PURPOSE: Perinatal hypoxic-ischemic (HI) brain injury remains a common cause of chronic handicapping conditions of cerebral palsy, mental retardation, learning disability, and epilepsy. HI brain injury induces cell death via either necrosis or apoptosis. Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family. It plays key roles in survival, differentiation, and maintenance of neurons. This study was to investigate the neuroprotective effects of BDNF via the mechanisms of anti-apoptosis in HI brain injury by using cortical astrocyte and neuronal cell culture. METHODS: Cortical astrocytes culture of 1-day-old Sprague-Dawley (SD) rat pups and embryonic cortical neuronal cell culture of SD rats at 14-day gestation were done. The Normoxia group was prepared in 5% CO2 incubators and the Hypoxia group and Hypoxia+BDNF group (after treatment with BDNF for 24 hours) were placed in 1% O2 incubators (94% N2, 5% CO2) for 6 or 18 hours. The expression of Bcl-2 and Bax were assessed by real-time PCR and western blot. The caspase-3 activation was evaluated by caspase activity assay kit. RESULTS: In astrocyte and neuronal cell, the expressions of Bcl-2 in the hypoxia groups were reduced compared to the normoxia groups, whereas, those in the Hypoxia+BDNF groups were increased compared to the hypoxia groups. However, the expressions of Bax and caspase-3 and the ratio of Bax/Bcl-2 were revealed reversely. In astrocyte, Hypoxia group for 6 hours was not significantly altered in Bcl-2, Bax expressions. CONCLUSION: BDNF neuroprotective effects on HI brain injury in neonatal rats may occur via anti-apoptotic mechanism.
Animals ; Anoxia ; Apoptosis ; Astrocytes ; Blotting, Western ; Brain Injuries ; Brain* ; Brain-Derived Neurotrophic Factor* ; Caspase 3 ; Cell Culture Techniques ; Cell Death ; Cerebral Palsy ; Epilepsy ; Humans ; Incubators ; Intellectual Disability ; Learning Disorders ; Necrosis ; Neurons ; Neuroprotective Agents ; Pregnancy ; Rats* ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction

Gestational diabetes mellitus (GDM) is an important disease which complicates pregnant woman and fetus. Large for gestational age (LGA) is one of the primary complications and is closely associated with the hyperglycemia of pregnant woman. Although strict control of blood glucose can decrease the occurrence of LGA, the rate of LGA in GDM pregnancy is higher than that of normal pregnancy. Understanding of the difference of fetal growth between LGA and adequate for gestational age in GDM pregnancy and consideration about the time and marker for prediction and prevention of LGA in GDM pregnancy are helpful for prenatal care of GDM pregnancy. In this article, the prediction and prevention of LGA in GDM pregnancy will be discussed.
Blood Glucose ; Diabetes, Gestational* ; Female ; Fetal Development ; Fetus ; Gestational Age* ; Humans ; Hyperglycemia ; Pregnancy ; Pregnant Women ; Prenatal Care

Babies born small for gestational age (SGA) are at risks of developing growth failure and impaired neurodevelopment as long-term outcomes when nutritional supply is inadequate during postnatal period. However, metabolic outcomes and cardiovascular risks later in life also do matter when excessive nutritional intake induces rapid catch-up growth after birth. Preterm infants born SGA and still small at hospital discharge need more nutrients than term infants to catch up within the first 2 years, whereas term infants born SGA should be cautious in gaining weight anytime. Therefore, nutritional strategies for optimal growth of SGA infants should be planned individually based on evidences.
Gestational Age* ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Parturition

Rotavirus is the most common cause of infectious gastroenteritis in infants and young children and estimated to cause more than 111 million cases of diarrhea annually. Most patients show no specific symptom or experience mild fever, vomiting, non-bloody diarrhea and symptoms often resolve within several days. However, some of patients suffer from severe complication such as necrotizing enterocolitis, intussusception, seizure, encephalitis, and cholestasis. We report a neonatal case of rotavirus infection presenting with reversible direct hyperbilirubinemia with a brief review of associated literatures.
Child ; Cholestasis ; Diarrhea ; Encephalitis ; Enterocolitis, Necrotizing ; Fever ; Gastroenteritis ; Humans ; Hyperbilirubinemia* ; Infant ; Infant, Newborn ; Intussusception ; Rotavirus Infections* ; Rotavirus* ; Seizures ; Vomiting

Pheochromocytoma is an extremely rare tumor in pregnant women with potentially fatal consequences. We report a case of pregnant woman at 22 weeks of gestation with pheochromocytoma. A correct diagnosis on the basis of differential clues from severe preeclampsia was obtained and laparoscopic adrenalectomy was performed.
Adrenalectomy* ; Diagnosis ; Female ; Humans ; Laparoscopy ; Pheochromocytoma* ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women

PURPOSE: This study was conducted to analyze recent trends and causes of maternal mortality in Korea between 2009 and 2014. METHODS: We investigated trends and causes of maternal death using the data from Complementary Investigations on the Infant, Maternal, and Perinatal Mortality carried out by Statistics Korea between 2009 and 2014. Maternal age, administrative district, causes of death and gestational age at the time of death were collected from data. Statistics including maternal mortality ratio (MMR) and maternal mortality rate were calculated. We also analyzed MMR according to the age, and administrative districts. The causes of maternal death were sorted and classified using International Classification of Diseases and World Health Organization recommendations. RESULTS: The average MMR during 6 years was 13.16 and maternal mortality rate was 0.45. MMR was highest in 2011 (17.2) and lowest in 2012 (9.9). The average MMR of the administrative districts varied greatly from 7.51 (Gwangju) to 26.84 (Jeju). The average MMR during the study period was lowest in maternal age of 20-24 (6.9), and highest in 45-49 (143.7). On average, direct and indirect maternal deaths accounted for 66.2% and 29.9% of total maternal death, respectively. The three most common causes of maternal deaths were obstetrical embolism (24.4%), postpartum hemorrhage (18.3%), and hypertensive disease of pregnancy (5.5%) in decreasing order of frequency. CONCLUSION: Although MMR is decreasing during the study period, it fluctuates widely according to maternal age, districts, and constant effort for improvements is necessary. To reduce maternal deaths, solution to control preventable causes of maternal deaths, careful management of pregnancies with advanced maternal age, and policy to solve the discrepancy in the medical services among diverse regions in the country are needed.
Cause of Death ; Embolism ; Gestational Age ; Humans ; Infant ; International Classification of Diseases ; Korea* ; Maternal Age ; Maternal Death ; Maternal Mortality* ; Perinatal Mortality ; Postpartum Hemorrhage ; Pregnancy ; World Health Organization

PURPOSE: Epidural hematoma (EDH) in newborn is very rare, but when it occurs it is usually due to birth injury. We have evaluated the incidence and clinical features of EDH related to birth in newborn. METHODS: We analyzed medical records of 12 newborns diagnosed with EDH at Cheil General Hospital and Women's Health Care Center from January 2000 to December 2015 retrospectively. RESULTS: The incidence of EDH related to birth was 0.01%, occurring in 1 of 10,000 live births. Of the total 12 cases, 10 occurred in male and 8 in vaginal delivery. Among them, 11 infants had evidences of birth injury. Clinical presentation was nonspecific: only 1 infant had neurologic symptoms. The temporooccipital area was the most frequent location of EDH. The median size of EDH was 3.2±0.8 cm in length and 1.2±0.7 cm in depth. Mass effect accompanied with midline shift on radiologic imaging was shown in one case. Surgical drainage was needed only in one infant with neurologic symptom and mass effect on radiologic imaging, while the others were treated conservatively. CONCLUSION: Neonatal EDH related to birth was treated conservatively in most cases. The radiologic mass effect and neurologic symptom should be considered as indication for surgical intervention.
Birth Injuries ; Drainage ; Hematoma* ; Hospitals, General ; Humans ; Incidence ; Infant ; Infant, Newborn* ; Live Birth ; Male ; Medical Records ; Neurologic Manifestations ; Parturition* ; Retrospective Studies ; Women's Health

Glucose is essential for energy metabolism in human, especially in brain, and is a source of energy storage in the form of glycogen, fat and protein. During fetal life, the predominant source of energy is also glucose, which crosses the placenta by facilitated diffusion. There is very little endogenous glucose production under normal circumstances during fetal life. During labor, the fetus is exposed to physiological challenges that require metabolic adaptation. A healthy infant successfully manages the postnatal transition by mobilizing and using alternative. After birth, there is a rapid surge in catecholamine and glucagon levels, and a steady decrease in insulin, as blood glucose levels decline. These hormonal changes induce enzyme activities that lead to glycogenolysis and gluconeogenesis. During the first 24-48 hours of life, plasma glucose concentrations of neonates are typically lower than later in life. Distinguishing between transitional neonatal glucose regulation in normal neonates and hypoglycemia that persists or occurs for the first time beyond the first 72 hours of life is important for prompt diagnosis and treatment to avoid serious consequences.
Blood Glucose ; Brain ; Diagnosis ; Energy Metabolism ; Facilitated Diffusion ; Fetus ; Glucagon ; Gluconeogenesis ; Glucose* ; Glycogen ; Glycogenolysis ; Homeostasis* ; Humans ; Hypoglycemia ; Infant ; Infant, Newborn ; Insulin ; Parturition ; Placenta

In this article, the third author's name was published incorrectly.

The preoperative diagnosis of uterine torsion is very difficult due to the rarity of this disorder and its nonspecific clinical course. A primigravida woman visited our hospital with severe abdominal pain at 34 weeks of gestation. Emergency cesarean section was carried out due to development of fetal distress and severe abdominal pain. During the cesarean section, we noticed the uterus was rotated 180 degrees and the torsion was corrected after the delivery by making a vertical incision at the posterior uterine wall. High degree of suspicion and prompt management are important factors contributing to good prognosis of uterine torsion.
Abdominal Pain ; Cesarean Section ; Diagnosis ; Emergencies ; Female ; Fetal Distress ; Humans ; Pregnancy ; Pregnancy Trimester, Third* ; Prognosis ; Uterus