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Lee SM, Lee JA, Chung SH, Lee JH, Shim JW, Lim JW, Kim CR, Chang YS. Nationwide Long-Term Growth and Developmental Outcomes of Infants for Congenital Anomalies in the Digestive System and Abdominal Wall Defects With Surgery in Korea. J Korean Med Sci 2023; 38:e372. [PMID: 38111278 PMCID: PMC10727918 DOI: 10.3346/jkms.2023.38.e372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/22/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Infants with congenital anomalies of the digestive system and abdominal wall defects requiring surgery are at risk of growth and developmental delays. The aim of this study was to analyze long-term growth and developmental outcomes for infants with congenital anomalies of the digestive system and abdominal wall defects who underwent surgery in Korea. METHODS We extracted data from the Korean National Health Insurance Service database for the years 2013-2019. Major congenital anomalies were defined according to the International Classification of Diseases-10 and surgery insurance claim codes. The χ² test and the Cochran-Armitage trend test were performed for data analysis. RESULTS A total of 4,574 infants with major congenital anomalies in the digestive system and abodminal wall defects, who had undergone surgey, were reviewed. Anorectal obstruction/stenosis was the most prevalent anomaly (4.9 per 10,000 live births). The prevalence of congenital anomalies of the digestive system was 15.5 per 10,000 live births, and that of abdominal wall defects was 1.5 per 10,000 live births. Seven percent of infants with congenital anomalies in the digestive system died, of which those with diaphragmatic hernia had the highest mortality rate (18.8%). Among 12,336 examinations at 6, 12, 24, 36, 48, 60, and 72 months of age, 16.7% showed a weight below the 10th percentile, 15.8% had a height below the 10th percentile, and 13.2% had a head circumference below the 10th percentile. Abnormal developmental screening results were observed in 23.0% of infants. Infants with esophageal atresia with/without tracheoesophageal fistula most often had poor growth and development. Delayed development and cerebral palsy were observed in 490 (10.7%) and 130 (2.8%) infants respectively. Comparing the results of infants born in 2013 between their 24- and 72-month health examinations, the proportions of infants with poor height and head circumference growth increased by 6.5% and 5.3%, respectively, whereas those with poor weight growth and abnormal developmental results did not markedly change between the two examinations. CONCLUSION Infants with congenital anomalies of the digestive system and abdominal wall defects exhibit poor growth and developmental outcomes until 72 months of age. Close monitoring and careful consideration of their growth and development after discharge are required.
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Affiliation(s)
- Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Jin A Lee
- Department of Pediatrics, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sung-Hoon Chung
- Department of Pediatrics, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Jang Hoon Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Jae Won Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Woo Lim
- Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Yun Sil Chang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea.
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Lee JA, Lee SM, Chung SH, Lee JH, Shim JW, Lim JW, Kim CR, Chang YS. Major Congenital Anomalies in Korean Livebirths in 2013-2014: Based on the National Health Insurance Database. J Korean Med Sci 2023; 38:e304. [PMID: 37821084 PMCID: PMC10562182 DOI: 10.3346/jkms.2023.38.e304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/08/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND In Korea, there have been no reports comparing the prevalence of major congenital anomalies with other countries and no reports on surgical treatment and long-term mortality. We investigated the prevalence of 67 major congenital anomalies in Korea and compared the prevalence with that of the European network of population-based registries for the epidemiological surveillance of congenital anomalies (EUROCAT). We also investigated the mortality and age at death, the proportion of preterm births, and the surgical rate for the 67 major congenital anomalies. METHODS Korean National Health Insurance claim data were obtained for neonates born in 2013-2014 and admitted within one-year-old. Sixty-seven major congenital anomalies were defined by medical diagnoses classified by International Classification of Diseases-10 codes according to the EUROCAT definition version 2014. Mortality and surgery were defined if any death or surgery claim code was confirmed until 2020. Poisson distribution was used to calculate the 95% confidence interval of the congenital anomaly prevalence. RESULTS The total prevalence of the 67 major anomalies was 433.5/10,000 livebirths. When compared with the prevalence of each major anomaly in EUROCAT, the prevalence of spina bifida, atrial septal defect (ASD), congenital megacolon, hip dislocation and/or dysplasia and skeletal dysplasia were more than five times higher in Korea. In contrast, the prevalence of aortic atresia/interrupted aortic arch and gastroschisis was less than one-fifth in Korea. The proportion of preterm births was 15.7%; however, more than 40% of infants with anencephaly, annular pancreas and gastroschisis were preterm infants. Additionally, 29.2% of the major anomalies were admitted to the neonatal intensive care units at birth, and 25.6% received surgical operation. The mortality rate was 1.7%, and 78.2% of the deaths occurred within the first year of life. However, in neonates with tricuspid valve atresia and stenosis, duodenal atresia or stenosis, and diaphragmatic hernia, more than half died within their first month of life. ASD and ventricular septal defect were the most common anomalies, and trisomy 18 and hypoplastic left heart syndrome were the most fatal anomalies. All infants with aortic atresia/interrupted aortic arch and conjoined twins received surgery. CONCLUSION The proportion of surgeries, preterm births and mortality was high in infants with major congenital anomalies. The establishment of a national registry of congenital anomalies and systematic support by national medical policies are needed for infants with major congenital anomalies in Korea.
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Affiliation(s)
- Jin A Lee
- Department of Pediatrics, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Sung-Hoon Chung
- Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jang Hoon Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Jae Won Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Woo Lim
- Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Yun Sil Chang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.
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Hwang JK, Kim DH, Na JY, Son J, Oh YJ, Jung D, Kim CR, Kim TH, Park HK. Two-stage learning-based prediction of bronchopulmonary dysplasia in very low birth weight infants: a nationwide cohort study. Front Pediatr 2023; 11:1155921. [PMID: 37384307 PMCID: PMC10294267 DOI: 10.3389/fped.2023.1155921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/16/2023] [Indexed: 06/30/2023] Open
Abstract
Introduction The aim of this study is to develop an enhanced machine learning-based prediction models for bronchopulmonary dysplasia (BPD) and its severity through a two-stage approach integrated with the duration of respiratory support (RSd) using prenatal and early postnatal variables from a nationwide very low birth weight (VLBW) infant cohort. Methods We included 16,384 VLBW infants admitted to the neonatal intensive care unit (NICU) of the Korean Neonatal Network (KNN), a nationwide VLBW infant registry (2013-2020). Overall, 45 prenatal and early perinatal clinical variables were selected. A multilayer perceptron (MLP)-based network analysis, which was recently introduced to predict diseases in preterm infants, was used for modeling and a stepwise approach. Additionally, we applied a complementary MLP network and established new BPD prediction models (PMbpd). The performances of the models were compared using the area under the receiver operating characteristic curve (AUROC) values. The Shapley method was used to determine the contribution of each variable. Results We included 11,177 VLBW infants (3,724 without BPD (BPD 0), 3,383 with mild BPD (BPD 1), 1,375 with moderate BPD (BPD 2), and 2,695 with severe BPD (BPD 3) cases). Compared to conventional machine learning (ML) models, our PMbpd and two-stage PMbpd with RSd (TS-PMbpd) model outperformed both binary (0 vs. 1,2,3; 0,1 vs. 2,3; 0,1,2 vs. 3) and each severity (0 vs. 1 vs. 2 vs. 3) prediction (AUROC = 0.895 and 0.897, 0.824 and 0.825, 0.828 and 0.823, 0.783, and 0.786, respectively). GA, birth weight, and patent ductus arteriosus (PDA) treatment were significant variables for the occurrence of BPD. Birth weight, low blood pressure, and intraventricular hemorrhage were significant for BPD ≥2, birth weight, low blood pressure, and PDA ligation for BPD ≥3. GA, birth weight, and pulmonary hypertension were the principal variables that predicted BPD severity in VLBW infants. Conclusions We developed a new two-stage ML model reflecting crucial BPD indicators (RSd) and found significant clinical variables for the early prediction of BPD and its severity with high predictive accuracy. Our model can be used as an adjunctive predictive model in the practical NICU field.
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Affiliation(s)
- Jae Kyoon Hwang
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Dae Hyun Kim
- Department of Artificial Intelligence, Hanyang University, Seoul, Republic of Korea
| | - Jae Yoon Na
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Joonhyuk Son
- Department of Pediatric Surgery, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Yoon Ju Oh
- Department of Artificial Intelligence, Hanyang University, Seoul, Republic of Korea
| | - Donggoo Jung
- Department of Artificial Intelligence, Hanyang University, Seoul, Republic of Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Tae Hyun Kim
- Department of Computer Science, Hanyang University, Seoul, Republic of Korea
| | - Hyun-Kyung Park
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
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Cha T, Kim HH, Keum J, Kwak MJ, Park JY, Hoh JK, Kim CR, Jeon BH, Park HK. Gut microbiome profiling of neonates using Nanopore MinION and Illumina MiSeq sequencing. Front Microbiol 2023; 14:1148466. [PMID: 37256051 PMCID: PMC10225602 DOI: 10.3389/fmicb.2023.1148466] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/17/2023] [Indexed: 06/01/2023] Open
Abstract
This study aimed to evaluate the difference in gut microbiomes between preterm and term infants using third-generation long-read sequencing (Oxford Nanopore Technologies, ONT) compared with an established gold standard, Illumina (second-generation short-read sequencing). A total of 69 fecal samples from 51 term (T) and preterm (P) infants were collected at 7 and 28 days of life. Gut colonization profiling was performed by 16S rRNA gene sequencing using ONT. We used Illumina to validate and compare the patterns in 13 neonates. Using bioinformatic analysis, we identified features that differed between P and T. Both T1 and P1 microbiomes were dominated by Firmicutes (Staphylococcus and Enterococcus), whereas sequentially showed dominant transitions to Lactobacillus (p < 0.001) and Streptococcus in T2 (p = 0.001), and pathogenic bacteria (Klebsiella) in P2 (p = 0.001). The abundance of beneficial bacteria (Bifidobacterium and Lactobacillus) increased in T2 (p = 0.026 and p < 0.001, respectively). These assignments were correlated with the abundance at the species-level. Bacterial α-diversity increased in T (p = 0.005) but not in P (p = 0.156), and P2 showed distinct β-diversity clustering than T2 (p = 0.001). The ONT reliably identified pathogenic bacteria at the genus level, and taxonomic profiles were comparable to those identified by Illumina at the genus level. This study shows that ONT and Illumina are highly correlated. P and T had different microbiome profiles, and the α- and β-diversity varied. ONT sequencing has potential for pathogen detection in neonates in clinical settings.
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Affiliation(s)
- Teahyen Cha
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Hoo Hugo Kim
- Department of Earth Resources and Environmental Engineering, Hanyang University, Seoul, Republic of Korea
| | - Jihyun Keum
- Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Min-Jin Kwak
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul, Republic of Korea
| | - Jae Yong Park
- Division of Microbiome, Int-Gen Company, Seoul, Republic of Korea
| | - Jeong Kyu Hoh
- Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Byong-Hun Jeon
- Department of Earth Resources and Environmental Engineering, Hanyang University, Seoul, Republic of Korea
| | - Hyun-Kyung Park
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
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Lee WS, Hwang JK, Ryu J, Choi YJ, Oh JW, Kim CR, Han MY, Oh IH, Lee KS. The relationship between childhood asthma and socioeconomic status: a Korean nationwide population-based study. Front Public Health 2023; 11:1133312. [PMID: 37181696 PMCID: PMC10167280 DOI: 10.3389/fpubh.2023.1133312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/05/2023] [Indexed: 05/16/2023] Open
Abstract
Purpose This study aimed to investigate associations of socioeconomic status (SES) with asthma exacerbation and asthma-related hospital utilization factors among children with asthma in the Republic of Korea. Methods This study retrospectively analyzed population-level data from the Korean National Health Insurance Service, collected from 2013 through 2019. SES was classified into five categories according to the national health insurance premiums quantiles (0 [lowest] to 4 [highest]). The hazard ratios (HRs) for asthma exacerbation, emergency department (ED) visits, hospital admission, and intensive care unit (ICU) admission were analyzed with respect to SES. Results Among the five SES groups, SES group 0 (medical aid), had the highest tallies and proportions of children who experienced asthma exacerbations (n = 1,682, 4.8%), ED visits (n = 932, 2.6%), hospital admission (n = 2,734, 7.7%) and ICU admission (n = 14, 0.04%). Compared with SES group 4, SES group 0 had adjusted HRs of 3.73 (p = 0.0113) and 1.04 (p < 0.0001) for ventilator support/tracheal intubation and administration of systemic corticosteroids, respectively. Relative to group 4, the adjusted HRs for ED visits, hospital admission, and ICU admission in group 0 were 1.88 (p < 0.0001), 2.20 (p < 0.0001), and 7.12 (p < 0.0001), respectively. In the survival analysis, group 0 had a significantly higher risk of ED presentation, hospital admission, and ICU admission than the other groups (log-rank p < 0.001). Conclusion Compared with children of higher SES, those in the lowest SES group had increased risk of asthma exacerbation, hospital admission, and receiving treatment for severe asthma symptoms.
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Affiliation(s)
- Won Seok Lee
- Department of Pediatrics, CHA Ilsan Medical Center, CHA University College of Medicine, Goyang, Republic of Korea
| | - Jae Kyoon Hwang
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Jiin Ryu
- Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, Republic of Korea
| | - Young-Jin Choi
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Jae-Won Oh
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Republic of Korea
| | - In Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Kyung Suk Lee
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
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Park MJ, Ahn JH, Lee HJ, Park HK, Hwang JK, Kim CR, Na JY. Rapidly Progressive Pericardial Effusion and Cardiac Tamponade in a Term Infant with an Umbilical Venous Catheter: A Case Report. Neonatal Med 2022. [DOI: 10.5385/nm.2022.29.4.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Pericardial effusion (PCE) in neonates has various clinical presentations depending on the amount and speed of fluid accumulation and can cause cardiac tamponade (CT). We report a case of rapidly accumulating PCE and near-fatal CT with an umbilical venous catheter successfully resolved by emergent echo-guided pericardiocentesis in a term infant who had been hospitalized with meconium aspiration syndrome and persistent pulmonary hypertension. This case report suggests that if a patient with an intracardiac umbilical catheter shows sudden cardiopulmonary instability, the possibility of PCE and CT should be considered. Furthermore, if necessary, emergency drainage of the PCE and removal of the umbilical catheter should be immediately performed.
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Hwang JK, Kang HN, Ahn JH, Lee HJ, Park HK, Kim CR. Effects of Ponderal Index on Neonatal Mortality and Morbidities in Extremely Premature Infants. J Korean Med Sci 2022; 37:e198. [PMID: 35726149 PMCID: PMC9247722 DOI: 10.3346/jkms.2022.37.e198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 05/17/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND To evaluate how intrauterine stress affects extremely premature infants in terms of intrauterine growth restriction. We hypothesized that extremely premature infants with mildly-low ponderal index (MPI) would have better neonatal outcomes. METHODS We selected 2,721 subjects of 23 to 28 weeks of gestation between 2013 and 2015 from Korean Neonatal Network database. They were divided into 4 groups based on ponderal index (PI) percentile; PI ≤ 3rd as severely-low PI (SPI, n = 82), 3rd < PI ≤ 10th as MPI (n = 190), 10th < PI ≤ 90th as adequate PI (API, n = 2,179), and PI > 90th as high PI (HPI, n = 270). RESULTS The mortality in MPI and API groups was comparable (16.3% vs. 16.9%). It was significantly lower than that in the SPI and HPI groups (30.5% and 24.9%, respectively; P = 0.001). The MPI and API groups had better neonatal morbidities compared with the SPI and/or HPI groups, while the MPI group (8.2%) showed a lower incidence of severe intraventricular hemorrhage (IVH) than the other groups (SPI, 21.3%; API, 15.0%; HPI, 19.7%, respectively; P = 0.004). The MPI group had a trend of a bottom in neonatal mortality and morbidities in extremely premature infants. CONCLUSION The MPI and API groups had lower mortality, massive pulmonary hemorrhage, severe bronchopulmonary dysplasia or death, pulmonary hypertension and neonatal seizure rates than the SPI and/or HPI groups, while the MPI group showed a lower incidence of severe IVH than the other groups. We speculate that the lower incidence of neonatal morbidities and mortality in the MPI group indicating mild intrauterine stress might accelerate fetal maturation resulting in better outcomes in extremely premature infants.
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Affiliation(s)
- Jae Kyoon Hwang
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Korea
| | - Ha-Na Kang
- Department of Pediatrics, Cheongju St. Mary's Hospital, Cheongju, Korea
| | - Ja-Hye Ahn
- Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Korea
| | - Hyun Ju Lee
- Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Korea
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
| | - Hyun-Kyung Park
- Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Korea
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Korea
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea.
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Ahn JH, Lee HJ, Lee K, Lim J, Hwang JK, Kim CR, Kim HA, Kim HS, Park HK. Effects of Lipopolysaccharide on Oligodendrocyte Differentiation at Different Developmental Stages: an In Vitro Study. J Korean Med Sci 2021; 36:e332. [PMID: 34931496 PMCID: PMC8688345 DOI: 10.3346/jkms.2021.36.e332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/25/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Lipopolysaccharide (LPS) exerts cytotoxic effects on brain cells, especially on those belonging to the oligodendrocyte lineage, in preterm infants. The susceptibility of oligodendrocyte lineage cells to LPS-induced inflammation is dependent on the developmental stage. This study aimed to investigate the effect of LPS on oligodendrocyte lineage cells at different developmental stages in a microglial cell and oligodendrocyte co-culture model. METHODS The primary cultures of oligodendrocytes and microglia cells were prepared from the forebrains of 2-day-old Sprague-Dawley rats. The oligodendrocyte progenitor cells (OPCs) co-cultured with microglial cells were treated with 0 (control), 0.01, 0.1, and 1 µg/mL LPS at the D3 stage to determine the dose of LPS that impairs oligodendrocyte differentiation. The co-culture was treated with 0.01 µg/mL LPS, which was the lowest dose that did not impair oligodendrocyte differentiation, at the developmental stages D1 (early LPS group), D3 (late LPS group), or D1 and D3 (double LPS group). On day 7 of differentiation, oligodendrocytes were subjected to neural glial antigen 2 (NG2) and myelin basic protein (MBP) immunostaining to examine the number of OPCs and mature oligodendrocytes, respectively. RESULTS LPS dose-dependently decreased the proportion of mature oligodendrocytes (MBP+ cells) relative to the total number of cells. The number of MBP+ cells in the early LPS group was significantly lower than that in the late LPS group. Compared with those in the control group, the MBP+ cell numbers were significantly lower and the NG2+ cell numbers were significantly higher in the double LPS group, which exhibited impaired oligodendrocyte lineage cell development, on day 7 of differentiation. CONCLUSION Repetitive LPS stimulation during development significantly inhibited brain cell development by impairing oligodendrocyte differentiation. In contrast, brain cell development was not affected in the late LPS group. These findings suggest that inflammation at the early developmental stage of oligodendrocytes increases the susceptibility of the preterm brain to inflammation-induced injury.
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Affiliation(s)
- Ja-Hye Ahn
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun Ju Lee
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Kyeongmi Lee
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Jean Lim
- Kangwon National University College of Veterinary Medicine, Chuncheon, Korea
| | - Jae Kyoon Hwang
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Korea
| | - Hyun A Kim
- Department of Child Psychotherapy, Hanyang University Graduate School of Medicine, Seoul, Korea
| | - Han-Suk Kim
- Department of Pediatrics, Seoul University College of Medicine, Seoul, Korea
| | - Hyun-Kyung Park
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.
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Na JY, Kim D, Kwon AM, Jeon JY, Kim H, Kim CR, Lee HJ, Lee J, Park HK. Artificial intelligence model comparison for risk factor analysis of patent ductus arteriosus in nationwide very low birth weight infants cohort. Sci Rep 2021; 11:22353. [PMID: 34785709 PMCID: PMC8595677 DOI: 10.1038/s41598-021-01640-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/01/2021] [Indexed: 12/14/2022] Open
Abstract
Despite the many comorbidities and high mortality rate in preterm infants with patent ductus arteriosus (PDA), therapeutic strategies vary depending on the clinical setting, and most studies of the related risk factors are based on small sample populations. We aimed to compare the performance of artificial intelligence (AI) analysis with that of conventional analysis to identify risk factors associated with symptomatic PDA (sPDA) in very low birth weight infants. This nationwide cohort study included 8369 very low birth weight (VLBW) infants. The participants were divided into an sPDA group and an asymptomatic PDA or spontaneously close PDA (nPDA) group. The sPDA group was further divided into treated and untreated subgroups. A total of 47 perinatal risk factors were collected and analyzed. Multiple logistic regression was used as a standard analytic tool, and five AI algorithms were used to identify the factors associated with sPDA. Combining a large database of risk factors from nationwide registries and AI techniques achieved higher accuracy and better performance of the PDA prediction tasks, and the ensemble methods showed the best performances.
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Affiliation(s)
- Jae Yoon Na
- Department of Pediatrics, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea
| | - Dongkyun Kim
- Department of Electrical and Electronic Engineering, Hanyang University, 55 Hanyangdaehak-ro, Sangnok-gu, Ansan, 15588, Korea
| | - Amy M Kwon
- Artificial Intelligence Convergence Research Center, Hanyang University ERICA, Ansan, 15588, Korea
| | - Jin Yong Jeon
- Department of Medical and Digital Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea
| | - Hyuck Kim
- Department of Thoracic and Cardiovascular Surgery, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea
| | - Hyun Ju Lee
- Department of Pediatrics, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea
| | - Joohyun Lee
- Department of Electrical and Electronic Engineering, Hanyang University, 55 Hanyangdaehak-ro, Sangnok-gu, Ansan, 15588, Korea.
| | - Hyun-Kyung Park
- Department of Pediatrics, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea.
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Lee KS, Kim K, Choi YJ, Yang S, Kim CR, Moon JH, Kim KR, Lee YS, Oh JW. Increased sensitization rates to tree pollens in allergic children and adolescents and a change in the pollen season in the metropolitan area of Seoul, Korea. Pediatr Allergy Immunol 2021; 32:872-879. [PMID: 33583098 DOI: 10.1111/pai.13472] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Children with allergies are at greater risk of becoming sensitized to allergenic pollens in response to environmental changes. This study investigated the relationship between changes in pollination associated with meteorologic changes and the sensitization rates of children to tree pollen allergens in the metropolitan area of Seoul, Korea. METHODS The study population consisted of 8,295 children who visited the pediatric allergy clinics at Hanyang University Seoul and Guri Hospital for allergy symptoms between January 1, 1998, and December 31, 2019. Pollen was collected at the two hospitals during the study using a Burkard 7-day sampler. Meteorologic data were obtained from the National Weather Service. RESULTS Among the major tree pollens, the largest increase in allergic sensitization was to oak, hazel, and alder pollens (0.28% annually). The pollen-sensitization rates increased annually within younger age groups. The duration of the pollen season was 98 days in 1998 and 140 days in 2019. Positive correlations were determined between the duration of the pollen season and the rates of sensitization to tree pollens, as well as between the pollen-sensitization rates and increasing temperature. CONCLUSIONS This study demonstrated the correlation between weather changes and the resulting changes in the pollen season with sensitization rates to allergenic pollens in children living in the Seoul metropolitan area. An annual increase in sensitization rates in younger children was determined. This pattern is expected to continue due to continuing climate change.
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Affiliation(s)
- Kyung Suk Lee
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
| | - Kyunghoon Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Jin Choi
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
| | - Seung Yang
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
| | - Jin-Hwa Moon
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
| | - Kyu Rang Kim
- Impact-based Forecast Research Team, High Impact Weather Research Department, National Institute of Meteorological Sciences, Seogwipo-si, Jeju, Korea
| | - Yung-Seop Lee
- Department of Statistics, College of Science, Dongguk University, Seoul, Korea
| | - Jae-Won Oh
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
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11
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Hauber ME, Abolins-Abols M, Kim CR, Paitz RT. Inter-Individual Variation in Anti-Parasitic Egg Rejection Behavior: A Test of the Maternal Investment Hypothesis. Integr Org Biol 2021; 2:obaa014. [PMID: 33791557 PMCID: PMC7671127 DOI: 10.1093/iob/obaa014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Hosts of avian brood parasites may reduce or forego the costs of caring for foreign young by rejecting parasitic eggs from the nest. Yet, many host species accept parasitic eggs and, even among rejecter species, some individuals go on to incubate and hatch them. The factors explaining the variation in egg rejection between species have received much theoretical and empirical attention, but the causes of intraspecific variation in different individuals’ propensity for accepting parasitic eggs are less well understood. Here we tested the maternal investment hypothesis, which predicts that hosts with costlier clutches will be more likely to reject parasitic eggs from their nest. We studied variation in the egg rejection responses of American robins (Turdus migratorius), a robust egg-rejecter host of the brood parasitic brown-headed cowbird (Molothrus ater), to 3D-printed cowbird-sized eggs which were painted dark blue, a color known to induce variable and repeatable egg rejection responses in individual robins. Costlier clutch investment was estimated by earlier laying date, larger clutch size, heavier unincubated yolk mass, and variable yolk steroid hormone concentrations. There was no statistical support for most of our predictions. However, we detected more concentrated and greater overall amount of deoxycorticosterone deposited in egg yolks of rejecters relative to acceptors, although this accounted for no more than 14% of variance in the data. Future work should test experimentally the potential physiological linkage between maternal egg yolk steroid investment and egg rejection propensity in this and other host species of avian brood parasites.
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Affiliation(s)
- M E Hauber
- Department of Evolution, Ecology, and Behavior, School of Integrative Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - M Abolins-Abols
- Department of Evolution, Ecology, and Behavior, School of Integrative Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.,Department of Biology, University of Louisville, Louisville, KY 40292, USA
| | - C R Kim
- Department of Evolution, Ecology, and Behavior, School of Integrative Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - R T Paitz
- School of Biological Sciences, Illinois State University, Normal, IL 61790, USA
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12
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Cha T, Choi YJ, Oh JW, Kim CR, Park DW, Seol IJ, Moon JH. Respiratory syncytial virus-associated seizures in Korean children, 2011-2016. Korean J Pediatr 2018; 62:131-137. [PMID: 30360041 PMCID: PMC6477548 DOI: 10.3345/kjp.2018.07066] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 10/22/2018] [Indexed: 12/26/2022]
Abstract
Purpose Respiratory syncytial virus (RSV) infection can cause various neurological complications. This study aimed to investigate the RSV-associated neurologic manifestations that present with seizures. Methods We retrospectively reviewed the medical records of patients aged less than 15 years with laboratory-confirmed RSV infections and seizures between January 2011 and December 2016 in a regional hospital in South Korea. Results During this period, 1,193 patients with laboratory-confirmed RSV infection were identified. Of these, 35 (35 of 1,193, 2.93%; boys, 19; girls, 16; mean age: 20.8±16.6 months) presented with seizure. Febrile seizure was the most common diagnosis (27 of 35, 77.1%); simple febrile seizures in 13 patients (13 of 27, 48.1%) and complex febrile seizures in 14 (14 of 27, 51.9%). Afebrile seizures without meningitis or encephalopathy were observed in 5 patients (5 of 35, 14.3%), seizures with meningitis in 2 (2 of 35, 5.7%), and seizure with encephalopathy in 1 (1 of 35, 2.9%) patient. Lower respiratory symptoms were not observed in 8 patients. In a patient with encephalopathy, brain diffusion-weighted magnetic resonance imaging revealed transient changes in white matter, suggesting cytotoxic edema as the mechanism underlying encephalopathy. Most patients recovered with general management, and progression to epilepsy was noted in only 1 patient. Conclusion Although febrile seizures are the most common type of seizure associated with RSV infection, the proportion of patients with complex febrile seizures was higher than that of those with general febrile seizures. Transient cytotoxic edema may be a pathogenic mechanism in RSV-related encephalopathy with seizures.
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Affiliation(s)
- Teahyen Cha
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Young Jin Choi
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Jae-Won Oh
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Dong Woo Park
- Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - In Joon Seol
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Jin-Hwa Moon
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
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Kang HN, Park HK, Lee HJ, Moon JH, Oh JW, Kim CR. Rotavirus infection as a frequent cause of neonatal fever. Pediatr Int 2018; 60:366-371. [PMID: 29290098 DOI: 10.1111/ped.13504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 12/14/2017] [Accepted: 12/26/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fever rather than diarrhea or vomiting was the most common symptom of neonatal rotavirus (RV) infection in our previous study. We investigated whether RV infection is a major cause of neonatal fever and compared the clinical characteristics of bacterial infection, viral infection and unknown causes of neonatal fever. METHOD We reviewed the electronic medical records of 48 newborns aged ≤28 days who were admitted to the Special Care Nursery of Hanyang University Guri Hospital for fever (≥38°C) from 2005 to 2009. All the newborns underwent complete blood count, urinalysis, C-reactive protein, cultures of blood, urine, and cerebrospinal fluid as well as stool RV enzyme-linked immunosorbent assay. Respiratory virus polymerase chain reaction for cough or rhinorrhea, and stool culture for diarrhea were also done. RESULTS All the babies were term, with mean age 13 ± 8 days and peak body temperature 38.5 ± 0.5°C. The causes of neonatal fever were viral (44%), bacterial (10%) and unknown (46%). The viral infections included RV (n = 12), enterovirus (n = 6), respiratory syncytial virus (n = 2), and rhinovirus (n = 1). All the rotavirus genotypes were G4P[6]. Only three of 12 RV-infected febrile newborns had diarrhea. The bacterial infections included three cases of urinary tract infection (Escherichia coli, n = 2; Klebsiella pneumoniae, n = 1), and two cases of sepsis complicated with meningitis (all Streptococcus agalactiae). CONCLUSIONS RV infection is the most common single cause of neonatal fever. It may be necessary to include stool RV tests for febrile newborns.
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Affiliation(s)
- Ha-Na Kang
- Department of Pediatrics, Hanyang University Hospital, Guri, Korea
| | - Hyun Kyung Park
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun-Ju Lee
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Jin-Hwa Moon
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Jae Won Oh
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
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Abstract
Background The contraceptive injectable is a safe and effective method that is used worldwide. With the variety of injectable delivery systems, there is potential for administration by the woman herself. Self‐administration of the contraceptive injectable is the subject of this systematic review. Objectives To assess how effective and safe the contraceptive injectable method is when women themselves perform/administer it, compared with when the usual healthcare providers administer it. Search strategy We searched PubMed, Popline, Cochrane, CINAHL, and Embase for articles with subject headings or text words related to ‘self‐administration’ and ‘contraception’. Selection criteria Studies that compared the administration of the contraceptive injectable by the woman herself versus administration by the healthcare provider were included. Outcomes of interest were continuation rates, safety, and the women's overall satisfaction with the contraceptive provider and method. Data collection and analysis We undertook data extraction, descriptive analysis, and assessment of risk of bias. Main results Three studies met the inclusion criteria. The best available evidence shows that there may be little or no difference in continuation rates when women self‐administer contraceptive injections (326 per 1000 women; 95% CI 192–554 per 1000 women) compared with administration by healthcare providers (304 per 1000 women). Safety was not estimable as no serious adverse events were reported in any of the studies. With regards to overall satisfaction towards the provider and the method, the effect of the intervention was uncertain. Authors’ conclusions Findings suggest that with appropriate information and training the provision of contraceptive injectables for the woman to self‐administer at home can be an option in some contexts. Tweetable abstract This review assessed the continuation rates and safety of self‐administration of the contraceptive injection. This review assessed the continuation rates and safety of self‐administration of the contraceptive injection.
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Affiliation(s)
- C R Kim
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - M S Fønhus
- Knowledge Centre for the Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - B Ganatra
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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15
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Choi YJ, Shin E, Jo TS, Moon JH, Lee SM, Kim JH, Oh JW, Kim CR, Seol IJ. A new mosaic der(18)t(1;18)(q32.1;q21.3) with developmental delay and facial dysmorphism. Korean J Pediatr 2016; 59:91-5. [PMID: 26958068 PMCID: PMC4781737 DOI: 10.3345/kjp.2016.59.2.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 06/19/2014] [Accepted: 06/25/2014] [Indexed: 11/27/2022]
Abstract
We report the case of a 22-month-old boy with a new mosaic partial unbalanced translocation of 1q and 18q. The patient was referred to our Pediatric Department for developmental delay. He showed mild facial dysmorphism, physical growth retardation, a hearing disability, and had a history of patent ductus arteriosus. White matter abnormality on brain magnetic resonance images was also noted. His initial routine chromosomal analysis revealed a normal 46,XY karyotype. In a microarray-based comparative genomic hybridization (aCGH) analysis, subtle copy number changes in 1q32.1–q44 (copy gain) and 18q21.33–18q23 (copy loss) suggested an unbalanced translocation of t(1;18). Repeated chromosomal analysis revealed a low-level mosaic translocation karyotype of 46,XY,der(18)t(1;18)(q32.1;q21.3)[12]/46,XY[152]. Because his parents had normal karyotypes, his translocation was considered to be de novo. The abnormalities observed in aCGH were confirmed by metaphase fluorescent in situ hybridization. We report this patient as a new karyotype presenting developmental delay, facial dysmorphism, cerebral dysmyelination, and other abnormalities.
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Affiliation(s)
- Young-Jin Choi
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Eunsim Shin
- Genome Research Center, Neodin Medical Institute, Seoul, Korea
| | - Tae Sik Jo
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Jin-Hwa Moon
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Se-Min Lee
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Joo-Hwa Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Jae-Won Oh
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - In Joon Seol
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
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Lim JW, Chung SH, Kang DR, Kim CR. Risk Factors for Cause-specific Mortality of Very-Low-Birth-Weight Infants in the Korean Neonatal Network. J Korean Med Sci 2015; 30 Suppl 1:S35-44. [PMID: 26566356 PMCID: PMC4641062 DOI: 10.3346/jkms.2015.30.s1.s35] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 07/27/2015] [Indexed: 11/20/2022] Open
Abstract
This study attempted to assess the risk factors for mortality of very-low-birth-weight (VLBW) infants in the neonatal intensive care unit (NICU, n=2,386). Using data from the Korean Neonatal Network, we investigated infants with birth weights <1,500 g and gestational ages (GAs) of 22-31 weeks born between January 2013 and June 2014. Cases were defined as death at NICU discharge. Controls were randomly selected from live VLBW infants and frequency matched to case subjects by GA. Relevant variables were compared between the cases (n=236) and controls (n=236) by Cox proportional hazards regression to determine their associations with cause-specific mortality (cardiorespiratory, neurologic, infection, gastrointestinal, and others). In a Cox regression analysis, cardiorespiratory death were associated with a foreign mother (hazard ratio, HR, 4.33; 95% confidence interval, CI, 2.08-9.02), multiple gestation (HR, 1.65; 95% CI, 1.07-2.54), small for gestational age (HR, 2.06; 95% CI, 1.25-3.41), male gender (HR, 1.69; 95% CI, 1.10-2.60), Apgar score ≤3 at 5 min (HR, 1.97; 95% CI, 1.18-3.31), and delivery room resuscitation (HR, 2.60; 95% CI, 1.53-4.40). An Apgar score ≤3 at 5 min was also associated with neurological death (HR, 2.95; 95% CI, 1.29-6.73). Death due to neonatal infection was associated with outborn delivery (HR, 5.09; 95% CI, 1.46-17.74). Antenatal steroid and preterm premature rupture of membranes reduced risk of cardiorespiratory death (HR, 0.43; 95% CI, 0.27-0.67) and gastrointestinal death (HR, 0.30; 95% CI, 0.13-0.70), respectively. In conclusion, foreign mother, multiple gestation, small gestation age, male gender, Apgar score ≤3 at 5 min, and resuscitation in the delivery room are associated with cardiorespiratory mortality of VLBW infants in NICU. An Apgar score ≤3 at 5 min and outborn status are associated with neurological and infection mortality, respectively.
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Affiliation(s)
- Jae Woo Lim
- Department of Pediatrics, College of Medicine, Konyang University, Daejon, Korea
| | - Sung-Hoon Chung
- Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea
| | - Dae Ryong Kang
- Office of Biostatistics, School of Medicine, Ajou University, Suwon, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
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Affiliation(s)
- Chang-Ryul Kim
- Department of Pediatrics, Hanyang University Kuri Hospital, Kyungki, Republic of Korea
| | - Ile-Kyu Park
- Department of Laboratory Medicine, Hanyang University Kuri Hospital, Kyungki, Republic of Korea
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18
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Kim CR, Oh JW, Yum MK, Lee JH, Kang JO. Rotavirus Infection in Neonates at a University Hospital in Korea. Infect Control Hosp Epidemiol 2015; 30:893-5. [DOI: 10.1086/599285] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
To develop measures to prevent neonatal rotavirus infection, we carried out rotavirus surveillance testing on all the newborns who were admitted to a newborn nursery in Korea during 1 year. We investigated the characteristics of neonatal rotavirus infection and found that it occurred throughout the year with the G4P[6] strain exclusively. Most newborns were infected nosocomially and showed no symptoms. We concluded that rotavirus might be transmitted from asymptomatic infected newborns who were born outside the hospital. We recommend isolation and rotavirus surveillance testing for all transfer patients.
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Kim JH, Cho TS, Moon JH, Kim CR, Oh JW. Serial Changes in Serum Eosinophil-associated Mediators between Atopic and Non-atopic Children after Mycoplasma pneumoniae pneumonia. Allergy Asthma Immunol Res 2014; 6:428-33. [PMID: 25229000 PMCID: PMC4161684 DOI: 10.4168/aair.2014.6.5.428] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 11/27/2013] [Accepted: 01/06/2014] [Indexed: 01/22/2023]
Abstract
Purpose Mycoplasma pneumoniae pneumonia (MP) is associated with the exacerbation, timing, and onset of asthma. The goal of this study was to elucidate the impact of MP on eosinophil-related hyper-reactive amplification in atopic children. Methods We studied 48 patients with MP (26 atopic, 22 non-atopic), between 3 and 12 years of age. Serial changes in blood eosinophil counts, serum interleukin-5 (IL-5), and serum eosinophil cationic protein (ECP) levels were measured in atopic and non-atopic children with MP upon admission, recovery, and at 2 months post-recovery. Serum IL-5 and ECP levels were measured by enzyme-linked immunosorbent assays; eosinophil counts were measured using an autoanalyzer. Results Serial changes in serum IL-5, ECP, and total eosinophil counts were significantly higher in atopic patients, relative to non-atopic controls (P≤0.001). Serum IL-5 and ECP levels were significantly higher in atopic patients at all three time points tested, while eosinophil counts were higher in the clinical recovery and follow-up phases, but not in the acute phase. Furthermore, among atopic patients, serum ECP levels were significantly higher in the recovery and follow-up phases than in the acute phase. Conclusions The present study demonstrated significant differences in eosinophil counts, serum IL-5, and serum ECP levels between atopic and non-atopic children with MP at admission, recovery, and 2 months after clinical recovery. These outcomes are suggestive of eosinophil-related hyperreactivity in atopic children, with this status maintained for at least 2 months after MP.
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Affiliation(s)
- Joo-Hwa Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Tae-Shik Cho
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Jin-Hwa Moon
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Jae-Won Oh
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
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Moon JH, Jun DW, Yum MK, Lee KN, Lee HL, Lee OY, Yoon BC, Choi HS, Hahm JS, Seol IJ, Oh JW, Kim CR. Prolonged N200 is the early neurophysiologic change in the patient with minimal hepatic encephalopathy. Scand J Gastroenterol 2014; 49:604-10. [PMID: 24646220 DOI: 10.3109/00365521.2013.878382] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND In neurophysiological studies, P300, is well known for reflecting early cognitive impairment in minimal hepatic encephalopathy (MHE). Although P300 is investigated extensively, other early event-related potential (ERP) parameters have not been studied in MHE. METHODS The subjects were 21 adult cirrhotic patients without clinical encephalopathy and 29 normal controls. For neuropsychological testing, number connection tests, A and B (NCT-A, NCT-B), the line tracing test, the serial dotting test (SDT), and the digit symbol test (DST) were performed. For ERP testing, auditory oddball paradigms were used. The N100, P200, N200, and P300 parameters were measured. RESULTS Cirrhosis had longer neuropsychological performance scores on NCT-A, SDT, and DST than the control group. In neurophysiological test, cirrhotic patients showed longer latencies for N100, P200, N200, and P300 than the control group. Although P300 alteration was not seen in patients without MHE compared to the control group (325.4±43.3 vs. 345.21±35.1, p=0.25), N200 latency was significantly prolonged in cirrhotic patients without MHE compared to the healthy group (242.1±30.3 vs. 259.58±33.3, p=0.006). N200 also showed good correlation with psychometric hepatic encephalopathy score and critical flicker frequency. CONCLUSIONS N200 is a useful tool for assessing early changes of cognitive dysfunction in cirrhosis. It suggests that slower auditory cortical processing is the first sign of cerebral deterioration in patients with hepatic encephalopathy.
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Affiliation(s)
- Jin-Hwa Moon
- Department of Pediatrics, Hanyang University School of Medicine , Seoul , Korea
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Moon JH, Na JY, Kim JH, Yum MK, Oh JW, Kim CR, Seol IJ. Neurological and muscular manifestations associated with influenza B infection in children. Pediatr Neurol 2013; 49:97-101. [PMID: 23859854 DOI: 10.1016/j.pediatrneurol.2013.04.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Revised: 03/15/2013] [Accepted: 04/08/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Influenza viruses have been associated with various neurological and muscular symptoms. The aim of this study was to evaluate the pediatric neurological and muscular manifestations of influenza B during a 5-month epidemic at a single center. METHODS We retrospectively reviewed the medical records of 355 pediatric patients with laboratory-confirmed influenza B infection. RESULTS Neurological and muscular symptoms were exhibited by 28 patients (7.9%). The mean age was 48.7 ± 25.2 months. The mean time between respiratory symptoms and neurological symptoms was 2.2 ± 1.5 days. The most common symptom was seizure (19/28, 67.9%), followed by myositis (5/28, 17.9%), increased intracerebral pressure (1/28, 3.6%), delirium (1/28, 3.6%), and severe headache (1/28, 3.6%). There was one severe case of meningitis with myocarditis (1/28, 3.6%). All seizures were febrile: 15 simple febrile seizures (78.9%), three complex febrile seizures (15.8%), and one febrile status epilepticus (5.3%). The mean age of nine patients with their first seizures was 37.9 ± 22.2 months, which was older than the typical age of onset for febrile seizure. All the patients, except one, were treated with oseltamivir. There were no deaths or chronic debilitating sequelae. CONCLUSIONS The neurological and muscular complications of influenza B infection in children are relatively mild, and febrile seizure is the most common. However, clinicians should be alert to the possibility of rare severe complications during influenza B outbreaks.
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Affiliation(s)
- Jin-Hwa Moon
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.
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Affiliation(s)
- Hae Lin Oh
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Eun Ju Yang
- RN at Hanyang University Guri Hospital, Guri, Korea
| | - Hyun Ju Lee
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun-Kyung Park
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
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Affiliation(s)
| | - Sung Charn Park
- Department of Laboratory Medicine; Hanyang University Guri Hospital; Guri-si Gyeonggi-do Korea
| | | | - Chang-Ryul Kim
- Department of Pediatrics; Hanyang University Guri Hospital; Guri-si Gyeonggi-do Korea
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Affiliation(s)
- Tae Hee Kim
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
| | - Young Jin Choi
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
| | - Hyun-Kyung Park
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
| | - Hyun Ju Lee
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
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25
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Affiliation(s)
- Chang-Ryul Kim
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Korea
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26
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Affiliation(s)
- Chang-Ryul Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Chong-Woo Bae
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Korea
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Kim CR, Sadowska GB, Newton SA, Merino M, Petersson KH, Padbury JF, Stonestreet BS. Na+,K+-ATPase activity and subunit protein expression: ontogeny and effects of exogenous and endogenous steroids on the cerebral cortex and renal cortex of sheep. Reprod Sci 2010; 18:359-73. [PMID: 20959645 DOI: 10.1177/1933719110385137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We examined the effects of development, exogenous, and endogenous glucocorticoids on Na(+),K(+)-ATPase activity and subunit protein expression in ovine cerebral cortices and renal cortices. Ewes at 60%, 80%, and 90% gestation, newborns, and adults received 4 dexamethasone or placebo injections. Cerebral cortex Na(+),K(+)-ATPase activity was higher (P < .05) in placebo-treated newborns than fetuses of placebo-treated ewes and adults, α(1)-expression was higher at 90% gestation than the other ages; α(2)-expression was higher in newborns than fetuses; α(3)-expression was higher in newborns than 60% gestation; β(1)-expression was higher in newborns than the other ages, and β(2)-expression higher at 60% than 80% and 90% gestation, and in adults. Renal cortex Na(+),K(+)-ATPase activity was higher in placebo-treated adults and newborns than fetuses. Cerebral cortex Na(+),K(+)-ATPase activity was higher in dexamethasone- than placebo-treated adults, and α(1)-expression higher in fetuses of dexamethasone- than placebo-treated ewes at 60% and 80% gestation. Renal cortex Na(+),K(+)-ATPase activity and α(1)-expression were higher in fetuses of dexamethasone- than placebo-treated ewes at each gestational age, and β(1)-expression was higher in fetuses of dexamethasone- than placebo-treated ewes at 90% gestation and in dexamethasone- than placebo-treated adults. Cerebral cortex Na(+),K(+)-ATPase activity, α(1)-expression, β(1)-expression, and renal cortex α(1)-expression correlated directly with increases in fetal cortisol. In conclusion, Na(+),K(+)-ATPase activity and subunit expression exhibit specific developmental patterns in brain and kidney; exogenous glucocorticoids regulate activity and subunit expression in brain and kidney at some ages; endogenous increases in fetal cortisol regulate cerebral Na(+),K(+)-ATPase, but exogenous glucocorticoids have a greater effect on renal than cerebral Na(+),K(+)-ATPase.
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Affiliation(s)
- Chang-Ryul Kim
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, The Warren Alpert Medical School of Brown University, Providence, RI 02905,USA
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Yum MK, Kim CR, Park EY, Kim JH, Park KJ. Different etiologies of intrauterine growth restriction and different consistencies in the occurrence of abnormal local nonstationarity of fetal heart rate. Clin Exp Hypertens 2006; 28:147-56. [PMID: 16546840 DOI: 10.1080/10641960500468391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Fetuses with intrauterine growth restriction (IUGR) can be programmed in utero to develop hypertension in adult life. The etiology of IUGR in human fetuses is not uniform. The present study demonstrated that different etiologies of growth restriction, idiopathic cause, and pregnancy-induced hypertension, produce different consistencies in the occurrence of an abnormal local very-short-term nonstationarity of heart rate during intrauterine period. Whether the consistent abnormality that was found in the growth-restricted fetuses associated with pregnancy-induced hypertension is linked to the different risk of later hypertension requires future studies.
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Affiliation(s)
- Myung-Kul Yum
- Department of Pediatrics, Hanyang University School of Medicine, Seoul, Korea.
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Kim CR, Sadowska GB, Petersson KH, Merino M, Sysyn GD, Padbury JF, Stonestreet BS. Effects of postnatal steroids on Na+/K+-ATPase activity and alpha1- and beta1-subunit protein expression in the cerebral cortex and renal cortex of newborn lambs. Reprod Fertil Dev 2006; 18:413-23. [PMID: 16737634 DOI: 10.1071/rd05114] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2005] [Accepted: 01/02/2006] [Indexed: 11/23/2022] Open
Abstract
Na(+)/K(+)-ATPase is a membrane-bound enzyme responsible for Na(+)/K(+) translocation across cell membranes. It is essential for the generation of electrochemical gradients, which control the ionic environment necessary for electrical activity and water and electrolyte balance. Newborn infants who are at risk of developing bronchopulmonary dysplasia (BPD) are frequently treated with corticosteroids. Although these infants are at risk for neurological, water and electrolyte abnormalities, there is little information regarding the effects of clinically relevant doses of corticosteroids on Na(+)/K(+)-ATPase activity and protein isoform expression in the brain and kidney of newborns. In the present study, we examined the effects of dexamethasone on cerebral cortical and renal cortical Na(+)/K(+)-ATPase activity and alpha1- and beta1-protein isoform expression in newborn lambs. Lambs were given four injections of a placebo (n = 11) or one of three different doses of dexamethasone (0.01 mg kg(-1), n = 9; 0.25 mg kg(-1), n = 11; or 0.50 mg kg(-1), n = 9) 12 h apart on Postnatal Days 3 and 4 up to 18 h before harvest of the cerebral cortex and renal cortex. We selected doses in a range to approximate those used to treat infants with BPD. Na(+)/K(+)-ATPase activity was measured in membrane preparations as ouabain-sensitive inorganic phosphate liberation from ATP and alpha1- and beta1-subunit abundance by Western immunoblot. Postnatal treatment of lambs with dexamethasone resulted in a 21.4% increase in Na(+)/K(+)-ATPase activity and a 30.4% increase in catalytic alpha1-protein expression in the cerebral cortex at a dose of 0.50 mg kg(-1) dexamethasone, but not at the lower doses. Dexamethasone treatment was not associated with changes in beta1-isoform expression in the cerebral cortex. In the kidney, dexamethasone treatment was not associated with significant changes in Na(+)/K(+)-ATPase activity or alpha1- or beta1-isoform expression for the doses we examined. Therefore, clinically relevant corticosteroid treatment exerts dose-related, differential organ-specific effects on Na(+)/K(+)-ATPase activity and protein isoform expression in newborn lambs.
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Affiliation(s)
- Chang-Ryul Kim
- Pediatrics, Women & Infants' Hospital of Rhode Island and Brown Medical School, Providence, RI 02905-2499, USA
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Yum MK, Kim CR, Park EY, Kim JH. Instability and frequency-domain variability of heart rates in fetuses with or without growth restriction affected by severe preeclampsia. Physiol Meas 2004; 25:1105-13. [PMID: 15535177 DOI: 10.1088/0967-3334/25/5/002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study investigated how the instability and frequency-domain variability in heart rates differ between fetuses affected only by severe preeclampsia and fetuses affected by both severe preeclampsia and growth restriction. From their antepartum fetal heart rates and those of control fetuses, the very short-term intermittency (C1alpha) and the spectral powers were calculated to evaluate the instability and frequency-domain variability, respectively. The fetuses affected only by severe preeclampsia showed abnormally high C1alpha and low- and high-frequency power. The fetuses affected by severe preeclampsia and growth restriction showed even higher C1alpha than that of the fetuses affected by severe preeclampsia and abnormally reduced low-frequency power. Conclusively, when compared to the heart rates of fetuses affected only by severe preeclampsia, the heart rates of fetuses affected by severe preeclampsia and growth restriction showed a greater abnormal instability and an abnormally reduced variability at low-frequency range.
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Affiliation(s)
- Myung-Kul Yum
- Department of Pediatrics, College of Medicine, Hanyang University, Sungdong-Ku, Seoul 133-792, Korea
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Lee IH, Lee YS, Kim CH, Kim CR, Hong T, Menzel L, Boo LM, Pohl J, Sherman MA, Waring A, Lehrer RI. Dicynthaurin: an antimicrobial peptide from hemocytes of the solitary tunicate, Halocynthia aurantium. Biochim Biophys Acta 2001; 1527:141-8. [PMID: 11479030 DOI: 10.1016/s0304-4165(01)00156-8] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We isolated a novel antimicrobial peptide, dicynthaurin, from hemocytes of a tunicate, Halocynthia aurantium. The native peptide had a mass of approximately 6.2 kDa and was composed of two 30-residue monomers without sequence homology to any previously identified peptides (ILQKAVLDCLKAAGSSLSKAAITAIYNKIT). Most cynthaurin molecules were C-terminally amidated and were linked covalently by a single cystine disulfide bond. When performed in membrane-mimetic environments, circular dichroism studies of dicynthaurin revealed largely alpha-helical conformations. Dicynthaurin's broad-spectrum activity encompassed Gram-positive (Micrococcus luteus, Staphylococcus aureus, Listeria monocytogenes) and Gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa), but not Candida albicans, a fungus. Although dicynthaurin was purified from a marine invertebrate, its antimicrobial activity was optimal at NaCl concentrations below 100 mM. This suggests that the antimicrobial actions of this molecule may take place intracellularly (e.g., within a phagosome) rather than extracellularly.
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Affiliation(s)
- I H Lee
- Department of Life Science, Hoseo University, Asan City, Chungnam-Do, South Korea.
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Abstract
OBJECTIVES To determine whether irregularity, and short- and long-term fractal correlation reflecting smoothness of heart rate behavior are changed in intrauterine growth restricted fetuses. STUDY DESIGN Fetal heart rate data of 192 normal fetuses and 86 intrauterine growth restricted fetuses between 31 and 42 weeks of gestation were studied. Approximate entropy to quantify irregularity, and short-term (< or =80 beats, alpha1) and long-term (>80 beats, alpha2) fractal scaling exponents to quantify the short- and long-term fractal correlation were calculated. RESULTS In the intrauterine growth restricted fetuses, the approximate entropy was significantly lower (P<0.001). The alpha2 value was significantly higher (P=0.0001) than in the normal fetuses, which performed better (F=34.2, P<0.0001) than other heart rate variability indexes in differentiating the intrauterine growth restricted fetuses from the normal fetuses in stepwise discriminant analysis. CONCLUSIONS Compared to normal fetuses, intrauterine growth restricted fetuses show a difference in that the irregularity of the fetal heart is decreased. A more apparent difference is that the long-term fractal correlation of the fetal heart is increased and the fetal heart is smoother in the long-term scale.
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Affiliation(s)
- M K Yum
- Department of Pediatric Cardiology, Hanyang University School of Medicine, 17 Haengdang-dong Sungdong-ku, 133-792, Seoul, South Korea.
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Abstract
In order to evaluate the results of pars plana vitrectomy (PPV) for the treatment of posteriorly dislocated intraocular lens (PC-IOL), we retrospectively examined and analyzed the hospital records of patients who had undergone PPV to exchange or reposition a PC-IOL dislocated into the vitreous cavity. Of 20 eyes in 20 patients, IOL exchange was performed in 6 eyes, and IOL repositioning in 14 eyes. Posteriorly dislocated IOL occurred in 14 eyes during or within 2 days, and in 6 eyes 6 months after the IOL implantation. Thirteen eyes were surgically treated early after the occurrence, within 3 days, while 7 eyes were treated later, between 5 to 7 days. Compared with preoperative best-corrected visual acuity, the final visual acuity improved more than 2 lines in 12 eyes. With no significant difference on the statistics, earlier visual rehabilitation seemed to be shown in late-treated patients than in early-treated. Accordingly, a posterior dislocation of IOL can be successfully treated with PPV, and barring any serious complications such as retinal detachment, there is no need for surgery immediately following the occurrence.
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Affiliation(s)
- M S Seo
- Department of Ophthalmology, Chonnam National University Medical School & Hospital, Chonnam National University Research Institute of Medical Sciences, Tong-ku, Kwangju 501-757, Korea
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Kim CR, Lee YH, Bang IS, Kim ES, Kang CS, Yun CY, Lee IH. cDNA cloning and antibacterial activities of cecropin D-like peptides from Agrius convolvuli. Arch Insect Biochem Physiol 2000; 45:149-155. [PMID: 11223934 DOI: 10.1002/1520-6327(200012)45:4<149::aid-arch2>3.0.co;2-h] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We have characterized full-length cDNAs encoding two isoforms of agriusin, cecropin D-like antibacterial peptide, present in the hemolymph of the immunized Agrius convolvuli larvae. The cloned cDNAs of agriusins 1 and 2 contain 331 and 329 bp, respectively. The nucleotide sequencing of cDNAs showed that they encode 62 amino acids, whose mature portion was deduced to consist of 38 amino acid residues with over 94% sequence identity. In the sequence homology search, mature agriusin 1 showed over 86 and 71% amino acid sequence homology with bactericidin 4 from Manduca sexta and cecropin D from Hyalophora cecropia, respectively. Since it was demonstrated from the deduced amino acid sequences that the C-terminal residues of agriusins are followed by a Gly residue, two types of synthetic agriusin 1 (syn-agriusin 1 amide and acid) were prepared to verify if natural agriusin 1 is C-terminally amidated. From acid-urea PAGE and reversed phase HPLC profiles to compare two synthetic peptides, we could confirm that the C-terminal amino acid residue of natural agriusin 1, like several cecropins so far identified, is amidated. Finally, our antibacterial assay performed with two syn-agriusins 1 revealed that there is little difference between antibacterial activities of both peptides against Gram-positive and Gram-negative bacteria.
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Affiliation(s)
- C R Kim
- Department of Life Science, Hoseo University, Asan City, Choongnam-Do, South Korea
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Oh JW, Lee HB, Yum MK, Kim CR, Kang JO, Park IK. ECP level in nasopharyngeal secretions and serum from children with respiratory virus infections and asthmatic children. Allergy Asthma Proc 2000; 21:97-100. [PMID: 10791110 DOI: 10.2500/108854100778250888] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Infection with respiratory virus has been shown to exacerbate asthma in humans. However, the role of a respiratory virus in the pathogenesis of chronic asthma and/or wheezing in young children has not been clearly defined. It has also been debated whether virus-induced wheezing in young children is one entity and allergic asthma another, or whether they are different expressions of the same disease. The present study was done to compare ECP concentrations in nasopharyngeal secretions and serum from 32 nonasthmatic wheezing children with viral infections (RSV in 15 children; influenza B virus in 17 children detected by immunofluorescence antibody technique), 8 asthmatic children without viral infections, and 13 normal children as the controls to understand the role of eosinophil inflammation. The geometric mean of ECP in nasopharyngeal secretions was significantly higher in asthmatic children than in children with virus-induced wheezing (p < 0.05). ECP levels of nasopharyngeal secretions from children with the virus-induced wheezing were significantly greater than those of the controls. However, there were no significant differences in ECP levels in serum among subjects.
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Affiliation(s)
- J W Oh
- Department of Pediatrics, Hanyang University, College of Medicine, Seoul, Korea
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Abstract
PURPOSE To evaluate (a) the displacement of the vaginal apex by a rod during radiation therapy simulation for gynecologic malignancy and (b) apical localization with implanted radiopaque markers. MATERIALS AND METHODS Metallic markers were implanted in the cervix or vaginal cuff in nine patients with cervical or endometrial carcinoma who underwent irradiation. In all but one patient, radiographs were obtained with and then without the vaginal rod. Displacement of the markers relative to bone landmarks was measured. The total displacement was the square root of the sum of the squares of displacement in each axial direction. RESULTS All patients showed displacement of the cervical markers by the vaginal rod (mean total displacement, 1.9 cm; range, 0.6-3.6 cm). The greatest displacement was cephalic (mean, 1.5 cm; range, 0.5-2.4 cm). Anteroposterior displacement occurred in all patients but was not as predictable as cephalic displacement. Displacement was anterior in five of the eight patients, posterior in three patients, and lateral in four patients. CONCLUSION Displacement of the vaginal apex and/or cervix with placement of the vaginal rod during simulation was marked in all patients. Use of implanted cervical markers to localize the vaginal apex or the cervix during simulation is more accurate than use of a vaginal rod.
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Affiliation(s)
- C R Kim
- Department of Radiation Oncology, St John Medical Center, Longview, WA 98632, USA
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Oh JW, Lee HB, Kim CR, Yum MK, Koh YJ, Moon SJ, Kang JO, Park IK. Analysis of induced sputum to examine the effects of inhaled corticosteroid on airway inflammation in children with asthma. Ann Allergy Asthma Immunol 1999; 82:491-6. [PMID: 10353582 DOI: 10.1016/s1081-1206(10)62727-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Analysis of induced sputum can be performed safely in children with asthma and is useful for both cellular and biochemical markers of inflammation. Glucocorticosteroid inhalation has become the first line therapy for chronic asthma by suppressing airway inflammation, which produces the decrease of bronchial hyperreactivity and reduces the number of eosinophil in bronchial submucosa. OBJECTIVE To determine the characteristics of the inflammatory cells and their markers in sputum and to examine the pharmacokinetic effects of glucocorticoid within 3 hours after inhalation therapy on FEV1 and sputum inflammatory indices in children with clinically defined chronic asthma. METHODS Thirty subjects with asthma included 14 current symptomatic asthmatics and 14 normal controls inhaled 4.5% hypertonic saline for 10 minutes by nebulizer. The expectorated sputum were collected from all asthmatics before and 3 hours after corticosteroid inhalation for children with asthma and were reduced by dithiotreitol. Total cell counts and differentials were determined. ECP was measured by CAP system. Interleukin-5, GM-CSF and albumin were measured by double sandwich ELISA. RESULTS The mean eosinophil percentage and ECP in induced sputum of asthmatics were significantly higher than that of controls. The induced sputum samples obtained after glucocorticoid inhalation showed a significant reduction in mean eosinophil percentage, but FEV1, IL-5, GM-CSF, albumin, and ECP values were not significantly decreased. CONCLUSION The present results in induced sputum may be interpreted to reflect direct steroid action on airways and lack of effect on bone marrow effectors at 3 hours after glucocorticoid inhalation.
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Affiliation(s)
- J W Oh
- Department of Pediatrics, Hanyang University, College of Medicine, Seoul, Korea
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Yum MK, Kim NS, Oh JW, Kim CR, Lee JW, Kim SK, Noh CI, Choi JY, Yun YS. Non-linear cardiac dynamics and morning dip: an unsound circadian rhythm. Clin Physiol 1999; 19:56-67. [PMID: 10068867 DOI: 10.1046/j.1365-2281.1999.00146.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The frequency of sudden cardiac death increases in the morning. The relationship between decreased complexity of heart rate dynamics and sudden cardiac death has been documented. An understanding of circadian variation in the complexity of cardiac dynamics may be important to predict and prevent sudden cardiac death. Dynamic 24-h electrocardiographic recordings were obtained from 30 healthy ambulant subjects aged 41-50 years, and the digitized data were partitioned into sections of 30 min duration. For each section, four indexes obtained from separate algorithms of non-linear dynamics of the RR interval--modified correlation dimension, Lyapunov exponent, approximate entropy, and fractal dimension--were calculated. Normalized low-(0.04-0.15 hertz) and high-frequency (> 0.15 hertz) components were also calculated. All four indexes of non-linear dynamics showed a remarkably similar circadian rhythm: a prominent morning dip preceded by a steep decline during the late night, a recovery during the evening and a peak around midnight. In the morning, the low-frequency component rose rapidly with concomitant reduction in the high-frequency component. The complexity of cardiac dynamics decreases significantly in the morning, and this may contribute to the ominously increased rate of cardiac death in the morning hours.
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Affiliation(s)
- M K Yum
- Department of Pediatrics, Hanyang University School of Medicine, Seoul, Korea
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Combadière B, Reis e Sousa C, Trageser C, Zheng LX, Kim CR, Lenardo MJ. Differential TCR signaling regulates apoptosis and immunopathology during antigen responses in vivo. Immunity 1998; 9:305-13. [PMID: 9768750 DOI: 10.1016/s1074-7613(00)80613-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Clonal selection theories postulate that lymphocyte fate is regulated by antigen receptor specificity. However, lymphocyte apoptosis is induced through nonantigen-specific receptors such as Fas (CD95/APO-1) or TNFR. We define a selective TCR that controls apoptosis by Fas or TNFR stimulation. Variant ligands can deliver this "competence to die" signal without the full TCR signals necessary for cytokine synthesis. These partial agonists regulate T cell deletion in vivo even when Fas or TNF is provided by T cells of unrelated specificity, but they do not cause the liver necrosis that is associated with T cell elimination by the full agonist. Thus, selective signaling ligands regulate T cell deletion and immune damage in vivo and may be important for peripheral T cell tolerance.
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Affiliation(s)
- B Combadière
- Molecular Development of the Immune System Section, Laboratory of Immunology National Institute of Allergy and Infectious Diseases, National Institutes of Health Bethesda, Maryland 20892-1892, USA
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Yum MK, Kim NS, Oh JW, Kim CR, Lee JU, Kim SK, Lee CB, Noh CI, Choi JY, Yun YS. Nonlinear Cardiac Dynamics and Morning Dip: An Unsound Circadian Rhythm. Korean Circ J 1998. [DOI: 10.4070/kcj.1998.28.3.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Abstract
Respiratory syncytial virus (RSV) has been recognized as a major nosocomial hazard on pediatric wards, but symptomatic RSV infection is uncommon during the first four weeks of life. We report here four cases of neonatal RSV infection in a special-care newborn nursery and two of them probably acquired the infection nosocomially. By rapid diagnosis using immunofluorescent technique and early implementation of infection control measures, we were able to prevent further spread of RSV infection.
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Affiliation(s)
- J O Kang
- Department of Clinical Pathology, Hanyang University Kuri Hospital, Kyomun-dong, Kyungki-do, Korea
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Abstract
We tested the hypothesis that, in newborn piglets, magnesium results in a dose-dependent prostanoid-mediated cerebrovasodilation. Pial arterioles (50-200 microns in diameter) were serially measured, and cortical subarachnoid cerebrospinal fluid (CSF) was collected for radioimmunoassay of 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha, hydrolysis product of prostacyclin) and thromboxane B2 (TxB2, metabolite of thromboxane A2) before and after CSF containing 1.2, 2.4, 4.8, and 9.6 mM MgCl2 was suffused over the parietal cortex under a closed cranial window in twelve 2- to 4-day-old piglets. Magnesium suffusion resulted (P < 0.05) in a dose-dependent pial arteriolar vasodilation. The increase in vessel diameter was greater (P < 0.001) with 2.4, 4.8, and 9.6 mM than with 1.2 mM concentration of magnesium. The increase in vessel diameter with 9.6 mM was also greater (P < 0.001) than with the 2.4 mM concentration of magnesium. Magnesium suffusion did not result in changes in cortical CSF prostanoid concentrations. The effect of intravenous indomethacin (5 mg/kg) on cyclooxygenase inhibition in the pial arterioles was confirmed by a 24 +/- 3% decrease in vessel diameter at the baseline (1.2 mM) magnesium concentration. In contrast, cyclooxygenase inhibition with intravenous indomethacin did not attenuate the magnesium-induced cerebrovasodilation. We conclude that in new born piglets magnesium suffusion over the parietal cortex results in a dose-dependent cerebrovasodilation that is most likely not mediated by prostanoids.
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Affiliation(s)
- C R Kim
- Department of Pediatrics, Brown University School of Medicine, Women and Infants' Hospital, Providence, Rhode Island 02905, USA
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Abstract
OBJECTIVE To determine the effects of mild vs severe maternal hypertension on the neonatal morbidity of very-low-birth-weight infants. DESIGN Cohort case-control study. SETTING Tertiary care center neonatal intensive care unit. PATIENTS Thirty-nine infants born to mothers with maternal hypertension (blood pressure > or = 140/90 mm Hg on 2 occasions during pregnancy) among 267 very-low-birth-weight infants (< or = 1250 g) admitted to the special care nursery between January 1, 1991, and December 31, 1992. Each infant was matched for gestational age and survival to 2 control infants born to normotensive mothers. The cohort included 11 infants of mothers with mild hypertension, 28 with severe hypertension, and 78 controls. MAIN OUTCOME MEASURES Late and variable decelerations, incidence of small size for gestational age, respiratory distress syndrome, intraventricular hemorrhage, patent ductus arteriosus, apnea, ventilator therapy, oxygen requirement, and bronchopulmonary dysplasia. RESULTS The mild and severe maternal hypertension groups had significantly lower birth weights and more infants small for gestational age than did controls. The incidence of respiratory distress syndrome, however, was significantly lower in infants of mothers with mild hypertension than in those with mothers with severe hypertension. Those in the mild group had fever days of ventilatory therapy and lower oxygen requirements than both the infants in the severe group and control infants. The incidence of apnea in the mild hypertension group was significantly lower than that in the severe hypertension group. CONCLUSIONS Although mothers with both mild and severe hypertension have an increased incidence of infants small for gestational age, the infants born to mothers with mild hypertension had less respiratory distress syndrome, apnea, ventilator therapy, oxygen requirements, and bronchopulmonary dysplasia when compared with very-low-birth-weight infants born to mothers with severe hypertension.
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Affiliation(s)
- C R Kim
- Hanyang University School of Medicine, Seoul, Korea
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Abstract
OBJECTIVE Because stress in utero may enhance neuromotor maturation, we hypothesized that infants born to mothers with preeclampsia would have a shorter absolute latency V and interpeak latency I-V period (brain-stem conduction time) of brain-stem auditory evoked response (BAER) than infants born to normotensive mothers. STUDY DESIGN A retrospective cohort study was performed to assess the effects of maternal preeclampsia on BAER of very low birth weight infants. The cohort consisted of 24 infants with a birth weight less than 1251 gm born to mothers with preeclampsia, and 48 infants born to normotensive mothers, matched for birth date within 2 months, gestational age, and chronologic age at the time of the BAER test. The BAER test was completed before discharge, with the infant in a quiet state and the use of a 30 dB stimulus. RESULTS The mean latencies of wave V were shortened bilaterally (left 8.60 +/- 0.6 msec vs 9.02 +/- 0.6 msec, p < 0.008; right 8.61 +/- 0.6 msec vs 8.96 +/- 0.6 msec, p < 0.033, and the interpeak latency of I-V was significantly shortened compared with the control subjects on the left (left 4.91 +/- 0.5 msec vs 5.38 +/- 0.6 msec, p < 0.003; right 5.17 +/- 0.5 msec vs 5.37 +/- 0.6 msec, not significant). CONCLUSION These results suggest that the intrauterine stress of maternal preeclampsia accelerates the maturation of the auditory nerve and brain-stem auditory pathway in very low birth weight infants.
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Affiliation(s)
- C R Kim
- Hanyang University School of Medicine, Seoul Korea
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Abstract
Catfish fillets were treated with combinations of lactic culture ( Lactococcus lactis spp. cremoris ATCC 19257) and lactic acid using a meat tumbler. Fillets were placed individually in Ziploc bags and stored at 4 or 10°C. Counts of gram-negative bacteria on crystal violet tetrazolium chloride agar (CVT), the pH, and the sensory quality of fillets were evaluated after 0, 3, 6, and 9 days of storage time. The combination of 2.5% lactic culture and either 2% lactic acid dip (5 min) or 3% lactic acid dip (1 or 5 min) effectively (P < 0.05) inhibited counts for 9 days. The most effective treatment combination was 2.5% lactic culture incubated for 48 h and 3% lactic acid dip. The pH of samples treated with lactic culture and lactic acid ranged from 5.6 to 6.1 for 9 days at 4 or 10°C Lactic culture and lactic acid combinations extended the refrigerated shelf life of catfish for an additional 3 days at 4 and 10°C and reduced CVT counts by two log cycles over untreated fish. The combination of lactic culture and lactic acid were generally preferred for flavor and odor compared to controls after 6 and 9 days of storage, respectively.
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Affiliation(s)
- C R Kim
- Department of Food Science and Technology, Mississippi State University, Box 9805, Mississippi State, Mississippi 39762
| | - J O Hearnsberger
- Department of Food Science and Technology, Mississippi State University, Box 9805, Mississippi State, Mississippi 39762
| | - J B Eun
- Department of Food Science and Technology, Chonnam National University, 300 Yongbong-dong Buk-ku, Kwangju, 500-757, Korea
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46
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Kim DH, Mkparu F, Kim CR, Caroll RF. Alteration of Ca2+ release channel function in sarcoplasmic reticulum of pressure-overload-induced hypertrophic rat heart. J Mol Cell Cardiol 1994; 26:1505-12. [PMID: 7897673 DOI: 10.1006/jmcc.1994.1169] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The effects of pressure-overload left ventricular hypertrophy on the Ca2+ release channel in sarcoplasmic reticulum (SR) were studied by [3H]ryanodine binding and 45Ca2+ flux measurements. The density of Ca2+ release channel in left ventricle determined by equilibrium [3H]ryanodine binding to whole homogenates was significantly lower in hypertrophy than sham (Bmax: 0.47 +/- 0.04 v 0.72 +/- 0.10 pmol/mg protein), whereas total number of Ca2+ release channels in whole left ventricle was similar in the two groups. Ryanodine binding to SR vesicles isolated by differential centrifugation was also similar in the two groups, but the SR yield was less in the hypertrophied left ventricle. The Ca2+ release channels in hypertrophied left ventricles showed a significantly increased sensitivity to Ca2+ release agonists (e.g. caffeine and doxorubicin), as characterized by the effects of these agonists on ryanodine binding to whole homogenates and Ca2+ release from isolated SR. These results indicate that pressure-overload left ventricular hypertrophy is associated with both qualitative and quantitative changes in Ca2+ release channel function.
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Affiliation(s)
- D H Kim
- Department of Medicine, University of Connecticut Health Center, Farmington 06030-1305
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47
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Abstract
A patient with recurrent sigmoid colon cancer developed an arterial-vaginal fistula after multiple surgeries and postoperative radiotherapy. Angiography revealed a fistula between the hypogastric artery and vaginal wall. Gelfoam and coil embolization controlled the hemorrhage and she recovered without incident. This case illustrates development of malignant fistula and intervention with embolization in a patient with multiple surgeries and postoperative irradiation in the pelvis.
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Affiliation(s)
- C R Kim
- Eastern Virginia Medical School, Norfolk
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48
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Long J, Gillilan R, Lee SG, Kim CR, Plantholt S. White-coat hypertension: detection and evaluation. Md Med J 1990; 39:555-9. [PMID: 2359353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- J Long
- Department of Medicine, St. Agnes Hospital, Baltimore
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49
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50
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Abstract
A case of ovarian endodermal sinus tumor (EST) with exclusive intestinal differentiation in a 28-year-old black woman is reported. The tumor cells form irregular glands with focal early Paneth cell differentiation resembling intestinal Luberkuhn's crypts. Clinical and pathological features as well as immunohistochemical findings are described.
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Affiliation(s)
- C R Kim
- Department of Pathology, Eastern Virginia Medical School
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