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Cho SJ, Jeong BY, Yoon SH, Park CG, Lee HY. Rab25 suppresses colon cancer cell invasion through upregulating claudin‑7 expression. Oncol Rep 2024; 51:26. [PMID: 38131227 PMCID: PMC10777460 DOI: 10.3892/or.2023.8685] [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] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/03/2023] [Indexed: 12/23/2023] Open
Abstract
Ras‑related protein 25 (Rab25) is a member of small GTPase and is implicated in cancer cell progression of various types of cancer. Growing evidence suggests the context‑dependent role of Rab25 in cancer invasiveness. Claudin‑7 is a tight junction protein and has been known to suppress cancer cell invasion. Although Rab25 was reported to repress cancer aggressiveness through recycling β1 integrin to the plasma membrane, the detailed underlying mechanism remains to be elucidated. The present study identified the critical role of claudin‑7 in Rab25‑induced suppression of colon cancer invasion. 3D Matrigel system and modified Boyden chamber analysis showed that enforced expression of Rab25 attenuated colon cancer cell invasion. In addition, Rab25 inactivated epidermal growth factor receptor (EGFR) and increased E‑cadherin expression. Unexpectedly, it was observed that Rab25 induces claudin‑7 expression through protein stabilization. In addition, ectopic claudin‑7 expression reduced EGFR activity and Snail expression as well as colon cancer cell invasion. However, silencing of claudin‑7 expression reversed the tumor suppressive role of Rab25, thereby increasing colon cancer cell invasiveness. Collectively, the present data indicated that Rab25 inactivates EGFR and colon cancer cell invasion by upregulating claudin‑7 expression.
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Affiliation(s)
- Su Jin Cho
- Department of Pharmacology, College of Medicine, Konyang University, Daejeon 35365, Republic of Korea
| | - Bo Young Jeong
- Department of Cell, Developmental and Cancer Biology, School of Medicine, Oregon Health Science University, Portland, OR 97201, USA
| | - Se-Hee Yoon
- Division of Nephrology and Department of Internal Medicine, College of Medicine, Konyang University, Daejeon 35364, Republic of Korea
| | - Chang Gyo Park
- Department of Pharmacology, College of Medicine, Konyang University, Daejeon 35365, Republic of Korea
| | - Hoi Young Lee
- Department of Pharmacology, College of Medicine, Konyang University, Daejeon 35365, Republic of Korea
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2
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Youn YA, Kim SY, Cho SJ, Chang YS, Miyake F, Kusuda S, Iskandar ATP, Rohsiswatmo R, Dewi R, Chee SC, Neoh SH, Imperial MLS, Velasco BAE, Quek BH, Lin YJ, Chang JH, Nuntnarumit P, Ngerncham S, Supapannachart S, Ozawa Y, Tomotaki S, Prempunpong C, Prempraphan P, Isayama T. Variations in medical practice of retinopathy of prematurity among 8 Asian countries from an international survey. Sci Rep 2023; 13:15602. [PMID: 37730731 PMCID: PMC10511409 DOI: 10.1038/s41598-023-42432-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/10/2023] [Indexed: 09/22/2023] Open
Abstract
Advances in perinatal care have led to the increased survival of preterm infants with subsequent neonatal morbidities, such as retinopathy of prematurity (ROP). This study aims to compare the differences of neonatal healthcare systems, resources, and clinical practice concerning ROP in Asia with review of current literature. An on-line survey at the institutional level was sent to the directors of 336 neonatal intensive care units (NICU) in 8 collaborating national neonatal networks through the Asian Neonatal Network Collaboration (AsianNeo). ROP screening was performed in infants born at < 34 weeks in Indonesia and Japan. In South Korea, Malaysia, and Taiwan, most screened for ROP in infants born at < 32 weeks. In all networks, majority of NICUs conducted ROP screening to infants with birth weight < 1500 g. In most NICU's in-hospital ophthalmologists performed indirect ophthalmoscopy and some were supplemented with digital imaging. Both laser photocoagulation and anti-vascular endothelial growth factor injection are performed for treatment and, vitreous surgeries are conducted less frequently in all countries. Despite limited information collected by the survey, this first study to compare ROP practices implemented in eight Asian countries through AsianNeo will enable an understanding of the differences and facilitate quality improvement by sharing better practices.
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Affiliation(s)
- Young-Ah Youn
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sae Yun Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University College of Medicine, 1071 AnYang Cheon-ro, YangCheon-gu, Seoul, 07985, Republic of Korea.
| | - Yun Sil Chang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
| | - Fuyu Miyake
- Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan
| | - Satoshi Kusuda
- Department of Pediatrics, Neonatal Research Network of Japan, Kyorin University, Tokyo, Japan
| | - Adhi Teguh Perma Iskandar
- Department of Child Health, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Rinawati Rohsiswatmo
- Department of Child Health, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Rizalya Dewi
- Budhi Mulia Mother and Child Hospital, Pekanbaru, Indonesia
| | - Seok Chiong Chee
- Department of Pediatrics, Selayang Hospital, Ministry of Health, Batu Caves, Kuala Lumpur, Malaysia
| | - Siew Hong Neoh
- Department of Paediatrics, Hospital Tunku Azizah, Ministry of Health, Kuala Lumpur, Malaysia
| | | | | | - Bin Huey Quek
- Department of Neonatology, KK Women's and Children's Hospital, Singapore City, Singapore
| | - Yuh-Jyh Lin
- Department of Pediatrics, National Cheng-Kung University Hospital, Tainan, Taiwan
| | - Jui-Hsing Chang
- Department of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan
| | - Pracha Nuntnarumit
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sopapan Ngerncham
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sarayut Supapannachart
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Yuri Ozawa
- Division of Neonatology, National Center for Child Health and Development, Department of Pediatrics, Kyorin University, Tokyo, Japan
| | - Seiichi Tomotaki
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Chatchay Prempunpong
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pathaporn Prempraphan
- Department of Pediatrics, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Tetsuya Isayama
- Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan
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3
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Jeong BY, Cho KH, Jeong KJ, Cho SJ, Won M, Kim SH, Cho NH, Hur GM, Yoon SH, Park HW, Mills GB, Lee HY. Lysophosphatidic acid-induced amphiregulin secretion by cancer-associated fibroblasts augments cancer cell invasion. Cancer Lett 2022; 551:215946. [PMID: 36209972 DOI: 10.1016/j.canlet.2022.215946] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/29/2022] [Accepted: 10/03/2022] [Indexed: 11/02/2022]
Abstract
Cancer-associated fibroblasts (CAFs) are key structural components of the tumor microenvironment and are closely associated with tumor invasion and metastasis. Lysophosphatidic acid (LPA) is a biolipid produced extracellularly and involved in tumorigenesis and metastasis. LPA has recently been implicated in the education and transdifferentiation of normal fibroblasts (NFs) into CAFs. However, little is known about the effects of LPA on CAFs and their participation in cancer cell invasion. In the present study, we identified a critical role of LPA-induced amphiregulin (AREG) secreted from CAFs in cancer invasiveness. CAFs secrete higher amounts of AREG than NFs, and LPA induces AREG expression in CAFs to augment their invasiveness. Strikingly, knocking out the AREG gene in CAFs attenuates cancer invasiveness and metastasis. Mechanistically, LPA induces Yes-associated protein (YAP) activation and Zinc finger E-box binding homeobox 1 (Zeb1) expression through the LPAR1 and LPAR3/Gi/Rho signaling axes, leading to AREG expression. Furthermore, we provide evidence that metformin, a biguanide derivative, significantly inhibits LPA-induced AREG expression in CAFs to attenuate cancer cell invasiveness. Collectively, the present data show that LPA induces AREG expression through YAP and Zeb1 in CAFs to promote cancer cell invasiveness, with the process being inhibited by metformin, providing potential biomarkers and therapeutic avenues to interdict cancer cell invasion.
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Affiliation(s)
- Bo Young Jeong
- Department of Pharmacology, College of Medicine, Konyang University, Daejeon, 35365, Republic of Korea; Division of Oncological Sciences Knight Cancer Institute, Oregon Health and Science University, Portland, OR, 97201, USA
| | - Kyung Hwa Cho
- Department of Pharmacology, College of Medicine, Konyang University, Daejeon, 35365, Republic of Korea
| | - Kang Jin Jeong
- Division of Oncological Sciences Knight Cancer Institute, Oregon Health and Science University, Portland, OR, 97201, USA
| | - Su Jin Cho
- Department of Pharmacology, College of Medicine, Konyang University, Daejeon, 35365, Republic of Korea
| | - Minho Won
- Biotechnology Process Engineering Center, Korea Research Institute of Bioscience & Biotechnology, Cheongju, 28116, Republic of Korea; Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, 35015, Republic of Korea
| | - Seung Hwa Kim
- Department of Pharmacology, College of Medicine, Konyang University, Daejeon, 35365, Republic of Korea
| | - Nam Hoon Cho
- Department of Pathology, College of Medicine, Yonsei University, Seoul, 03722, Republic of Korea
| | - Gang Min Hur
- Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, 35015, Republic of Korea
| | - Se-Hee Yoon
- Division of Nephrology and Department of Internal Medicine, College of Medicine, Konyang University, Daejeon, 35364, Republic of Korea
| | - Hwan-Woo Park
- Department of Cell Biology, College of Medicine, Konyang University, Daejeon, 35365, Republic of Korea
| | - Gordon B Mills
- Division of Oncological Sciences Knight Cancer Institute, Oregon Health and Science University, Portland, OR, 97201, USA
| | - Hoi Young Lee
- Department of Pharmacology, College of Medicine, Konyang University, Daejeon, 35365, Republic of Korea.
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4
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McAdams RM, Kaur R, Sun Y, Bindra H, Cho SJ, Singh H. Predicting clinical outcomes using artificial intelligence and machine learning in neonatal intensive care units: a systematic review. J Perinatol 2022; 42:1561-1575. [PMID: 35562414 DOI: 10.1038/s41372-022-01392-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Received: 11/26/2021] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Advances in technology, data availability, and analytics have helped improve quality of care in the neonatal intensive care unit. OBJECTIVE To provide an in-depth review of artificial intelligence (AI) and machine learning techniques being utilized to predict neonatal outcomes. METHODS The PRISMA protocol was followed that considered articles from established digital repositories. Included articles were categorized based on predictions of: (a) major neonatal morbidities such as sepsis, bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity; (b) mortality; and (c) length of stay. RESULTS A total of 366 studies were considered; 68 studies were eligible for inclusion in the review. The current set of predictor models are primarily built on supervised learning and mostly used regression models built on retrospective data. CONCLUSION With the availability of EMR data and data-sharing of NICU outcomes across neonatal research networks, machine learning algorithms have shown breakthrough performance in predicting neonatal disease.
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Affiliation(s)
- Ryan M McAdams
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Ravneet Kaur
- Child Health Imprints (CHIL) USA Inc, Madison, WI, USA
| | - Yao Sun
- Division of Neonatology, University of California San Francisco, San Francisco, CA, USA
| | | | - Su Jin Cho
- College of Medicine, Ewha Womans University Seoul, Seoul, Korea
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5
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Cho SJ, Jeong BY, Song YS, Park CG, Cho DY, Lee HY. STAT3 mediates RCP-induced cancer cell invasion through the NF-κB/Slug/MT1-MMP signaling cascade. Arch Pharm Res 2022; 45:460-474. [PMID: 35809175 DOI: 10.1007/s12272-022-01396-0] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022]
Abstract
Rab coupling protein (RCP) has been known to induce cancer invasion and metastasis, and STAT3 is one of major oncogenic factors. In the present study, we identify the critical role of STAT3 in RCP-induced cancer cell invasion. Immunohistochemical data of ovarian cancer tissues presented that levels of RCP expression are closely correlated with those of phospho-STAT3 (p-STAT3). In addition, ovarian cancer patients with high expression of both RCP and p-STAT3 had significantly lower progress-free and overall survival rates compared to those with low either RCP or p-STAT3 expression. Mechanistically, RCP induced STAT3 phosphorylation in both ovarian and breast cancer cells. Silencing or pharmacological inhibition of STAT3 significantly inhibited RCP-induced cancer cell invasion. In addition, we provide evidence that the β1 integrin/EGFR axis is important for RCP-induced STAT3 phosphorylation. Furthermore, STAT3 activated NF-κB for Slug expression that in turn upregulated MT1-MMP expression for cancer cell invasion. Collectively, our present data demonstrate that STAT3 is located downstream of the β1 integrin/EGFR axis and induces Slug and MT1-MMP expression for cancer cell invasion.
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Affiliation(s)
- Su Jin Cho
- Department of Pharmacology, College of Medicine, Konyang University, 821 Medical Science Building, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Republic of Korea
| | - Bo Young Jeong
- Department of Pharmacology, College of Medicine, Konyang University, 821 Medical Science Building, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Republic of Korea.,Department of Cell, Developmental and Cancer Biology, School of Medicine, Oregon Health Science University, Portland, OR, 97201, USA
| | - Young Soo Song
- Department of Pathology, College of Medicine, Konyang University, Daejeon, 35365, Republic of Korea
| | - Chang Gyo Park
- Department of Pharmacology, College of Medicine, Konyang University, 821 Medical Science Building, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Republic of Korea
| | - Do Yeun Cho
- Department of Hematology and Oncology, College of Medicine, Konyang University, Daejeon, 35365, Republic of Korea
| | - Hoi Young Lee
- Department of Pharmacology, College of Medicine, Konyang University, 821 Medical Science Building, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Republic of Korea.
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6
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Shim SY, Cho SJ, Park EA. Neurodevelopmental Outcomes at 18-24 Months of Corrected Age in Very Low Birth Weight Infants with Late-onset Sepsis. J Korean Med Sci 2021; 36:e205. [PMID: 34490752 PMCID: PMC8422039 DOI: 10.3346/jkms.2021.36.e205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/25/2020] [Accepted: 07/09/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Preterm infants are prone to sepsis owing to their immature innate immunity and prolonged hospitalization. We aimed to evaluate the association between late-onset sepsis (LOS) during hospitalization and neurodevelopmental delay at 18-24 months of corrected age in very low birth weight infants (VLBWIs), and to ascertain this association when adjusted for perinatal risk factors. METHODS This is a population-based study of VLBWIs born at 23-32 weeks of gestation between January 2014 and December 2017 who were enrolled in the Korean Neonatal Network. Bayley scales of infant development were evaluated at 18-24 months of corrected age in 2,098 infants. To test for LOS as a risk factor for neurodevelopmental delay, multiple logistic regression was used and adjusted for parental education status and clinical variables. RESULTS Blood culture positive LOS was identified in 419 (20.0%) infants. Cognitive and motor delays were found in 392 (18.7%) and 347 (16.5%) infants, respectively. When multivariate analysis was performed, LOS had a significant association with cognitive delay (odds ratio, 1.48; 95% confidence interval, 1.02-2.16), but no association with motor delay in VLBWIs. Both delays were significantly more frequent in cases of intraventricular hemorrhage (IVH) ≥ grade 3, periventricular leukomalacia (PVL), and intrauterine growth restriction (IUGR) and duration of mechanical ventilation. Male sex and necrotizing enterocolitis ≥ grade 2 had an effect on motor delay, whereas paternal college graduation affected cognitive delay. CONCLUSION In VLBWIs with LOS, there is a heightened risk of cognitive delays at 18-24 months of corrected age. Brain injury, such as severe IVH and PVL, duration of mechanical ventilation, and IUGR, were also associated with cognitive and motor delays.
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Affiliation(s)
- So-Yeon Shim
- Division of Neonatology, Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea.
| | - Su Jin Cho
- Division of Neonatology, Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
| | - Eun Ae Park
- Division of Neonatology, Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
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7
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Sun Y, Kaur R, Gupta S, Paul R, Das R, Cho SJ, Anand S, Boutilier JJ, Saria S, Palma J, Saluja S, McAdams RM, Kaur A, Yadav G, Singh H. Development and validation of high definition phenotype-based mortality prediction in critical care units. JAMIA Open 2021; 4:ooab004. [PMID: 33796821 PMCID: PMC7991779 DOI: 10.1093/jamiaopen/ooab004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 01/12/2021] [Accepted: 01/24/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives The objectives of this study are to construct the high definition phenotype (HDP), a novel time-series data structure composed of both primary and derived parameters, using heterogeneous clinical sources and to determine whether different predictive models can utilize the HDP in the neonatal intensive care unit (NICU) to improve neonatal mortality prediction in clinical settings. Materials and Methods A total of 49 primary data parameters were collected from July 2018 to May 2020 from eight level-III NICUs. From a total of 1546 patients, 757 patients were found to contain sufficient fixed, intermittent, and continuous data to create HDPs. Two different predictive models utilizing the HDP, one a logistic regression model (LRM) and the other a deep learning long–short-term memory (LSTM) model, were constructed to predict neonatal mortality at multiple time points during the patient hospitalization. The results were compared with previous illness severity scores, including SNAPPE, SNAPPE-II, CRIB, and CRIB-II. Results A HDP matrix, including 12 221 536 minutes of patient stay in NICU, was constructed. The LRM model and the LSTM model performed better than existing neonatal illness severity scores in predicting mortality using the area under the receiver operating characteristic curve (AUC) metric. An ablation study showed that utilizing continuous parameters alone results in an AUC score of >80% for both LRM and LSTM, but combining fixed, intermittent, and continuous parameters in the HDP results in scores >85%. The probability of mortality predictive score has recall and precision of 0.88 and 0.77 for the LRM and 0.97 and 0.85 for the LSTM. Conclusions and Relevance The HDP data structure supports multiple analytic techniques, including the statistical LRM approach and the machine learning LSTM approach used in this study. LRM and LSTM predictive models of neonatal mortality utilizing the HDP performed better than existing neonatal illness severity scores. Further research is necessary to create HDP–based clinical decision tools to detect the early onset of neonatal morbidities.
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Affiliation(s)
- Yao Sun
- Division of Neonatology, Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Ravneet Kaur
- Research and Development, Child Health Imprints (CHIL) Pte. Ltd., Singapore
| | - Shubham Gupta
- Research and Development, Child Health Imprints (CHIL) Pte. Ltd., Singapore
| | - Rahul Paul
- Research and Development, Child Health Imprints (CHIL) Pte. Ltd., Singapore
| | - Ritu Das
- Research and Development, Child Health Imprints (CHIL) Pte. Ltd., Singapore
| | - Su Jin Cho
- Department of Pediatrics, College of Medicine, Ewha Womans University Seoul, Seoul, Korea
| | - Saket Anand
- Department of Computer Science, Indraprastha Institute of Information Technology, New Delhi, India
| | - Justin J Boutilier
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Wisconsin, USA
| | - Suchi Saria
- Machine Learning and Healthcare Lab, Johns Hopkins University, Baltimore, Maryland, USA.,Department of Applied Math & Statistics, Johns Hopkins University, Baltimore, Maryland, USA.,Department of Health Policy & Management, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jonathan Palma
- Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Satish Saluja
- Department of Neonatology, Sir Ganga Ram Hospital, New Delhi, India
| | - Ryan M McAdams
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Avneet Kaur
- Department of Neonatology, Apollo Cradle Hospitals, New Delhi, India
| | - Gautam Yadav
- Department of Pediatrics, Kalawati Hospital, Rewari, India
| | - Harpreet Singh
- Research and Development, Child Health Imprints (CHIL) Pte. Ltd., Singapore
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Shim SY, Yun JY, Cho SJ, Kim MH, Park EA. The Prediction of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants through Clinical Indicators within 1 Hour of Delivery. J Korean Med Sci 2021; 36:e81. [PMID: 33754511 PMCID: PMC7985290 DOI: 10.3346/jkms.2021.36.e81] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 01/21/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Despite the advances in neonatology, the incidence of bronchopulmonary dysplasia (BPD) is increasing. It is important to prevent the development of BPD in the first place. The online BPD outcome estimator from National Institute of Children Health and Human Development and Neonatal Research Network is available. However, it is not applicable for Asians. Moreover, limits are set for birth weight and gestational weeks excluding those who may still have BPD. The aim of this study was to develop a prediction model for BPD using first hour perinatal and neonatal factors in Korean very low birth weight infants (VLBWIs). METHODS Data were collected for 8,022 VLBWIs with gestational age (GA) ≥ 22 weeks who were born between January 1, 2013 and December 31, 2016, and admitted to the neonatal intensive care units of the KNN. Multiple logistic regression models reanalyzed by stepwise selection with significant clinical indicators for BPD. PROC package was used to calculate the area under curve (AUC) and corresponding 95% confidence intervals. Moreover, it was used to search the best cut-off value. External validation was performed with the 2017 Korean neonatal network (KNN) data. RESULTS After all missing data were excluded, 4,600 VLBWIs were included in the training dataset of the prediction model. Predictability of presence of BPD was 90.8% and prediction P value cut off was 0.550. Five-minute Apgar score, birth weight, GA, sex, surfactant use were significant indicators. Predictability of severe BPD was 81.5% and prediction P value cut off was 0.160. Five-minute Apgar score, birth weight, maternal PIH, chronic maternal hypertension, GA, sex, respiratory distress syndrome, need of resuscitation at birth were significant indicators. After external validation, sensitivity and specificity did not change significantly. CONCLUSION From this study, high predictability was obtained using clinical parameters obtained within one hour of life. P value for prediction of each grade of BPD and equation for calculation was presented. It can be helpful for the early prediction of BPD in Korean VLBWI. This study will contribute to the prediction of BPD in Asians especially Korean VLBWIs, not currently included in the NICHD BPD online BPD predictor. In addition, the predictive power may be continuously increased with the cumulative data of KNN.
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Affiliation(s)
- So Yeon Shim
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Ji Yun Yun
- Department of Pediatrics, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Min Ho Kim
- Informatization Department, Ewha Womans University, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea.
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9
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Lee HA, Park B, Min J, Choi EJ, Kim UJ, Park HJ, Park EA, Cho SJ, Kim HS, Lee H, Kim YJ, Hong YS, Kim EJ, Ha EH, Park H. Cohort profile: the Ewha Birth and Growth Study. Epidemiol Health 2021; 43:e2021016. [PMID: 33677859 PMCID: PMC8060523 DOI: 10.4178/epih.e2021016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/20/2021] [Indexed: 12/11/2022] Open
Abstract
With the introduction of life-course epidemiology, researchers realized the importance of identifying risk factors in early life to prevent chronic diseases. This led to the establishment of the Ewha Birth and Growth Study in 2001; the study is a prospective birth cohort designed to provide evidence of early life risk factors for a child's growth and health. Participants were recruited from those who visited Ewha Womans University Mokdong Hospital (a tertiary hospital in southwest Seoul, Korea) for prenatal care at 24-28 weeks of gestation. In total, 891 mothers enrolled in this study between 2001 and 2006 and their offspring (n=940) were followed-up. Regular check-up examinations of offspring were conducted at 3 years, 5 years, and 7 years of age and every year thereafter. To consider age-related health issues, extensive data were collected using questionnaires and measurements. In 2021, the study subjects will reach 19 years of age, and we are planning a check-up examination for early adulthood. About 20 years have passed since the cohort data were collected, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. Recently, we started reporting on topics related to adolescent health. The findings will facilitate identification of early life risk factors for chronic diseases and the development of interventions for diseases later in life.
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Affiliation(s)
- Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Bohyun Park
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jungwon Min
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Eun Jeong Choi
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ui Jeong Kim
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea.,Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Hyun Jin Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea.,Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hwayoung Lee
- Department of Anatomy, Ewha Womans University College of Medicine, Seoul, Korea
| | - Young Ju Kim
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea.,Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Young Sun Hong
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Eui-Jung Kim
- Department of Psychiatry, Ewha Womans University College of Medicine, Seoul, Korea
| | - Eun Hee Ha
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea.,Department of Occupational and Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea.,Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
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10
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Singh H, Cho SJ, Gupta S, Kaur R, Sunidhi S, Saluja S, Pandey AK, Bennett MV, Lee HC, Das R, Palma J, McAdams RM, Kaur A, Yadav G, Sun Y. Designing a bed-side system for predicting length of stay in a neonatal intensive care unit. Sci Rep 2021; 11:3342. [PMID: 33558618 PMCID: PMC7870925 DOI: 10.1038/s41598-021-82957-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 04/08/2020] [Accepted: 01/20/2021] [Indexed: 11/13/2022] Open
Abstract
Increased length of stay (LOS) in intensive care units is directly associated with the financial burden, anxiety, and increased mortality risks. In the current study, we have incorporated the association of day-to-day nutrition and medication data of the patient during its stay in hospital with its predicted LOS. To demonstrate the same, we developed a model to predict the LOS using risk factors (a) perinatal and antenatal details, (b) deviation of nutrition and medication dosage from guidelines, and (c) clinical diagnoses encountered during NICU stay. Data of 836 patient records (12 months) from two NICU sites were used and validated on 211 patient records (4 months). A bedside user interface integrated with EMR has been designed to display the model performance results on the validation dataset. The study shows that each gestation age group of patients has unique and independent risk factors associated with the LOS. The gestation is a significant risk factor for neonates < 34 weeks, nutrition deviation for < 32 weeks, and clinical diagnosis (sepsis) for ≥ 32 weeks. Patients on medications had considerable extra LOS for ≥ 32 weeks’ gestation. The presented LOS model is tailored for each patient, and deviations from the recommended nutrition and medication guidelines were significantly associated with the predicted LOS.
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Affiliation(s)
- Harpreet Singh
- Child Health Imprints (CHIL) Pte. Ltd, Singapore, Singapore.
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Shubham Gupta
- Child Health Imprints (CHIL) Pte. Ltd, Singapore, Singapore
| | - Ravneet Kaur
- Child Health Imprints (CHIL) Pte. Ltd, Singapore, Singapore
| | - S Sunidhi
- Child Health Imprints (CHIL) Pte. Ltd, Singapore, Singapore
| | - Satish Saluja
- Department of Neonatology, Sir Ganga Ram Hospital, New Delhi, India
| | - Ashish Kumar Pandey
- Department of Mathematics, Indraprastha Institute of Information Technology, New Delhi, India
| | - Mihoko V Bennett
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, CA, USA.,California Perinatal Quality Care Collaborative, Stanford, CA, USA
| | - Henry C Lee
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, CA, USA.,California Perinatal Quality Care Collaborative, Stanford, CA, USA
| | - Ritu Das
- Child Health Imprints (CHIL) Pte. Ltd, Singapore, Singapore
| | - Jonathan Palma
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Ryan M McAdams
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Avneet Kaur
- Department of Neonatology, Apollo Cradle Hospitals, New Delhi, India
| | - Gautam Yadav
- Department of Pediatrics, Kalawati Hospital, Rewari, India
| | - Yao Sun
- University of California, San Francisco, USA
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11
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Singh H, Kusuda S, McAdams RM, Gupta S, Kalra J, Kaur R, Das R, Anand S, Pandey AK, Cho SJ, Saluja S, Boutilier JJ, Saria S, Palma J, Kaur A, Yadav G, Sun Y. Machine Learning-Based Automatic Classification of Video Recorded Neonatal Manipulations and Associated Physiological Parameters: A Feasibility Study. Children (Basel) 2020; 8:children8010001. [PMID: 33375101 PMCID: PMC7822162 DOI: 10.3390/children8010001] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/15/2020] [Accepted: 12/18/2020] [Indexed: 11/16/2022]
Abstract
Our objective in this study was to determine if machine learning (ML) can automatically recognize neonatal manipulations, along with associated changes in physiological parameters. A retrospective observational study was carried out in two Neonatal Intensive Care Units (NICUs) between December 2019 to April 2020. Both the video and physiological data (heart rate (HR) and oxygen saturation (SpO2)) were captured during NICU hospitalization. The proposed classification of neonatal manipulations was achieved by a deep learning system consisting of an Inception-v3 convolutional neural network (CNN), followed by transfer learning layers of Long Short-Term Memory (LSTM). Physiological signals prior to manipulations (baseline) were compared to during and after manipulations. The validation of the system was done using the leave-one-out strategy with input of 8 s of video exhibiting manipulation activity. Ten neonates were video recorded during an average length of stay of 24.5 days. Each neonate had an average of 528 manipulations during their NICU hospitalization, with the average duration of performing these manipulations varying from 28.9 s for patting, 45.5 s for a diaper change, and 108.9 s for tube feeding. The accuracy of the system was 95% for training and 85% for the validation dataset. In neonates <32 weeks’ gestation, diaper changes were associated with significant changes in HR and SpO2, and, for neonates ≥32 weeks’ gestation, patting and tube feeding were associated with significant changes in HR. The presented system can classify and document the manipulations with high accuracy. Moreover, the study suggests that manipulations impact physiological parameters.
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Affiliation(s)
- Harpreet Singh
- Child Health Imprints (CHIL) Pte. Ltd., Singapore 048545, Singapore; (S.G.); (J.K.); (R.K.); (R.D.)
- Correspondence: ; Tel.: +65-91-9910861112
| | - Satoshi Kusuda
- Department of Pediatrics, Kyorin University, Tokyo 181-8612, Japan;
| | - Ryan M. McAdams
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA;
| | - Shubham Gupta
- Child Health Imprints (CHIL) Pte. Ltd., Singapore 048545, Singapore; (S.G.); (J.K.); (R.K.); (R.D.)
| | - Jayant Kalra
- Child Health Imprints (CHIL) Pte. Ltd., Singapore 048545, Singapore; (S.G.); (J.K.); (R.K.); (R.D.)
| | - Ravneet Kaur
- Child Health Imprints (CHIL) Pte. Ltd., Singapore 048545, Singapore; (S.G.); (J.K.); (R.K.); (R.D.)
| | - Ritu Das
- Child Health Imprints (CHIL) Pte. Ltd., Singapore 048545, Singapore; (S.G.); (J.K.); (R.K.); (R.D.)
| | - Saket Anand
- Department of Computer Science and Engineering, Indraprastha Institute of Information Technology, New Delhi 110020, India;
| | - Ashish Kumar Pandey
- Department of Mathematics, Indraprastha Institute of Information Technology, New Delhi 110020, India;
| | - Su Jin Cho
- College of Medicine, Ewha Womans University Seoul, Seoul 03760, Korea;
| | - Satish Saluja
- Department of Neonatology, Sir Ganga Ram Hospital, New Delhi 110060, India;
| | - Justin J. Boutilier
- Department of Industrial and Systems Engineering, College of Engineering, University of Wisconsin, Madison, WI 53706, USA;
| | - Suchi Saria
- Machine Learning and Healthcare Lab, Johns Hopkins University, 3400 N. Charles St, Baltimore, MD 21218, USA;
| | - Jonathan Palma
- Department of Pediatrics, Stanford University, Stanford, CA 94305, USA;
| | - Avneet Kaur
- Department of Neonatology, Apollo Cradle Hospitals, New Delhi 110015, India;
| | - Gautam Yadav
- Department of Pediatrics, Kalawati Hospital, Rewari 123401, India;
| | - Yao Sun
- Division of Neonatology, University of California, San Francisco, CA 92521, USA;
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12
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Yun JY, Kim JS, Shim SY, Cho SJ, Park EA, Chong HJ. Effects of Music Intervention Techniques on Very-Low-Birth-Weight Infants in Neonatal Intensive Care Unit: A Preliminary Study. Neonatal Med 2020. [DOI: 10.5385/nm.2020.27.4.174] [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: 11/01/2022] Open
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13
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Jung EM, Kim KN, Park H, Shin HH, Kim HS, Cho SJ, Kim ST, Ha EH. Association between prenatal exposure to PM 2.5 and the increased risk of specified infant mortality in South Korea. Environ Int 2020; 144:105997. [PMID: 32768726 DOI: 10.1016/j.envint.2020.105997] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/12/2020] [Accepted: 07/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Findings from previous studies on the association between exposure to fine particulate matter (PM2.5) and the risk of infant mortality were inconsistent. Thus, two main objectives of our study were to examine the association between exposure to PM2.5 and specified infant mortality and to identify critical trimesters. METHODS We retrospectively created a birth cohort of singleton full-term infants born in South Korea between 2010 and 2015 using national birth and infant mortality data. The specified causes of infant mortality were circulatory and respiratory diseases, perinatal conditions, congenital anomalies, and sudden infant death syndrome. We performed 1:10 propensity score matching for various exposure windows: each trimester, prenatal, and postnatal (up to age 1). Conditional logistic regression was applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs), while accounting for gestational age, birth weight, maternal education level, season of birth, and regions (metropolitan areas/provinces). We also conducted sex-stratified analyses and used different matching ratios for sensitivity analyses. RESULTS A total of 2,501,836 births and 761 deaths (0.03%) were identified in the birth cohort. We found an increased risk of infant mortality per 10 µg/m3 increase in PM2.5 exposure during the prenatal period (OR: 1.29, 95% CI: 1.07-1.55). Exposure in the 1st and 2nd trimesters was linked to an elevated risk (OR: 1.19, 95% CI: 1.02-1.37; OR: 1.21, 95% CI: 1.04-1.40). However, no association was shown in the third trimester. PM2.5 exposure in the 1st and 2nd trimesters was associated with elevated male infant mortality, but did not reach statistical significance in female infants. The use of different matching ratios did not significantly affect the results. CONCLUSION The study findings suggest that exposure to PM2.5 could affect infant mortality differently by the timing of exposure and sex, which suggests a relation to fetal development. However, further investigations are warranted.
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Affiliation(s)
- Eun Mi Jung
- Department of Occupational and Environmental Medicine, Ewha Womans University, Seoul, Republic of Korea; Ewha Global Health Institute for Girls, Ewha Womans University, Seoul, Republic of Korea
| | - Kyoung-Nam Kim
- Division of Public Health and Preventive Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hwashin H Shin
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada; Department of Mathematics and Statistics, Queen's University, Kingston, ON, Canada
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University, Seoul, Republic of Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University, Seoul, Republic of Korea
| | - Soon Tae Kim
- Department of Environmental and Safety Engineering, Ajou University, Suwon, Republic of Korea
| | - Eun Hee Ha
- Department of Occupational and Environmental Medicine, Ewha Womans University, Seoul, Republic of Korea; Ewha Global Health Institute for Girls, Ewha Womans University, Seoul, Republic of Korea.
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14
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Lee SH, Lee HA, Park EA, Cho SJ, Oh SY, Park B, Park H. Combined effects of dietary zinc at 3 years of age and obesity at 7 years of age on the serum uric acid levels of Korean children. Nutr Res Pract 2020; 14:365-373. [PMID: 32765816 PMCID: PMC7390735 DOI: 10.4162/nrp.2020.14.4.365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/18/2019] [Accepted: 01/16/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND/OBJECTIVES To assess the longitudinal associations of the antioxidant capacity of zinc and body mass index (BMI) with serum uric acid (SUA) in South Korean children. SUBJECTS/METHODS Using follow-up data from the Ewha Birth and Growth Cohort, we included subjects who were seen at 3 and 7 years of age (n = 183; 90 boys, 93 girls). Daily zinc intake and BMI were assessed at 3 and 7 years of age. SUA measured at 7 years was used as the outcome variable. Using a general linear model, the effects of dietary zinc intake and BMI on SUA were assessed. We also assessed the combined effect of early dietary zinc intake and BMI on SUA in children. RESULTS The dietary zinc intake at 3 years of age was negatively correlated (ρ = −0.18, P = 0.04), whereas the BMI at 7 years of age was positively correlated (r = 0.18, P = 0.01), with the SUA level at 7 years of age. The dietary zinc intake level at 3 years of age and the BMI level at 7 years of age were, together, significantly related to SUA in children at 7 years of age. SUA was lower in group 1 (normal-weight, high-zinc group) than in the other two groups (group 2: normal-weight, low-zinc and overweight, high-zinc group; and group 3: overweight, low-zinc group). Our results demonstrate the combined effect of zinc intake and BMI on SUA. The combined association remained significant in both the crude and adjusted models (P < 0.01). CONCLUSIONS SUA was related to combined BMI and dietary zinc intake, and increased zinc intake and normal body weight had a beneficial effect on reducing SUA in children.
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Affiliation(s)
- Sung Hee Lee
- Department of Preventive Medicine, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Korea
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul 07985, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul 07985, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul 07985, Korea
| | - Se Young Oh
- Department of Food & Nutrition, College of Human Ecology, Kyung Hee University, Seoul 02447, Korea
| | - Bohyun Park
- Department of Preventive Medicine, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Korea
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15
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Lee MK, Lee JH, Kim JH, Kim H, Joo L, Kim M, Cho SJ, Suh CH, Chung SR, Choi YJ, Baek JH. Diagnostic Accuracy of MRI-Based Morphometric Parameters for Detecting Olfactory Nerve Dysfunction. AJNR Am J Neuroradiol 2020; 41:1698-1702. [PMID: 32763901 DOI: 10.3174/ajnr.a6697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/09/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Although olfactory dysfunction is a common cranial nerve disorder, there are no simple objective morphometric criteria to assess olfactory dysfunction. The aim of this study was to evaluate the diagnostic performance of MR imaging morphometric parameters for detecting olfactory dysfunction. MATERIALS AND METHODS This prospective study enrolled patients from those presenting with olfactory symptoms who underwent both an olfactory function test and MR imaging. Controls without olfactory dysfunction were recruited during the preoperative work-up for pituitary adenoma. Two independent neuroradiologists measured the olfactory bulb in 3D and assessed olfactory bulb concavity on MR imaging while blinded to the clinical data. Diagnostic performance was assessed using receiver operating characteristic curve analysis. RESULTS Sixty-four patients and 34 controls were enrolled. The patients were significantly older than the controls (mean age, 57.8 ± 11.9 years versus 47.1 ± 12.1 years; P < .001). Before age adjustment, the olfactory bulb height was the only olfactory bulb parameter showing a significant difference between patients and controls (1.6 ± 0.3 mm versus 2.0 ± 0.3 mm, P < .001). After age adjustment, all parameters and olfactory bulb concavity showed significant intergroup differences, with the olfactory bulb height having the highest area under the curve (0.85). Olfactory bulb height was confirmed to be the only significant parameter showing a difference in the detection of olfactory dysfunction in 22 pairs after matching for age and sex (area under the curve = 0.87, P < .001). Intraclass correlation coefficients revealed moderate-to-excellent degrees of inter- and intrareader agreement. CONCLUSIONS MR imaging morphometric analysis can differentiate patients with olfactory dysfunction, with the olfactory bulb height having the highest diagnostic performance for detecting olfactory dysfunction irrespective of age.
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Affiliation(s)
- M K Lee
- From the Department of Radiology and Research Institute of Radiology (M.K.L., J.H.L., H.K., L.J., M.K., S.J.C., C.H.S., S.R.C., Y.J.C., J.H.B.).,Department of Radiology (M.K.L.), Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J H Lee
- From the Department of Radiology and Research Institute of Radiology (M.K.L., J.H.L., H.K., L.J., M.K., S.J.C., C.H.S., S.R.C., Y.J.C., J.H.B.)
| | - J H Kim
- Department of Otorhinolaryngology (J.H.K.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - H Kim
- From the Department of Radiology and Research Institute of Radiology (M.K.L., J.H.L., H.K., L.J., M.K., S.J.C., C.H.S., S.R.C., Y.J.C., J.H.B.)
| | - L Joo
- From the Department of Radiology and Research Institute of Radiology (M.K.L., J.H.L., H.K., L.J., M.K., S.J.C., C.H.S., S.R.C., Y.J.C., J.H.B.)
| | - M Kim
- From the Department of Radiology and Research Institute of Radiology (M.K.L., J.H.L., H.K., L.J., M.K., S.J.C., C.H.S., S.R.C., Y.J.C., J.H.B.)
| | - S J Cho
- From the Department of Radiology and Research Institute of Radiology (M.K.L., J.H.L., H.K., L.J., M.K., S.J.C., C.H.S., S.R.C., Y.J.C., J.H.B.)
| | - C H Suh
- From the Department of Radiology and Research Institute of Radiology (M.K.L., J.H.L., H.K., L.J., M.K., S.J.C., C.H.S., S.R.C., Y.J.C., J.H.B.)
| | - S R Chung
- From the Department of Radiology and Research Institute of Radiology (M.K.L., J.H.L., H.K., L.J., M.K., S.J.C., C.H.S., S.R.C., Y.J.C., J.H.B.)
| | - Y J Choi
- From the Department of Radiology and Research Institute of Radiology (M.K.L., J.H.L., H.K., L.J., M.K., S.J.C., C.H.S., S.R.C., Y.J.C., J.H.B.)
| | - J H Baek
- From the Department of Radiology and Research Institute of Radiology (M.K.L., J.H.L., H.K., L.J., M.K., S.J.C., C.H.S., S.R.C., Y.J.C., J.H.B.)
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16
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Cho SJ, Suh CH, Baek JH, Chung SR, Choi YJ, Lee JH. Diagnostic performance of MRI to detect metastatic cervical lymph nodes in patients with thyroid cancer: a systematic review and meta-analysis. Clin Radiol 2020; 75:562.e1-562.e10. [PMID: 32303337 DOI: 10.1016/j.crad.2020.03.025] [Citation(s) in RCA: 1] [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] [Received: 07/10/2019] [Accepted: 03/11/2020] [Indexed: 02/02/2023]
Abstract
AIM To evaluate the diagnostic performance of magnetic resonance imaging (MRI) in the diagnosis of metastatic cervical lymph nodes. MATERIALS AND METHODS Ovid-MEDLINE and EMBASE databases were searched up until 12 June 2018. Eleven articles were included in the qualitative systematic review and nine of the 11 in the quantitative analysis. Two radiologists independently performed data extraction and methodological quality assessment using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A qualitative systematic review and quantitative analysis were performed, followed by a meta-regression analysis to determine factors causing heterogeneity. RESULTS The pooled sensitivity and specificity in the diagnosis of metastatic cervical lymph nodes were 80% (95% confidence interval [CI]: 68-88%) and 85% (95% CI: 63-95%), respectively. The sensitivity and false-positive rate (correlation coefficient, 0.655) showed a positive correlation due to a threshold effect, which was responsible for heterogeneity across the studies, as indicated by a Q-test (p<0.01) and Higgins I2 statistic (sensitivity, I2=90.11%; specificity, I2=92.49%). In the meta-regression analysis, fat-suppressed imaging, and the analysis method were significant factors influencing the heterogeneity in diagnostic performance. CONCLUSIONS MRI shows moderate diagnostic performance in the diagnosis of metastatic lymph nodes in patients with thyroid cancer in the neck. MRI may be an optional or complementary imaging method to ultrasound or computed tomography (CT) in thyroid cancer patients.
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Affiliation(s)
- S J Cho
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - C H Suh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - J H Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
| | - S R Chung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Y J Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - J H Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
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17
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Lee HA, Park B, Park EA, Cho SJ, Kim HS, Choi EJ, Kim NE, Park H. Blood Pressure Curve for Children Less than 10 Years of Age: Findings from the Ewha Birth and Growth Cohort Study. J Korean Med Sci 2020; 35:e91. [PMID: 32233160 PMCID: PMC7105512 DOI: 10.3346/jkms.2020.35.e91] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 09/30/2019] [Accepted: 01/28/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Routine blood pressure (BP) measurement is recommended to begin at 3 years of age, but there are no national BP reference values for Korean children less than 7 years of age. Therefore, we developed sex-, age-, and height-specific BP reference values for non-overweight children aged 3-9 years. METHODS We analyzed the data of 416, 340, 321, 323, and 332 subjects aged 3, 5, 7, 8, and 9 years, respectively, who participated in the Ewha Birth and Growth Cohort Study. BP percentile curves were generated using generalized additive models for location, scale, and shape. Reference values for the 50th, 90th, and 95th percentiles of BP were determined according to sex, age, and height percentiles. RESULTS In both boys and girls, a gradual increase in systolic blood pressure (SBP) with age was more pronounced than that in diastolic blood pressure (DBP). In boys, the reference values for 90th percentile of SBP/DBP at median height for children aged 3 and 9 years were 105/69 and 118/70, respectively. In girls, the reference values corresponding to the above conditions were 105/69 and 116/70, respectively. Among children aged 7-9 years of median height, the 90th percentile of SBP in the current study was lower and that of DBP was similar to the national reference values of Korea. For children aged < 7 years of median height, the reference value for SBP, but not that for DBP, was similar to that developed in the European study. CONCLUSION Although further research is needed, our findings could be used to help identify high BP in children less than 10 years of age.
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Affiliation(s)
- Hye Ah Lee
- Clinical Trial Center, Mokdong Hospital, Ewha Womans University, Seoul, Korea
| | - Bohyun Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Eun Jeong Choi
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Nam Eun Kim
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
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18
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Park B, Park B, Lee HA, Lee S, Han H, Park E, Cho SJ, Kim HS, Kim YJ, Ha EH, Park H. Association between pre-and postnatal growth and longitudinal trends in serum uric acid levels and blood pressure in children aged 3 to 7 years. BMC Pediatr 2020; 20:23. [PMID: 31959148 PMCID: PMC6971928 DOI: 10.1186/s12887-020-1922-8] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 01/10/2020] [Indexed: 02/07/2023] Open
Abstract
Background Uric acid has been identified as an important factor in the development of hypertension. If low birth weight (LBW) combined with catch-up growth (CUG) is associated with continuously elevated serum uric acid levels (SUA) level trajectories, LBW children who experience CUG may have an increased risk of hypertension later in life. Therefore, this cohort study analyzed longitudinal trends in SUA levels and changes in blood pressure in relation to pre- and postnatal growth over an extended follow-up period. Methods This prospective cohort study of 364 children from the Ewha Birth and Growth Cohort assessed the effects of pre- and postnatal growth status on SUA at 3, 5, and 7 years of age using a linear mixed model and the change in blood pressure over the 7-year follow-up period using a generalized linear model (analysis of covariance). CUG was defined as a change in weight (between birth and age 3) with a z-score > 0.67 for LBW subjects. The multivariate model considered sex, gestational age, and uric acid, height, and weight at 3 years of age. Results Children with LBW and CUG had higher SUA for the first 7 years of life compared to the normal birth weight group. This trend was particularly evident when comparing LBW children at term to children with normal birth weight. Within the group with LBW at term, children with greater CUG had higher SUA than children with normal birth weight, and this difference increased with age. Changes in the systolic blood pressure between 3 and 7 years of age were higher by 7.9 mmHg in children who experienced LBW and CUG compared with those who had a normal birth weight after adjusting for sex, gestational age, and height, weight, and uric acid at 3 years of age (p-value = 0.08). Conclusions The uric acid levels and changes in systolic blood pressure were consistently higher among LBW children who experienced CUG compared with NBW children for the first 7 years of life. LBW children who experienced greater weight gain from birth to age 3 had even higher uric acid levels compared with NBW children.
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Affiliation(s)
- Bomi Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, 25, Magokdong-ro 2-gil, Gangseo-gu, Seoul, 07804, Republic of Korea.,National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Bohyun Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, 25, Magokdong-ro 2-gil, Gangseo-gu, Seoul, 07804, Republic of Korea
| | - Hye Ah Lee
- Clinical Trial Center, Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Seonhwa Lee
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, 25, Magokdong-ro 2-gil, Gangseo-gu, Seoul, 07804, Republic of Korea
| | - Hyejin Han
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, 25, Magokdong-ro 2-gil, Gangseo-gu, Seoul, 07804, Republic of Korea
| | - Eunae Park
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Su Jin Cho
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hae Soon Kim
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Eun-Hee Ha
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, 25, Magokdong-ro 2-gil, Gangseo-gu, Seoul, 07804, Republic of Korea.
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Lee KJ, Yoo J, Kim YH, Kim SH, Kim SC, Kim YH, Kwak DW, Kil K, Park MH, Park H, Shim JY, Son GH, Lee KA, Oh SY, Oh KJ, Cho GJ, Shim SY, Cho SJ, Cho HY, Cha HH, Choi SK, Hwang JY, Hwang HS, Kwon EJ, Kim YJ. The Clinical Usefulness of Predictive Models for Preterm Birth with Potential Benefits: A KOrean Preterm collaboratE Network (KOPEN) Registry-Linked Data-Based Cohort Study. Int J Med Sci 2020; 17:1-12. [PMID: 31929733 PMCID: PMC6945556 DOI: 10.7150/ijms.37626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 10/25/2019] [Indexed: 11/05/2022] Open
Abstract
Background: Preterm birth is strongly associated with increasing mortality, incidence of disability, intensity of neonatal care required, and consequent costs. We examined the clinical utility of the potential preterm birth risk factors from admitted pregnant women with symptomatic preterm labor and developed prediction models to obtain information for prolonging pregnancies. Methods: This retrospective study included pregnant women registered with the KOrean Preterm collaboratE Network (KOPEN) who had symptomatic preterm labor, between 16 and 34 gestational weeks, in a tertiary care center from March to November 2016. Demographics, obstetric and medical histories, and basic laboratory test results obtained at admission were evaluated. The preterm birth probability was assessed using a nomogram and decision tree according to birth gestational age: early preterm, before 32 weeks; late preterm, between 32 and 37 weeks; and term, after 37 weeks. Results: Of 879 registered pregnant women, 727 who gave birth at a designated institute were analyzed. The rates of early preterm, late preterm, and term births were 18.16%, 44.02%, and 37.83%, respectively. With the developed nomogram, the concordance index for early and late preterm births was 0.824 (95% CI: 0.785-0.864) and 0.717 (95% CI: 0.675-0.759) respectively. Preterm birth was significantly more likely among women with multiple pregnancy and had water leakage due to premature rupture of membrane. The prediction rate for preterm birth based on decision tree analysis was 86.9% for early preterm and 73.9% for late preterm; the most important nodes are watery leakage for early preterm birth and multiple pregnancy for late preterm birth. Conclusion: This study aims to develop an individual overall probability of preterm birth based on specific risk factors at critical gestational times of preterm birth using a range of clinical variables recorded at the initial hospital admission. Therefore, these models may be useful for clinicians and patients in clinical decision-making and for hospitalization or lifestyle coaching in an outpatient setting.
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Affiliation(s)
- Kyung Ju Lee
- Department of Obstetrics and Gynecology, Korea University Medical Center, Seoul, Korea.,Department of Public Health, Korea University Graduate School, Seoul, Korea
| | - Jinho Yoo
- YooJin BioSoft Co., Ltd, Goyang-si Gyeonggi-do, Korea
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Hyun Kim
- Department of Obstetrics & Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Seung Chul Kim
- Department of Obstetrics and Gynecology, Biomedical Research Institute, Pusan National University College of Medicine, Busan, Korea
| | - Yoon Ha Kim
- Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju, Korea
| | - Dong Wook Kwak
- Department of Obstetrics and Gynecology, Cheil General Hospital and Woman's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea
| | - Kicheol Kil
- Department of Obstetrics and Gynecology, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Mi Hye Park
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Jae-Yoon Shim
- Department of Obstetrics & Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ga Hyun Son
- Department of Obstetrics and Gynecology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Kyung A Lee
- Department of Obstetrics and Gynecology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Soo-Young Oh
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Joon Oh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University Medical Center, Seoul, Korea
| | - So-Yeon Shim
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Hee Young Cho
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Hyun-Hwa Cha
- Department of Obstetrics & Gynecology, Kyungpook National University Hospital, Kyungpook National University, School of Medicine, Daegu, Korea
| | - Sae Kyung Choi
- Department of Obstetrics and Gynecology, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Jong Yun Hwang
- Department of Obstetrics and Gynecology, Kangwon National University School of Medicine, Kangwon-do, Korea
| | - Han-Sung Hwang
- Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Eun Jin Kwon
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Korea
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20
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Suh CH, Lee JH, Lee MK, Cho SJ, Chung SR, Choi YJ, Baek JH. CT and MRI Findings of Glomangiopericytoma in the Head and Neck: Case Series Study and Systematic Review. AJNR Am J Neuroradiol 2020; 41:155-159. [PMID: 31806599 DOI: 10.3174/ajnr.a6336] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/07/2019] [Indexed: 11/07/2022]
Abstract
Glomangiopericytoma is a rare sinonasal mesenchymal tumor of borderline or low malignant potential. We reviewed the CT and MR imaging findings of head and neck glomangiopericytoma via a retrospective case series study and systematic review. Our study revealed that glomangiopericytoma is a well-defined lobulated avidly enhancing soft-tissue mass with erosive bony remodeling that is most commonly found in the sinonasal cavity. Typically, it is hyperintense on T2-weighted images with vascular signal voids, has a high mean ADC value, and a wash-in and washout pattern on dynamic contrast-enhanced MR imaging. Although the CT findings are nonspecific, typical MR imaging findings, including those on the ADC map and dynamic contrast-enhanced MR imaging, may be helpful for differentiating glomangiopericytomas from other hypervascular tumors in the head and neck.
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Affiliation(s)
- C H Suh
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - J H Lee
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
| | - M K Lee
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S J Cho
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S R Chung
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Y J Choi
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - J H Baek
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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21
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Singh H, Kaur R, Saluja S, Cho SJ, Kaur A, Pandey AK, Gupta S, Das R, Kumar P, Palma J, Yadav G, Sun Y. Development of data dictionary for neonatal intensive care unit: advancement towards a better critical care unit. JAMIA Open 2019; 3:21-30. [PMID: 32607484 PMCID: PMC7309238 DOI: 10.1093/jamiaopen/ooz064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 09/18/2019] [Accepted: 11/17/2019] [Indexed: 11/14/2022] Open
Abstract
Background Critical care units (CCUs) with extensive use of various monitoring devices generate massive data. To utilize the valuable information of these devices; data are collected and stored using systems like clinical information system and laboratory information management system. These systems are proprietary, allow limited access to their database and, have the vendor-specific clinical implementation. In this study, we focus on developing an open-source web-based meta-data repository for CCU representing stay of the patient with relevant details. Methods After developing the web-based open-source repository named data dictionary (DD), we analyzed prospective data from 2 sites for 4 months for data quality dimensions (completeness, timeliness, validity, accuracy, and consistency), morbidity, and clinical outcomes. We used a regression model to highlight the significance of practice variations linked with various quality indicators. Results DD with 1555 fields (89.6% categorical and 11.4% text fields) is presented to cover the clinical workflow of a CCU. The overall quality of 1795 patient days data with respect to standard quality dimensions is 87%. The data exhibit 88% completeness, 97% accuracy, 91% timeliness, and 94% validity in terms of representing CCU processes. The data scores only 67% in terms of consistency. Furthermore, quality indicators and practice variations are strongly correlated (P < 0.05). Conclusion This study documents DD for standardized data collection in CCU. DD provides robust data and insights for audit purposes and pathways for CCU to target practice improvements leading to specific quality improvements.
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Affiliation(s)
- Harpreet Singh
- Child Health Imprints (CHIL) Pte. Ltd, Singapore, Singapore
| | - Ravneet Kaur
- Child Health Imprints (CHIL) Pte. Ltd, Singapore, Singapore
| | - Satish Saluja
- Department of Neonatology, Sir Ganga Ram Hospital, New Delhi, India
| | - Su Jin Cho
- Department of pediatrics, College of Medicine, Ewha Woman's University Seoul, Seoul, Republic of Korea
| | - Avneet Kaur
- Department of Pediatrics, Apollo Hospitals, New Delhi, India
| | - Ashish Kumar Pandey
- Department of Mathematics, Indraprastha Institute of Information Technology, New Delhi, India
| | - Shubham Gupta
- Child Health Imprints (CHIL) Pte. Ltd, Singapore, Singapore
| | - Ritu Das
- Child Health Imprints (CHIL) Pte. Ltd, Singapore, Singapore
| | - Praveen Kumar
- Department of Neonatology, PGIMER, Chandigarh, India
| | - Jonathan Palma
- Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Gautam Yadav
- Department of Pediatrics, Kalawati Hospital, Rewari, India
| | - Yao Sun
- Department of pediatrics, UCSF Benioff Children's Hospital, William H. Tooley Intensive Care Nursery, San Francisco, California, USA
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22
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Park B, Lee JW, Kim HS, Park EA, Cho SJ, Park H. Effects of Prenatal Growth Status on Subsequent Childhood Renal Function Related to High Blood Pressure. J Korean Med Sci 2019; 34:e174. [PMID: 31243933 PMCID: PMC6597485 DOI: 10.3346/jkms.2019.34.e174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 12/12/2018] [Accepted: 06/03/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Hypertension is one of the major causes of chronic diseases. The effect on high blood pressure (BP) with fetal growth restriction is now well-established. Recent studies suggest that a reduced number of nephrons programmed during the intrauterine period contribute to a subsequently elevated BP, due to a permanent nephron deficit. However, few studies have examined this in children. We investigated the effects of low birth weight (LBW) and preterm birth on the renal function markers related to a high BP in childhood. METHODS We used data from 304 children aged 7-12 years who participated in the 2014 Ewha Birth and Growth Cohort survey in Korea. We assessed the serum uric acid, cystatin C, blood urea nitrogen (BUN), creatinine levels, and the estimated glomerular filtration rate (eGFR) in childhood. Anthropometric characteristics, BP in childhood, birth weight and gestational age were collected. RESULTS The serum uric acid was significantly higher in LBW children (4.0 mg/dL) than in normal birth weight children (3.7 mg/dL). The cystatin C levels were highest among children who were very preterm (0.89 mg/dL) compared with those who were not (preterm, 0.84 mg/dL; normal, 0.81 mg/dL), although the result was only borderline significant (P for trend = 0.06). Decreased birth weight was found to be significantly associated with an increased serum BUN level in childhood. In the analysis of the effects of renal function on BP, subjects with an eGFR lower than the median value had a significantly higher diastolic BP in childhood (difference = 2.4 mmHg; P < 0.05). CONCLUSION These findings suggest that LBW and preterm birth are risk factors for increased serum levels of renal function markers in childhood. Reduced eGFR levels were significantly associated with elevated diastolic BP in childhood. It is necessary to identify vulnerable individuals during their life and intervene appropriately to reduce the risk of an increased BP in the future.
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Affiliation(s)
- Bohyun Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jung Won Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
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23
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Lee KE, Jung SA, Park SH, Moon CM, Shim SY, Kim ES, Cho SJ, Kim SE, Cho KB, Yang SK. Influence of anti-tumor necrosis factor-alpha therapy to pregnant inflammatory bowel disease women and their children's immunity. Intest Res 2019; 17:237-243. [PMID: 30727711 PMCID: PMC6505087 DOI: 10.5217/ir.2018.00071] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 11/17/2018] [Indexed: 12/11/2022] Open
Abstract
Background/Aims The onset of inflammatory bowel disease (IBD) usually occurs at young age, and therefore, women IBD patients experience pregnancy during their disease progression. Recently, the use of anti-tumor necrosis factor-α (anti-TNF-α) has been rapidly increasing. The aim of this study was to evaluate pregnancy related outcomes in women with IBD who were treated with anti-TNF-α during pregnancy and immunity of their children. Methods Korean women with IBD who had been treated with anti-TNF-α during pregnancy had been enrolled. Medical records were reviewed and a survey was performed for each patient. For the patients who agreed on additional examination for their children, children’s growth, medical history and antibody to hepatitis B surface antigen (anti-HBs) titer were checked. Results All 18 patients had been diagnosed with Crohn’s disease. There was not any case of preterm delivery, low birth-weight infant, congenital anomaly, nor stillbirth. All 12 children had followed the regular vaccination schedule for hepatitis B and 4 of them showed negative results for anti-HBs. After the 1 booster vaccination, all children demonstrated seroconversion. Regarding live vaccines, 4 children had bacillus Calmette-Guerin and 4 had rotavirus vaccine before 6 months, without any specific side effects. Conclusions This was the first study of immunity of the children born from IBD women who had been treated with anti-TNF-α medication during their pregnancy. IBD women had comparable pregnancy outcomes with the general women population, suggesting that the disease activity rather than the administered medication would be more important in healthy pregnancy. Considering the history of vaccination and anti-HBs titers, immunity seems to be intact in the children.
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Affiliation(s)
- Ko Eun Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Sung-Ae Jung
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Sang Hyoung Park
- Department of Gastroenterology, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Mo Moon
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - So Yeon Shim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Eun Soo Kim
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.,Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Seong-Eun Kim
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kwang Bum Cho
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Suk-Kyun Yang
- Department of Gastroenterology, University of Ulsan College of Medicine, Seoul, Korea
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Youn Y, Lee SM, Hwang JH, Cho SJ, Kim EK, Kim EAR. National Registry Data from Korean Neonatal Network: Two-Year Outcomes of Korean Very Low Birth Weight Infants Born in 2013-2014. J Korean Med Sci 2018; 33:e309. [PMID: 30473651 PMCID: PMC6249169 DOI: 10.3346/jkms.2018.33.e309] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 06/11/2018] [Accepted: 08/16/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The aim of this study was to observe long-term outcomes of very low birth weight infants (VLBWIs) born between 2013 and 2014 in Korea, especially focusing on neurodevelopmental outcomes. METHODS The data were collected from Korean Neonatal Network (KNN) registry from 43 and 54 participating units in 2013 and 2014, respectively. A standardized electronic case report form containing 30 items related to long-term follow up was used after data validation. RESULTS Of 2,660 VLBWI, the mean gestational age and birth weight were 291/7 ± 26/7 weeks and 1,093 ± 268 g in 2013 and 292/7 ± 26/7 weeks and 1,125 ± 261 g in 2014, respectively. The post-discharge mortality rate was 1.2%-1.5%. Weight < 50th percentile was 46.5% in 2013 and 66.1% in 2014. The overall prevalence of cerebral palsy among the follow up infants was 6.2% in 2013 and 6.6% in 2014. The Bayley Scales of Infant Developmental Outcomes version II showed 14%-25% of infants had developmental delay and 3%-8% of infants in Bayley version III. For the Korean developmental screening test for infants and children, the area "Further evaluation needed" was 5%-12%. Blindness in both eyes was reported to be 0.2%-0.3%. For hearing impairment, 0.8%-1.9% showed bilateral hearing loss. Almost 50% were readmitted to hospital with respiratory illness as a leading cause. CONCLUSION The overall prevalence of long-term outcomes was not largely different among the VLBWI born between 2013 and 2014. This study is the first large national data study of long-term outcomes.
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Affiliation(s)
- YoungAh Youn
- Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Soon Min Lee
- Department of Pediatrics, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Hee Hwang
- Department of Pediatrics, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Ee-Kyung Kim
- Departmemt of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Ellen Ai-Rhan Kim
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
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Kim NH, Youn YA, Cho SJ, Hwang JH, Kim EK, Kim EAR, Lee SM. The predictors for the non-compliance to follow-up among very low birth weight infants in the Korean neonatal network. PLoS One 2018; 13:e0204421. [PMID: 30273357 PMCID: PMC6166943 DOI: 10.1371/journal.pone.0204421] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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] [Received: 05/07/2018] [Accepted: 09/09/2018] [Indexed: 12/02/2022] Open
Abstract
The critical need to emphasize preterm infant follow-up after neonatal intensive care unit (NICU) discharge assures early identification of and intervention for neurodevelopmental disability. The aims of this study were to observe the follow-up rates in high-risk follow-up clinics, and analyze factors associated with non-compliance to follow-up among very low birth weight (VLBW) infants. The data was prospectively collected for 3063 VLBW infants between January 2013 and December 2014 from 57 Korean neonatal network (KNN) centers at a corrected age of 18–24 months. Correlations among demographic data, clinical variables, and neonatal intensive care unit (NICU) volume (divided into 4 quartiles) with the occurrence of non-compliance were analyzed. The overall follow-up rate at the corrected age of 18–24 month was 65.4%. The follow-up rates were inversely related to birth weight and gestational age. Apgar score, hospital stay, maternal age, and maternal education were significantly different between the compliance and non-compliance groups. The follow-up rate was higher for mothers with chorioamnionitis, abnormal amniotic fluid, multiple pregnancy, and in vitro fertilization. Infants with respiratory distress syndrome, bronchopulmonary dysplasia, patent ductus arteriosus ligation, periventricular leukomalacia, and retinopathy of prematurity were more common in the compliance group. Follow-up rates showed significant differences according to NICU volume. Using multivariate logistic regression, high birth weight, low NICU volume, siblings, foreign maternal nationality and high 5 min APGAR scores were significant independent factors associated with the non-compliance of VLBW infants for follow-up at 18–24 months of age. This is the first nation-wide analysis of follow-up for VLBW infants in Korea. Understanding factors associated with failure of compliance could help improve the long-term follow-up rates and neurodevelopmental outcomes through early intervention.
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Affiliation(s)
- Nam Hyo Kim
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Young Ah Youn
- Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Jong-Hee Hwang
- Department of Pediatrics, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Ee-Kyung Kim
- Departmemt of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Ellen Ai-Rhan Kim
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Soon Min Lee
- Department of Pediatrics, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Lee HA, Park BH, Park EA, Cho SJ, Kim HS, Park H. Long-term effects of the SLC2A9 G844A and SLC22A12 C246T variants on serum uric acid concentrations in children. BMC Pediatr 2018; 18:296. [PMID: 30189835 PMCID: PMC6127956 DOI: 10.1186/s12887-018-1272-y] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 08/30/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND We evaluated the effects of two single-nucleotide polymorphisms on UA concentrations in the first decade of life using repeated-measures data. METHODS We included all subjects who were followed-up at least once and for whom we had both UA and genotypic data (i.e., 375, 204, 307, and 363 patients aged 3, 5, 7, and 9 years, respectively). All participated in the Ewha Birth and Growth Cohort study. We used a mixed model analysis to estimate the longitudinal association of serum UA concentration due to the rs3825017 (SLC22A12 c. 246C > T) and rs16890979 (SLC2A9 c. 844G > A) genotypes. RESULTS Overall, the tracking coefficient of UA concentrations in children 3 to 9 years of age was 0.31, and was higher in boys than in girls (0.34 vs. 0.29, respectively). Regarding individual variance, serum UA concentrations decreased as age increased (β = - 0.07, p < 0.05), but there were no significant differences by sex. The effects of rs3825017 on UA concentration were significant in boys, but not in girls. Boys with the T allele of rs3825017 had higher concentrations than their counterparts regardless of the time of follow-up. The rs16890979 genotypes were not significantly associated with serum UA concentration in either sex. CONCLUSION This study showed that rs3825017 in the SLC22A12 gene was associated with UA concentration in childhood.
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Affiliation(s)
- Hye Ah Lee
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-ku, Seoul, 158-710, Korea.,Clinical Trial Center, Mokdong Hospital, Ewha Womans University, Seoul, Korea
| | - Bo Hyun Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-ku, Seoul, 158-710, Korea
| | - Eun Ae Park
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Hae Soon Kim
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-ku, Seoul, 158-710, Korea.
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Park B, Choi EJ, Park B, Han H, Cho SJ, Choi HJ, Lee S, Park H. Factors Influencing Vaccination in Korea: Findings From Focus Group Interviews. J Prev Med Public Health 2018; 51:173-180. [PMID: 30071704 PMCID: PMC6078915 DOI: 10.3961/jpmph.18.063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 05/25/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives Immunization is considered one of the most successful and cost-effective public health interventions protecting communities from preventable infectious diseases. The Korean government set up a dedicated workforce for national immunization in 2003, and since then has made strides in improving vaccination coverage across the nation. However, some groups remain relatively vulnerable and require intervention, and it is necessary to address unmet needs to prevent outbreaks of communicable diseases. This study was conducted to characterize persistent challenges to vaccination. Methods The study adopted a qualitative method in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. Three focus group interviews were conducted with 15 professionals in charge of vaccination-related duties. The interviews were conducted according to a semi-structured guideline, and thematic analysis was carried out. Data saturation was confirmed when the researchers agreed that no more new codes could be found. Results A total of 4 main topics and 11 subtopics were introduced regarding barriers to vaccination. The main topics were vaccine hesitancy, personal circumstances, lack of information, and misclassification. Among them, vaccine hesitancy was confirmed to be the most significant factor impeding vaccination. It was also found that the factors hindering vaccination had changed over time and disproportionately affected certain groups. Conclusions The study identified ongoing unmet needs and barriers to vaccination despite the accomplishments of the National Immunization Program. The results have implications for establishing tailored interventions that target context- and group-specific barriers to improve timely and complete vaccination coverage.
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Affiliation(s)
- Bomi Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Eun Jeong Choi
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Bohyun Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyejin Han
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hee Jung Choi
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Seonhwa Lee
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
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Kong DY, Kim HJ, Kang TK, Oh SC, Cho SJ, Choi SW, Ryu SY. The Association between Facial Fracture Patterns and Traumatic Head Injury in Injured Motorcycle Riders According to Helmet Use Status. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791302000403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study was undertaken to identify the association between facial fracture patterns and traumatic head injury in injured motorcycle riders. Methods Retrospective study design. We reviewed the medical records of patients who underwent facial bone computed tomography (CT) and brain CT simultaneously among the injured motorcycle riders between May 2009 and July 2011. Data collected included age, sex, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), facial fracture patterns, head protective device (helmet) use, alcohol intake, time of accident and seat position. Facial fracture patterns were grouped as upper, mid, and lower face. Traumatic head injury (THI) included skull fracture, brain haemorrhage and diffuse axonal injury. Results Of the 154 patients included, 138 (89.6%) were male, 57 (37%) had facial fracture, 69 (44.8%) wore helmets and 30 (19.5%) had THI. Their mean age was 29.0+15.0 years. After multivariate logistic regression analysis, THI was associated with GCS, seat position of riders and accident time. THI was correlated with the combination of upper and midfacial fractures in helmeted group and isolated upper facial fracture or the combination of upper and midfacial fractures in unhelmeted group. The rest of facial fracture patterns were not correlated with THI regardless of helmet. Conclusions The combination of upper and midfacial fractures are the risk factor of THI regardless of helmet. The patients with the combination of upper and midfacial fractures should be further evaluated for head injury regardless of helmet.
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Shim SY, Cho SJ, Kong KA, Park EA. Gestational age-specific sex difference in mortality and morbidities of preterm infants: A nationwide study. Sci Rep 2017; 7:6161. [PMID: 28733681 PMCID: PMC5522396 DOI: 10.1038/s41598-017-06490-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 06/14/2017] [Indexed: 01/13/2023] Open
Abstract
This study aims to determine whether male sex has adverse effect on mortality and morbidities in very low birth weight infants (VLBWI) <30 weeks of gestation and to ascertain this sex effect, stratified by gestational age, adjusting for perinatal risk factors. This is a population-based study from Korean Neonatal Network for VLBWI born at 23+0 and 29+6 weeks of gestation between January 2013 and December 2014. The primary outcome was gestation-specific sex difference in the occurrence of mortality, combined morbidities, and individual morbidity. A total of 2228 VLBWI were enrolled (males, 51.7%). Mortality was not different between sexes. The risk of bronchopulmonary dysplasia and combined morbidities was significantly higher in males ≤25 weeks of gestation (odds ratio [OR] 2.08, 95% confidence interval [CI] 1.35-3.20 and OR 2.00, CI 1.19-3.39, respectively). Males had a significantly higher incidence of periventricular leukomalacia at 23 and 29 weeks of gestation. The risk of severe retinopathy of prematurity was higher in females >25 weeks of gestation. Although both sexes have similar risk for mortality, male sex remains an independent risk for major morbidities, especially at ≤25 weeks of gestation. The risk of each outcome for males has a specific pattern with increasing gestational age.
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Affiliation(s)
- So-Yeon Shim
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Kyoung Ae Kong
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea.
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Shim SY, Jeong HJ, Park HJ, Kwon EY, Kim BM, Choi YJ, Choi YH, Cho SJ, Choi JH, Park EA. Functional variation of SHP-2 promoter is associated with preterm birth and delayed myelination and motor development in preterm infants. Sci Rep 2017; 7:6052. [PMID: 28729690 PMCID: PMC5519743 DOI: 10.1038/s41598-017-06401-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Received: 03/31/2017] [Accepted: 06/13/2017] [Indexed: 12/18/2022] Open
Abstract
Src homology 2 domain-containing protein tyrosine phosphatase 2 (SHP-2) is a cytoplasmic tyrosine phosphatase that is highly expressed in hematopoietic cells and in the CNS and exerts opposite effects on signal transduction by exerting a neuroprotective or proapoptotic effect. Several mutations of SHP-2 have been found in children with myeloproliferative disorders or malignant leukemia, and some of these can affect brain development. In the present study, we aimed to identify and functionally characterize genetic variations in SHP-2 in 72 preterm and 58 full-term infants and to evaluate the effect of the variations on neurodevelopment in preterm infants. Twelve genetic variations were identified. Among them, two variations in the SHP-2 promoter, g.-317C > T and g.-273G > A, were found to significantly increase promoter activity, and the frequency of g.-273G > A was higher in preterm infants than in full-term infants. Two transcription factors, NF-κB and GABPα, were found to be involved in the transcriptional regulation of SHP-2 by the two above-mentioned variations. In particular, we found that g.-273G > A was significantly associated with delayed myelination and poor motor development in preterm infants. Our results suggest that a functional promoter variation in SHP-2 is associated with spontaneous preterm birth itself as well as white matter myelination and neurodevelopment.
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Affiliation(s)
- So-Yeon Shim
- Division of Neonatology, Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Hye Jin Jeong
- Neuroscience Research Institute, Gachon University, Incheon, Korea
| | - Hyo Jin Park
- Department of Pharmacology, Tissue Injury Defense Research Center, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Eun Young Kwon
- Department of Pharmacology, Tissue Injury Defense Research Center, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Bo Min Kim
- Department of Pharmacology, Tissue Injury Defense Research Center, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Yang Ji Choi
- Department of Pharmacology, Tissue Injury Defense Research Center, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Youn-Hee Choi
- Department of Physiology, Tissue Injury Defense Research Center, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Su Jin Cho
- Division of Neonatology, Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Ji Ha Choi
- Department of Pharmacology, Tissue Injury Defense Research Center, School of Medicine, Ewha Womans University, Seoul, Korea.
| | - Eun Ae Park
- Division of Neonatology, Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea.
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Park B, Lee HA, Lee SH, Park BM, Park EA, Kim HS, Cho SJ, Park H. Association Between Serum Levels of Uric Acid and Blood Pressure Tracking in Childhood. Am J Hypertens 2017; 30:713-718. [PMID: 28338917 DOI: 10.1093/ajh/hpx037] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 02/15/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Recent studies suggest that high levels of serum uric acid of very early life are a result of the in-utero environment and may lead to elevated blood pressure (BP) in adulthood. However, serum uric acid levels can change throughout life. We investigated the effect of serum uric acid levels in childhood on the BP tracking and analysed BP according to changes in serum uric acid levels in early life. METHODS A total of 449 children from the Ewha Birth and Growth Cohort study underwent at least 2 follow-up examinations. Data were collected across 3 check-up cycles. Serum uric acid levels, BP, and anthropometric characteristics were assessed at 3, 5, and 7 years of age. RESULTS Children with a serum uric acid level higher than the median values had significantly increased systolic BP (SBP) and diastolic BP at 3 years of age. Baseline serum uric acid levels measured at 3 years of age, significantly affected subsequent BP in the sex and body mass index adjusted longitudinal data analysis (P < 0.05). Considering the changing pattern of serum uric acid over time, subjects with high uric acid levels at both 3 and 5 years of age had the highest SBP at 7 years of age. CONCLUSIONS These findings suggest the importance of maintaining an adequate level of serum uric acids from the early life. Appropriate monitoring and intervention of uric acid levels in a high-risk group can reduce the risk of a future increased BP.
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Affiliation(s)
- Bohyun Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Hye Ah Lee
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Sung Hee Lee
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Bo Mi Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Eun Ae Park
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Hae Soon Kim
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Su Jin Cho
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Hyesook Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea
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Kwon JH, Lee HA, Kim YJ, Lee H, Park EA, Cho SJ, Gwak HS, Ha E, Park H, Kim HS. Effects of Adrenal Androgen Levels on Bone Age Advancement in Prepubertal Children: Using the Ewha Birth and Growth Cohort Study. J Korean Med Sci 2017; 32:968-973. [PMID: 28480655 PMCID: PMC5426240 DOI: 10.3346/jkms.2017.32.6.968] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 11/28/2016] [Accepted: 04/02/2017] [Indexed: 11/20/2022] Open
Abstract
Bone age (BA) advancement in prepubertal children may be associated with earlier onset of puberty and obesity. This study aimed to define the effects of adrenal androgen levels on the advancement of BA in prepubertal children, independent of obesity. During July and August 2011, we examined BA in 200 prepubertal children aged 7-9 years who were part of the Ewha Birth & Growth Cohort Study. BA was assessed by the Greulich-Pyle method. An index of BA advancement was calculated as the ratio of BA to chronological age (CA) (BA/CA), and this ratio was classified into 3 tertiles. We analyzed the relationship between BA advancement and anthropometric characteristics and adrenal hormone levels. The number of overweight children increased from the first group to the third group (P(Trend) = 0.03). The levels of adrenal androgens showed a significant positive correlation with the tertile groups after adjusting for age and sex (testosterone: r = 0.26, P < 0.001; dehydroepiandrosterone: r = 0.21, P < 0.001; androstenedione: r = 0.20, P < 0.001). Further, after controlling for body mass index (BMI), sex, and age, the BA/CA was found to be positively correlated with androstenedione (β = 0.04, R² = 3.7%) and testosterone levels (β = 0.05, R² = 4.7%). Based on our results, it is suggested that adrenal androgen levels are associated with BA advancement independent of BMI.
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Affiliation(s)
- Jung Hyun Kwon
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Hye Ah Lee
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
- Clinical Trial Center, Mokdong Hospital, Ewha Womans University, Seoul, Korea
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hwayoung Lee
- Department of Anatomy, Ewha Womans University College of Medicine, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hye Sun Gwak
- College of Pharmacy, Ewha Womans University, Seoul, Korea
| | - Eunhee Ha
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hae Soon Kim
- College of Pharmacy, Ewha Womans University, Seoul, Korea.
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Lee HA, Hwang HJ, Oh SY, Park EA, Cho SJ, Kim HS, Park H. Which Diet-Related Behaviors in Childhood Influence a Healthier Dietary Pattern? From the Ewha Birth and Growth Cohort. Nutrients 2016; 9:nu9010004. [PMID: 28025537 PMCID: PMC5295048 DOI: 10.3390/nu9010004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/07/2016] [Accepted: 12/15/2016] [Indexed: 01/09/2023] Open
Abstract
This study was performed to examine how childhood dietary patterns change over the short term and which changes in diet-related behaviors influence later changes in individual dietary patterns. Using food frequency questionnaire data obtained from children at 7 and 9 years of age from the Ewha Birth and Growth Cohort, we examined dietary patterns by principal component analysis. We calculated the individual changes in dietary pattern scores. Changes in dietary habits such as eating a variety of food over two years were defined as “increased”, “stable”, or “decreased”. The dietary patterns, termed “healthy intake”, “animal food intake”, and “snack intake”, were similar at 7 and 9 years of age. These patterns explained 32.3% and 39.1% of total variation at the ages of 7 and 9 years, respectively. The tracking coefficient of snack intake had the highest coefficient (γ = 0.53) and that of animal food intake had the lowest (γ = 0.21). Intra-individual stability in dietary habits ranged from 0.23 to 0.47, based on the sex-adjusted weighted kappa values. Of the various behavioral factors, eating breakfast every day was most common in the “stable” group (83.1%), whereas consuming milk or dairy products every day was the least common (49.0%). Moreover, changes in behavior that improved the consumption of milk or dairy products or encouraged the consumption of vegetables with every meal had favorable effects on changes in healthy dietary pattern scores over two years. However, those with worsened habits, such as less food variety and more than two portions of fried or stir-fried food every week, had unfavorable effects on changes in healthy dietary pattern scores. Our results suggest that diet-related behaviors can change, even over a short period, and these changes can affect changes in dietary pattern.
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Affiliation(s)
- Hye Ah Lee
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Hyo Jeong Hwang
- Biomaterials Research Institute, Sahmyook University, Seoul 01795, Korea.
| | - Se Young Oh
- Department of Food & Nutrition, Research Center for Human Ecology, College of Human Ecology, Kyung Hee University, Seoul 02447, Korea.
| | - Eun Ae Park
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Su Jin Cho
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Hae Soon Kim
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Hyesook Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
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Yu SJ, Kim HJ, Lee ES, Park CG, Cho SJ, Jeon SH. β-Catenin Accumulation Is Associated With Increased Expression of Nanog Protein and Predicts Maintenance of MSC Self-Renewal. Cell Transplant 2016; 26:365-377. [PMID: 27684957 DOI: 10.3727/096368916x693040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Human mesenchymal stem cells (hMSCs) are self-renewing cells with the ability to differentiate into organized, functional network of cells. Recent studies have revealed that activation of the Wnt/β-catenin pathway by a glycogen synthase kinase (GSK)-3-specific pharmacological inhibitor, Bio, results in the maintenance of self-renewal in both mouse and human ES cells. The molecular mechanism behind the maintenance of hMSCs by these factors, however, is not fully understood. We found that rEGF enhances the level of β-catenin, a component of the Wnt/β-catenin signaling pathway. Furthermore, it was found that β-catenin upregulates Nanog. EGF activates the β-catenin pathway via the Ras protein and also increased the Nanog protein and gene expression levels 2 h after rEGF treatment. These results suggest that adding EGF can enhance β-catenin and Nanog expression in MSCs and facilitate EGF-mediated maintenance of MSC self-renewal. EGF was shown to augment MSC proliferation while preserving early progenitors within MSC population and thus did not induce differentiation. Thus, EGF not only can be used to expand MSC in vitro but also be utilized to autologous transplantation of MSCs in vivo.
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Jeong HJ, Shim SY, Cho HJ, Cho SJ, Son DW, Park EA. Cerebellar Development in Preterm Infants at Term-Equivalent Age Is Impaired after Low-Grade Intraventricular Hemorrhage. J Pediatr 2016; 175:86-92.e2. [PMID: 27283462 DOI: 10.1016/j.jpeds.2016.05.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 01/28/2016] [Revised: 04/04/2016] [Accepted: 05/04/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To investigate cerebellar development in preterm infants at term-equivalent age compared with healthy full-term infants and to examine the effect of a low-grade intraventricular hemorrhage (IVH) on cerebellar development. STUDY DESIGN This study used 3T magnetic resonance and diffusion tensor imaging (DTI) at 36-41 weeks' postmenstrual age (PMA) in 72 preterm infants without severe brain injury and 16 full-term infants. Cerebellar volumes and DTI parameters of the cerebellar peduncles including fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity, and radial diffusivities were measured. Clinical variables that may affect brain development were collected. RESULTS Compared with full-term infants, preterm infants showed smaller cerebellar volumes and a lower FA, greater ADC, and increased radial diffusivities in the cerebellar peduncles (all P < .05). This cerebellar impairment was associated significantly with PMA and IVH grade 2 but was independent of gestational age at birth. When we adjusted for clinical variables, an IVH grade 2 was related with 1.73 cm(3) reduction in cerebellar volumes and altered DTI parameters in the cerebellar peduncles, including decreased FA and increased radial diffusivities in the superior cerebellar peduncle and increases in ADC, axial diffusivity, and radial diffusivities of the middle cerebellar peduncle (all P < .05). Cerebellar hemispheric volumes were associated with both ipsilateral and contralateral IVH grade 2. CONCLUSION Preterm infants without severe brain abnormalities showed impaired cerebellar development at term-equivalent age after we controlled for PMA at the time of the scan, and this is associated with IVH grade 2. These findings suggest that even a low-grade IVH has potential harmful effects on cerebellar development.
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Affiliation(s)
- Hye Jin Jeong
- Neuroscience Research Institute, Gachon University, Incheon, Korea
| | - So-Yeon Shim
- Division of Neonatology, School of Medicine, Ewha Womans University, Seoul, Korea.
| | - Hye Jung Cho
- Division of Neonatology, Gachon University, Gil Hospital, Incheon, Korea
| | - Su Jin Cho
- Division of Neonatology, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Dong Woo Son
- Division of Neonatology, Gachon University, Gil Hospital, Incheon, Korea
| | - Eun Ae Park
- Division of Neonatology, School of Medicine, Ewha Womans University, Seoul, Korea
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Abstract
The association of preterm birth with obesity and metabolic syndrome later in life is well established. Although the biological mechanism for this association is poorly understood, epigenetic alterations of metabolic-related genes in early life may have important roles in metabolic dysfunction. Thus, we investigated the associations of DNA methylations of melanocortin 4 receptor (MC4R) and hepatocyte nuclear factor 4 alpha (HNF4α) with metabolic profiles in cord blood of term and preterm infants.We measured metabolic profiles in cord blood samples of 85 term and 85 preterm infants. DNA methylation and mRNA expression levels of MC4R and HNF4α in cord blood cells were quantified using pyrosequencing and real-time PCR. Triglyceride (TG) levels were grouped by percentile as low (<10th percentile), mid (11th-89th percentiles), and high (>90th percentile). A multiple linear regression model was used to assess the differential effects of DNA methylation on metabolic indices in cord blood between term and preterm infants.The beta-coefficients for associations between TG levels and methylation statuses of MC4R-CpG3 and HNF4α-CpG2 in the P1 promoter differed significantly between term and preterm infants (P = 0.04 and P = 0.003, respectively). DNA methylation statuses of MC4R-CpG3 and HNF4α-CpG2 in the P1 promoter were significantly lower in preterm infants in the high-TG group compared with those in the mid- and low-TG groups (P = 0.01). Notably, preterm infants in the high-TG group had higher TG levels in cord blood than term infants in the high-TG group (60.49 vs 54.57 mg/dL). In addition, MC4R and HNF4α expression levels were higher in preterm infants than in term infants (P < 0.05).Epigenetic alterations of the newly identified genes MC4R and HNF4α in early life might contribute to metabolic profile changes, especially increased TG levels, in the cord blood of preterm infants.
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Affiliation(s)
- Eun Jin Kwon
- Department of Obstetrics and Gynecology
- Department of Occupational and Environmental Medicine
| | | | | | | | - Su Jin Cho
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Eun Hee Ha
- Department of Occupational and Environmental Medicine
| | - Young Ju Kim
- Department of Obstetrics and Gynecology
- Correspondence: Young Ju Kim, Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-ku, Seoul 158-710, Republic of Korea (e-mail: )
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Kim ARE, Kim HS, Cho SJ, Choi YS, Kim ES, Park HW, Cheon YH, Park MS, Chang YS, Kim YH, Kim DY, Yoon HJ, Kim YH, Chung SP, Hwang SO. Part 7. Neonatal resuscitation: 2015 Korean Guidelines for Cardiopulmonary Resuscitation. Clin Exp Emerg Med 2016; 3:S62-S65. [PMID: 27752647 PMCID: PMC5052916 DOI: 10.15441/ceem.16.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/19/2016] [Accepted: 03/19/2016] [Indexed: 11/23/2022] Open
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Lee JH, Lee YS, Shim SY, Cho SJ, Park EA, Chung SS, Park S. Tailgut Cyst in a Neonate: A Case Report. J Pathol Transl Med 2016; 50:315-7. [PMID: 27048241 PMCID: PMC4963966 DOI: 10.4132/jptm.2015.11.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 11/25/2015] [Accepted: 11/27/2015] [Indexed: 12/23/2022] Open
Affiliation(s)
- Ji Hyen Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yun Suk Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - So Yeon Shim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Soon Sup Chung
- Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea
| | - Sanghui Park
- Department of Pathology, Ewha Womans University School of Medicine, Seoul, Korea
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Cho SJ, Cox-Ganser JM, Park JH. Observational scores of dampness and mold associated with measurements of microbial agents and moisture in three public schools. Indoor Air 2016; 26:168-78. [PMID: 25650175 PMCID: PMC4526443 DOI: 10.1111/ina.12191] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 01/27/2015] [Indexed: 05/06/2023]
Abstract
We examined associations between observational dampness scores and measurements of microbial agents and moisture in three public schools. A dampness score was created for each room from 4-point-scale scores (0-3) of water damage, water stains, visible mold, moldy odor, and wetness for each of 8 room components (ceiling, walls, windows, floor, ventilation, furniture, floor trench, and pipes), when present. We created mixed microbial exposure indices (MMEIs) for each of 121 rooms by summing decile ranks of 8 analytes (total culturable fungi; total, Gram-negative, and Gram-positive culturable bacteria; ergosterol; (1→3)-β-D-glucan; muramic acid; and endotoxin) in floor dust. We found significant (P ≤ 0.01) linear associations between the dampness score and culturable bacteria (total, Gram-positive, and Gram-negative) and the MMEIs. Rooms with dampness scores greater than 0.25 (median) had significantly (P < 0.05) higher levels of most microbial agents, MMEIs, and relative moisture content than those with lower scores (≤0.25). Rooms with reported recent water leaks had significantly (P < 0.05) higher dampness scores than those with historical or no reported water leaks. This study suggests that observational assessment of dampness and mold using a standardized form may be valuable for identifying and documenting water damage and associated microbial contamination.
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Affiliation(s)
- S J Cho
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - J M Cox-Ganser
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - J-H Park
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, WV, USA
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Cho SJ, Lee HA, Park BH, Ha EH, Kim YJ, Park EA, Park H. Combined effect of folate and adiposity on homocysteine in children at three years of age. Nutr Res Pract 2016; 10:74-80. [PMID: 26865919 PMCID: PMC4742314 DOI: 10.4162/nrp.2016.10.1.74] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 11/25/2015] [Accepted: 11/25/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND/OBJECTIVES Cardiovascular diseases is a major cause of death and is responsible for 23.8% of deaths in Korea. Clinical symptoms manifest in adulthood, but susceptibility begins in utero. Elevated homocysteine levels and adiposity might be linked to a greater risk in children as well as adults. We hypothesized that those who have simultaneous risk for folate and adiposity would be affected with elevated homocysteine levels at 3 years of age. SUBJECTS/METHODS From the ongoing birth cohort at Ewha Womans University Mok-Dong Hospital, we compared adiposity parameters, serum homocysteine, and folate levels in 238 children (118 boys and 120 girls) at three years of age. The relationship between birth outcome, current weight and body mass index (BMI), postnatal growth, and homocysteine level were assessed using correlation and general linear model. Additionally, we assessed the combined effect between blood folate status and adiposity on current homocysteine levels. RESULTS Birth characteristics were not correlated with homocysteine. Current weight, BMI, upper-arm circumference, skinfold thickness, waist circumference, and hip circumference were positively correlated with homocysteine at three years of age (P < 0.05). Folate level was negatively correlated with homocysteine at three years of age (P < 0.0001). A relative high anthropometric measure which is compatible with adiposity and low folate level was associated with high homocysteine levels. CONCLUSION We found a combined effect of adiposity and folate levels with homocysteine levels at three years of age. This implicates the beneficial role of folate supplementation in the high-risk population at an early age.
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Affiliation(s)
- Su Jin Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea
| | - Hye Ah Lee
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul 07985, Korea
| | - Bo Hyun Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul 07985, Korea
| | - Eun Hee Ha
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul 07985, Korea
| | - Young Ju Kim
- Department of Obstetrics, Ewha Womans University School of Medicine, Seoul 07985, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul 07985, Korea
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Lee H, Shim SY, Park EA, Cho SJ. The Clinical Features and Prognosis of Nephrocalcinosis in Preterm Neonates : A Single Center Study in Korea. Neonatal Med 2016. [DOI: 10.5385/nm.2016.23.3.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Hyunju Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - So Yeon Shim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
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Lee H, Lee SW, Shim SY, Park EA, Cho SJ. Neonatal Group B Streptococcal Meningitis Complicated with Secondary Hypopituitarism: A Case Report. Neonatal Med 2016. [DOI: 10.5385/nm.2016.23.4.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Hyunju Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Sang Won Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - So Yeon Shim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
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Cho SJ, Shin J, Namgung R. Initial Resuscitation at Delivery and Short Term Neonatal Outcomes in Very-Low-Birth-Weight Infants. J Korean Med Sci 2015; 30 Suppl 1:S45-51. [PMID: 26566357 PMCID: PMC4641063 DOI: 10.3346/jkms.2015.30.s1.s45] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 04/14/2015] [Accepted: 07/30/2015] [Indexed: 11/20/2022] Open
Abstract
Survival of very-low-birth-weight infants (VLBWI) depends on professional perinatal management that begins at delivery. Korean Neonatal Network data on neonatal resuscitation management and initial care of VLBWI of less than 33 weeks gestation born from January 2013 to June 2014 were reviewed to investigate the current practice of neonatal resuscitation in Korea. Antenatal data, perinatal data, and short-term morbidities were analyzed. Out of 2,132 neonates, 91.7% needed resuscitation at birth, chest compression was performed on only 104 infants (5.4%) and epinephrine was administered to 80 infants (4.1%). Infants who received cardiac compression and/or epinephrine administration at birth (DR-CPR) were significantly more acidotic (P < 0.001) and hypothermic (P < 0.001) than those who only needed positive pressure ventilation (PPV). On logistic regression, DR-CPR resulted in greater early mortality of less than 7 days (OR, 5.64; 95% CI 3.25-9.77) increased intraventricular hemorrhage ≥ grade 3 (OR, 2.71; 95% CI 1.57-4.68), periventricular leukomalacia (OR, 2.94; 95% CI 1.72-5.01), and necrotizing enterocolitis (OR, 2.12; 95% CI 1.15-3.91) compared with those infants who needed only PPV. Meticulous and aggressive management of infants who needed DR-CPR at birth and quality improvement of the delivery room management will result in reduced morbidities and early death for the vulnerable VLBWI.
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Affiliation(s)
- Su Jin Cho
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Jeonghee Shin
- Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
| | - Ran Namgung
- Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
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Lee DK, Shim SY, Cho SJ, Park EA, Lee SW. Comparison of gastric and other bowel perforations in preterm infants: a review of 20 years' experience in a single institution. Korean J Pediatr 2015; 58:288-93. [PMID: 26388893 PMCID: PMC4573442 DOI: 10.3345/kjp.2015.58.8.288] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 07/28/2014] [Revised: 09/28/2014] [Accepted: 10/20/2014] [Indexed: 01/15/2023]
Abstract
Purpose In this study, we aimed to review the clinical presentation of preterm infants with gastrointestinal perforations and compare the clinical features of gastric perforation with other intestinal perforations. Methods The medical records of preterm neonates with pneumoperitoneum, admitted to the neonatal intensive care unit (NICU) between January 1994 and December 2013, were retrospectively reviewed. Results Twenty-one preterm infants underwent exploratory laparotomy to investigate the cause of the pneumoperitoneum. The sample consisted of five patients (23.8%) with gastric perforation and 16 patients (76.2%) with intestinal perforation. No statistical differences were found in the birth history and other perinatal factors between the two groups. Underlying necrotizing enterocolitis, bilious vomiting, and paralytic ileus preceding the perforation were statistically more common in the intestinal perforation group. All preterm infants with gastric perforation survived to discharge; however, six preterm infants with intestinal perforation expired during treatment in the NICU. In the gastric perforation group, sudden pneumoperitoneum was the most common finding, and the mean age at diagnosis was 4.4±1.7 days of life. The location and size of the perforations varied, and simple closure or partial gastrectomy was performed. Conclusion Patients with gastric perforation did not have a common clinical finding preceding the perforation diagnosis. Although mortality in previous studies was high, all patients survived to discharge in the present study. When a preterm infant aged less than one week presents with sudden abdominal distension and pneumoperitoneum, gastric perforation should first be excluded. Prompt exploratory laparotomy will increase the survival rates of these infants.
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Affiliation(s)
- Do Kyung Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - So Yeon Shim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Sun Wha Lee
- Department of Radiology, Ewha Womans University School of Medicine, Seoul, Korea
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Kwon JH, Lee SE, Lee HA, Kim YJ, Lee HY, Gwak HS, Park EA, Cho SJ, Oh SY, Ha EH, Park H, Kim HS. Relationship of serum 25-Hydroxyvitamin D (25[OH]D) levels and components of metabolic syndrome in prepubertal children. Nutrition 2015; 31:1324-7. [PMID: 26283573 DOI: 10.1016/j.nut.2015.04.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 04/28/2015] [Accepted: 04/30/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The relationship between 25-hydroxyvitamin D (25[OH]D) levels and the lipid and metabolic levels of the prepubertal normal population is unclear. Our goals were to investigate the association of serum 25(OH)D concentrations with lipid and metabolic levels in Korean prepubertal children ages 7-9 y. METHODS We followed 205 children, ages 7-9 y in the Ewha Birth and Growth Cohort study, a prospective cohort sample established in 2001-2006, from July to August 2011. We studied the association of serum 25-hydroxyvitamin D (25[OH]D) levels with components of metabolic syndrome and insulin resistance indices using multivariate regression analysis adjusted for body mass index (BMI) z-scores. RESULTS The mean age of the 205 subjects was 7.89 ± 0.85 y, and the sample included 109 boys (53.2%). The average 25(OH)D levels of all participants was 25.0 ± 5.4 ng/mL. After adjustment for age and sex, triacylglycerol levels were significantly associated with 25(OH)D (β = -0.02, P = 0.02) concentrations even after adjustment for BMI z-scores (β = -0.02, P = 0.04). However, other metabolic components were not correlated with 25(OH)D status. Those with the lowest quartile of 25(OH)D levels had the highest serum triacylglycerol levels (P = 0.04, Ptrend = 0.01). CONCLUSIONS We found that serum 25(OH)D levels were negatively associated with serum triacylglycerol levels, even independently of adiposity, in prepubertal children. This study suggests that 25(OH)D insufficiency is related to metabolic syndrome via the derangement of triacylglycerol metabolism.
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Affiliation(s)
- Jung Hyun Kwon
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Seung Eun Lee
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Hye Ah Lee
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Hwa Young Lee
- Department of Anatomy, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Hye Sun Gwak
- College of Pharmacy, Ewha Womans University, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Se Young Oh
- Department of Food and Nutrition, Kyung Hee University, Seoul, Korea
| | - Eun Hee Ha
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
| | - Hae Soon Kim
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea.
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Abstract
Debriefing is a conversational session that revolves around the sharing and examining of information after a specific event has taken place. Debriefing may follow a simulated or actual experience and provides a forum for the learners to reflect on the experience and learn from their mistakes. Originating from the military and aviation industry, it is used on a daily basis to reflect and improve the performance in other high-risk industries. Expert debriefers may facilitate the reflection by asking open-ended questions to probe into the framework of the learners and apply lessons learned to future situations. Debriefing has been proven to improve clinical outcomes such as the return of spontaneous circulation after cardiac arrest and the teaching of teamwork and communication in pediatrics. Incorporating debriefing into clinical practice would facilitate the cultural change necessary to talk more openly about team performance and learn from near misses, errors, and successes that will improve not only clinical outcome but also patient safety.
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Affiliation(s)
- Su Jin Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
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Kim KH, Seoh JY, Cho SJ. Phenotypic and functional analysis of HL-60 cells used in opsonophagocytic-killing assay for Streptococcus pneumoniae. J Korean Med Sci 2015; 30:145-50. [PMID: 25653484 PMCID: PMC4310939 DOI: 10.3346/jkms.2015.30.2.145] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [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: 08/14/2014] [Accepted: 09/25/2014] [Indexed: 11/20/2022] Open
Abstract
Differentiated HL-60 is an effector cell widely used for the opsonophagocytic-killing assay (OPKA) to measure efficacy of pneumococcal vaccines. We investigated the correlation between phenotypic expression of immunoreceptors and phagocytic ability of HL-60 cells differentiated with N,N-dimethylformamide (DMF), all-trans retinoic acid (ATRA), or 1α, 25-dihydroxyvitamin D3 (VitD3) for 5 days. Phenotypic change was examined by flow cytometry with specific antibodies to CD11c, CD14, CD18, CD32, and CD64. Apoptosis was determined by flow cytometry using 7-aminoactinomycin D. Function was evaluated by a standard OPKA against serotype 19F and chemiluminescence-based respiratory burst assay. The expression of CD11c and CD14 gradually increased upon exposure to all three agents, while CD14 expression increased abruptly after VitD3. The expression of CD18, CD32, and CD64 increased during differentiation with all three agents. Apoptosis remained less than 10% until day 3 but increased after differentiation by DMF or ATRA. Differentiation with ATRA or VitD3 increased the respiratory burst after day 4. DMF differentiation showed a high OPKA titer at day 1 which sustained thereafter while ATRA or VitD3-differentiated cells gradually increased. Pearson analysis between the phenotypic changes and OPKA titers suggests that CD11c might be a useful differentiation marker for HL-60 cells for use in pneumococcal OPKA.
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Affiliation(s)
- Kyung-Hyo Kim
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Ju Young Seoh
- Department of Microbiology, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
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Lee JM, Lee SB, Shim SY, Cho SJ, Park EA. Causes and Neonatal Outcome of Early-Onset Thrombocytopenia in Preterm Neonates. Neonatal Med 2015. [DOI: 10.5385/nm.2015.22.3.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Jung Min Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Seul Bee Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - So Yeon Shim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
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Lee JM, Lee SB, Lee SW, Shim SY, Cho SJ, Park EA, Huh JW. A Case of Langer-Giedion Syndrome with a De Novo Del(8)(q23q24.1). Neonatal Med 2015. [DOI: 10.5385/nm.2015.22.2.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Jung Min Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Seul Bee Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Sang Won Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - So Yeon Shim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jung Won Huh
- Department of Laboratory Medicine, Ewha Womans University School of Medicine, Seoul, Korea
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Chu M, Cho SJ, Kim WJ, Kim JM. EHMTI-0075. Is insomnia associated with migraineurs attributable to anxiety and depression? J Headache Pain 2014. [PMCID: PMC4180186 DOI: 10.1186/1129-2377-15-s1-d10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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