemoglobin level, hematocrit level, absolute neutrophil count, and high-sensitivity C-reactive protein level. Results: Of the 625 premature infants admitted to our NICU, 214 were detected with thrombocytopenia. The mortality rate in thrombocytopenic neonates was 18.2% (39/214), whereas a mortality rate of only 1.0% was observed in non-thrombocytopenic neonates. The major causes of thrombocytopenia were perinatal insufficiency and sepsis in premature infants. Severe thrombocytopenia was noted more frequently in premature infants with higher WBC counts and in those with a younger gestational age. Conclusion: Platelet count, WBC count, and gestational age are reliable predictors for severe neonatal thrombocytopenia. The major causes of thrombocytopenia were perinatal insufficiency and sepsis in premature infants.

• Neonatal Medicine
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• 제25권1호
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• pp.49-52
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• 2018

Arterial tortuosity syndrome (ATS) is a very rare autosomal recessive connective tissue disease characterized by generalized elongation and tortuosity of the medium- to large-sized arteries, and other systemic connective tissue manifestations. To date, this disease entity has not been reported in Korea. We report a case of ATS diagnosed in a neonate who presented with severe elongation and tortuosity of the aorta and its major branches, as well as the intracranial arteries. Additionally, the patient presented with a tortuous dilatation of the inferior vena cava, an aneurysmal dilatation of the extra-hepatic bile ducts, and an inguinal and sliding hiatal hernia. The diagnosis was confirmed using DNA sequencing analysis, and the patient demonstrated a compound heterozygosity for two novel mutations (c.738delG [p.Gln247Serfs*33] and c.362T>C [p.Ile121Thr]) in exon 2 of the SLC2A10 gene. Genetic analysis also confirmed that both parents were heterozygous carriers of the responsible mutations. Owing to such clinical manifestations, ATS is often misdiagnosed as other connective tissue diseases including Loeys-Dietz syndrome, Marfan syndrome, and Ehlers-Danlos syndrome. In patients presenting with a high index of suspicion, thorough clinical evaluation and screening for ATS including computed tomography or magnetic resonance angiography and target gene analysis are necessary for early diagnosis and management.

• Neonatal Medicine
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• 제25권3호
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• pp.102-108
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• 2018

Purpose: Congenital diaphragmatic hernia (CDH) is rare but potentially fatal. The overall outcome is highly variable. This study aimed to identify a simple and dynamic parameter that helps predict the mortality of CDH patients in real time, without invasive tests. Methods: We conducted a retrospective chart review of 59 CDH cases. Maternal and fetal information included the gestational age at diagnosis, site of defect, presence of liver herniation, and lung-to-head ratio (LHR) at 20 to 29 weeks of gestational age. Information regarding postnatal treatment, including the number of days until surgery, the need for inhaled nitric oxide (iNO), the need for extracorporeal membrane oxygenation (ECMO), and survival, was collected. The highest respiratory severity score (RSS) within 24 hours after birth was also calculated. Results: Statistical analysis showed that a younger gestational age at the initial diagnosis (P<0.001), a lower LHR (P=0.001), and the presence of liver herniation (P=0.003) were prenatal risk factors for CDH mortality. The RSS and use of iNO and ECMO were significant factors affecting survival. In the multivariate analysis, the only remaining significant risk factor was the highest preoperative RSS within 24 hours after birth (P=0.002). The area under the receiver operating characteristic curve was 0.9375, with a sensitivity of 91.67% and specificity of 83.87% at the RSS cut-off value of 5.2. The positive and negative predictive values were 82.14% and 92.86%, respectively. Conclusion: Using the RSS as a prognostic predictor with simple calculations will help clinicians plan CDH management.

• Neonatal Medicine
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• 제25권3호
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• pp.109-117
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• 2018

Purpose: Minimally invasive surfactant therapy (MIST) is currently used as a method of surfactant replacement therapy (SRT) for the treatment of respiratory distress syndrome (RDS) in preterm infants with a gestational age of less than 30 weeks. However, few studies have been conducted on MIST in neonates with a gestational age of 30 weeks or more. In this study, we compared MIST with endotracheal intubation as a rescue SRT for spontaneously breathing neonates with a gestational age of 30 weeks or more who were diagnosed with RDS. Methods: We investigated the clinical characteristics of spontaneously breathing neonates admitted to the neonatal intensive care unit of the Inje University Sanggye Paik Hospital from January 1, 2014 to December 31, 2016. These neonates were born at a gestational age of 30 weeks or more and were diagnosed with RDS. The neonates who were administered surfactant by MIST were categorized into the MIST group (n=16) and those who underwent endotracheal intubation were categorized into the control group (n=45). Thereafter, the clinical characteristics between the groups were compared. Results: Compared to the control group, the MIST group was less likely to require mechanical ventilation within 72 hours (P<0.001). The frequency of bradycardia during SRT was also low in the MIST group (P=0.033). Conclusion: MIST is considered relatively feasible and safe for treating RDS for reducing the need for mechanical ventilation and decreasing the occurrence of bradycardia during surfactant administration in neonates with a gestational age of 30 weeks or more.

• Neonatal Medicine
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• 제25권3호
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• pp.118-125
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• 2018

Purpose: The pre-pregnancy body mass index (BMI) is associated with adverse neonatal outcomes. However, studies on very low birth weight (VLBW) infants are rare. This study aimed to investigate the effect of maternal pre-pregnancy BMI on VLBW infants. Methods: This retrospective study evaluated singleton VLBW infants born at the CHA Gangnam Medical Center from 2006 to 2016. The neonates were classified into three groups according to the maternal pre-pregnancy BMI: underweight (<$18.5kg/m^2$), normal weight (${\geq}18.5$ to <$23kg/m^2$), and overweight or obese (${\geq}23kg/m^2$). Clinical characteristics and morbidities of mothers and infants were analyzed. Results: A total of 181 infants belonging to underweight (16.6%), normal weight (58.6%), and overweight or obese (24.8%) groups were enrolled. The pre-pregnancy BMI had a significant negative correlation with gestational age (r=-0.198, P=0.001) and a significant positive correlation with the z-score of the birth weight (r=0.078, P=0.001) and body length (r=0.067, P=0.008). The number of extremely preterm infants was significantly higher in the overweight or obese group. The proportion of risk of small for gestational age infants was higher in the underweight group (adjusted odds ratio [OR], 2.958; 95% confidence interval [CI], 1.113 to 7.864), whereas that of infants with severe retinopathy of prematurity was higher in the overweight or obese group (adjusted OR, 9.546; 95% CI, 1.230 to 74.109). Conclusion: In our population of VLBW infants, the pre-pregnancy BMI was associated with gestational age, intrauterine growth, and adverse neonatal outcomes. Therefore, proper weight control before pregnancy is important.

• 한국임상수의학회지
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• 제28권4호
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• pp.365-368
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• 2011

Next to performing an expert physical examination, a blood sample submitted for a complete blood count is the most basic tool available to owners or veterinary practitioners. Reference values of complete blood count were determined at 6 different ages in 114 Thoroughbred foals during the second month of life. Hematologic results were as follows: RBC 8.2-10.5 ($10^6/{\mu}l$), Hb 10.9-13.3 (g/dl), HCT 28.2-35.2 (%), MCV 30.7-35.8 (fL), MCH 11.9-13.5 (pg), MCHC 37.9-40.5 (g/dl), RDW 24.5-25.7 (%), PLT 146.3-256.4 ($10^3/{\mu}l$), MPV 6.7-8.3(fL), total WBC 8.1-12.5 ($10^3/{\mu}l$), basophils 0.0 ($10^3/{\mu}l$), eosinophils 0.0-0.3 ($10^3/{\mu}l$), neutrophils 2.4-8.6 ($10^3/{\mu}l$), lymphocytes 1.8-2.9 ($10^3/{\mu}l$) and monocytes 0.0-1.4 ($10^3/{\mu}l$). The results of this study serve as reference ranges for Thoroughbred neonatal foals populations and can be useful for health control, regular examination and pre-sale soundness examination.

• Neonatal Medicine
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• 제16권1호
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• pp.71-75
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• 2009

9번 염색체 장완의 중복은 거의 드문 형태의 염색체 이상이며, 특징적인 얼굴형태와 손가락 형태, 정신지체 등이 나타나는 것으로 알려져 있다. 얼굴 형태는 정상이었으나 선천성 심장기형과 수신증, 음낭 탈장이 동반된 미숙아에게서 46,X,Y,dup(9)(q21.2q22.1)를 확인하였고, 표현형이 정상인 환아의 아버지에게서 유래된 것으로 생각되어진 예를 경험하였기에 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.5083-5088
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• 2014

Background: Scientometrics is a useful method for management of financial and human resources and has been applied many times in medical sciences during recent years. The aim of this study was to investigate the status of science production by Iranian scientists in the gastric cancer field based on the Medline database. Materials and Methods: In this descriptive-cross sectional study Iranian science production concerning gastric cancer during 2000-2011 was investigated based on Medline. After two stages of searching, 121 articles were found, then we reviewed publication date, authors names, journal title, impact factor (IF), and cooperation coefficient between researchers. SPSS.19 was used for statistical analysis. Results: There was a significant increase in published articles about gastric cancer by Iranian researchers in Medline database during 2006-2011. Mean cooperation coefficient between researchers was $6.14{\pm}3.29$ person per article. Articles of this field were published in 19 countries and 56 journals. Those basex in Thailand, England, and America had the most published Iranian articles. Tehran University of Medical Sciences and Mohammadreza Zali had the most outstanding role in publishing scientific articles. Conclusions: According to results of this study, improving cooperation of researchers in conducting research and scientometric studies about other fields may have an important role in increasing both quality and quantity of published studies.

• Clinical and Experimental Pediatrics
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• 제53권10호
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• pp.880-885
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• 2010

Purpose: The recent trends of multiple births (MBs) conceived by assisted reproductive technology (ART) in Korea were analyzed as well as the relationship with maternal age, especially advanced maternal age. Methods: Data were obtained from the Korean Statistical Information Service and annual ART reports from the ART committee of the Korean Society of Obstetrics and Gynecology. Results: MBs increased from the early 1990s; there was a 275% increase by 2008. The number of total live births was 448,153 and MBs accounted for 10,767; the MB rate was 24.0% in 2006. Among 2,326 deliveries conceived by ART, multiple deliveries accounted for 786 (33.8%). The total number of live births with ART was 3,125 and 1,585 (50.7%) of them were MBs. During 2006, 14.7% of the entire MBs in Korea were associated with ART. The proportion of women of advanced maternal age was much higher in the ART group than in the total live birth group. Conclusion: MBs in women of advanced maternal age have been increasing in Korea with the use of ART. The results of this study showed that ART was a significant factor associated with the increase in MBs in Korea.

• Neonatal Medicine
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• 제17권2호
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• pp.232-238
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• 2010

목적: 모유수유율이 증가하면서 재수유에 관한 수요가 증가하고 있다. 이에 성공적인 재수유에 기여하는 인자를 조사하기 위해서 약물, 모유수유 보충기, 상담, 가족의 지지 등의 기여도를 조사하였다. 방법: 후향적인 의무기록 조사와 2004년 1월부터 2007년 4월까지 본원 재수유 클리닉을 방문한 아기 엄마들에게 전화설문을 실시하였다. 결과: 총 84명의 자료를 분석하여 재수유의 성공에 도움이 되는 인자를 조사하였다. 75%에서 완전 모유수유로 성공적으로 이행할 수 있었다. 재수유 클리닉을 다니면서 재수유에 성공한 경우 의료진에 의해서 재수유 클리닉으로 의뢰된 경우, 약물을 사용한 경우와 가족의 지지가 있는 경우가 통계적으로 유의하게 높았다. 결론: 재수유에 성공하기 위해서는 산모들에게 재수유에 관한 정보를 미리 제공하고, 필요 시 유즙분비를 촉진하는 약물을 처방하고 상담 기간 동안 가족과 함께 상담을 받게 해서 정신적인 지지를 제공하는 것이 중요하다.