No abstract available.
Respiratory Sounds*

PURPOSE: To analyze the significance of interleukin-6 (IL-6) concentration and Ureaplasma urealyticum (UU) from tracheal aspirates (TA) taken immediately after birth in the development of chronic lung disease of prematurity (CLD), and to analyze the risk factors for CLD according to the preceding illnesses. METHODS: A retrospective cohort study was done in 75 inborn preterm infants admitted to a university hospital NICU and intubated at birth for the respiratory care. TA was taken to measure IL-6 by ELISA and to perform UU PCR. The patients were grouped into four, according to the history of respiratory distress syndrome (RDS) and chorioamnionitis (CA). RESULTS: PCR positive rate of UU was 25.3%. Positive PCR was significantly frequent in the patients with CLD or CA. IL-6 in TA was significantly higher with CLD, CA, or positive PCR. Risk factors for CLD were increased IL-6, positive UU PCR, and PDA in all patients. The risk factors for CLD were PDA in RDS(+)CA(-) group [OR 2.11; 95% CI 1.15-3.89]; PDA [OR 12.0; 95% CI 2.50-57.67] and IL-6 (>284.7 pg/mL) [OR 3.75; 95% CI 1.01-13.90] in RDS(+)CA(+) group; and IL-6 (>284.7 pg/mL) [OR 8.25; 95% CI 1.54-44.14] in RDS(-)CA(+) group. CONCLUSION: PDA was a risk factor for CLD following RDS and increased IL-6 for CLD following CA. Inflammatory response of fetal lung, measured by IL-6 and UU PCR in TA at birth in preterm infants, was associated with CA and might be a risk factor for the development of CLD.
Bronchopulmonary Dysplasia ; Chorioamnionitis ; Cohort Studies ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Interleukin-6* ; Lung Diseases* ; Lung* ; Parturition* ; Polymerase Chain Reaction* ; Pregnancy ; Retrospective Studies ; Risk Factors* ; Ureaplasma urealyticum* ; Ureaplasma*

We analyzed neurodevelopmental outcome data of 36 selected studies. Data of individual studies were pooled by birth weight group: <800g, <1.000g, <1.500g and by time period of birth year: Period I (pre-intensive care era), 1960-67:Period II (beginning period of intensive care), 1968-76: and Period III (established period of intensive care), 1977-87. In all weight groups, survival and intact outcome rates based on live birth have progressively improved over the three period. The major neurodevelopmental handicap rate of the <1,500g decreased in Period III vs. Period I and Period II (66,70, and 45 per 1,000 live births in I, II, and III, respectively). However, the major handicap rate in the <800g and the <1,000g live births increased: in the <800g, from 48 per 1,000 live births in Period II to 101 in Period III and, in the <1000g, from 28 per 1,000 live births in Period I to 67 in Period II and 73 in Period III. Increases in major handicap rate in two lower weight groups were predominantly the effect of increasing number of survivors over these periods and had little to do with the change in handicap rates in the survivors. In the <1,500g, the magnitude of reduction in handicap rate in the survivors was sufficient to overwhelm the effect of increased survival, resulting in a reduction in the number of major handicapped children. We conclude that based on the currently avaiable reports, neonatal intensive care has provided very low birth weight infants with a reduction in mortality, an increase in intact outcome, and decrease in the number of major neurodevelopmentally handicapped children. We try to estimate the trend of major neurodevelopmental handicap and intactoutcome of infants with birth weights <1,500g in Korea and speculate that major handicap rate have progressively increased over the three period in spite of increase in intact outcome.
Birth Weight ; Disabled Children ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal* ; Korea ; Live Birth ; Mortality ; Parturition ; Survivors

No abstract available.
Animals ; Extracellular Matrix* ; Hyaluronic Acid* ; Hyperoxia* ; Lung Injury* ; Lung* ; Rats*

We studied the effects of chronic hyperoxia (>95% oxygen for 14 days) in change of body weight, wet to dry lung weight ratio, and morphologic changes of lung tissue compared with that of room air (21% oxygen for 14 days) in Sprague-Dawley neonatal rat pups. The results were as follows: 1) In neonatal rat pups exposed to room air (normoxia group), body weight of initial 3 days of neonatal rat pups was 9.18 0.18g, and body weights of developing rat pups exposed to room air for 7, 10, 14 days were 14.07 1.90, 17.00 2.09, 23.07 1.93g respectively. In neonatal rat pups exposed to hyperoxia (hyperoxia group), body weight of initial 3 days of neonatal rat pups was 9.35 0.80 g, and body weights of developing rat pups exposed to hyperoxia for 7, 10, 14 days were 11.06 1.31, 12.64 1.77, 15,41 1.65 g respectively. These results suggest that changes of body weight in developing rat pups were stunted significantly in the hyperoxia group compared with normoxia group during 14days-experiment (p<0.01). 2) No appreciable difference of wet to dry lung weight ratio was noted at initial 3 days of neonatal rat pups between normoxia group and hyperoxia group, but considerably increased wet to dry lung weight ratio was noted significantly at 7 days of exposure in the hyperoxia group compared with the normoxia group (p<0.05). The difference of wet to dry lung weight ratio was not significant at 10, 14 days of exposure between normoxia group and hyperoxia group. These results suggested that relative water content of wet lung was at a peak at 7 days of exposure in hyperoxia group. 3) The lung from developing rat pups exposed to room air for 7 days had many small alveoli and numerous septal buds. However, in the lung from developing rat pups exposed to hyperoxia for 7 days, presence of pink staining material within the lumen of the air spaces (proteinaceous edema fluid) and increased interstitial cellularity due to infiltration by macrophages and neutrophils was observed, and these findings suggested acute exudative lung injury. 4) In most lungs from developing rat pups exposed to room air for 14 days, much increased alveolarization including the secondary septal bud formation was observed. However, in most lungs from developing rat pups exposed to hypeoxia for 14 days, increased septal and interstitial cellularity and thickness and interstitial fibrosis were observed significantly compared with normoxia group (p<0.01). In conclusion we could make a experimental animal model which had similar histopathologic finding of bronchopulmonary dysplasia in human infant and this model will be useful for research of pathogenesis of bronchopulmonary dysplasia.
Animals ; Body Weight ; Bronchopulmonary Dysplasia ; Edema ; Fibrosis ; Humans ; Hyperoxia* ; Infant ; Infant, Newborn ; Lung Injury ; Lung* ; Macrophages ; Models, Animal ; Neutrophils ; Oxygen ; Pulmonary Edema ; Rats* ; Rats, Sprague-Dawley

No abstract available.
Humans ; Infant, Newborn*

Intraventricular hemorrhage (IVH) is common in the premature infants and occurs mainly in subependymal germinal matrix. In contrast, IVH in the term infants is rare and different in pathogenesis and bleeding sites from those of the premature infants. Most studies of IVH in term infants have been studied by computerized tomography and postmortem examination. Brain ultrasonography which has become a frequently used diagnostic tool of IVH in the premature infants is reported to be also effective in diagnosis in the term infants. The study population comprised 11 term neonates admitted to the Neonatal Intensive Care Unit of Seoul National University Children's Hospital between July 1989 and June 1991, in whom IVH was diagnosed by ultrasonography. We analysed severity of birth asphyxia. ultrasonographic findings and clinical manifestations to investigate severity, timing, risk factors, and pathogenesis of IVH in the term neonates. 1) Apgar scores were available in 7 cases with severe asphyxia (Apgar at 1 min: less than 3), 1 cases with mild asphyxia (Apgar at 1 min: between 5~7), and 2 cases without asphyxia. 2) Clinically, 4 cases had fetal distress, and 3 cases had meconium aspiration pneumonia. 3) Bleeding sites by ultrasonography were subependymal germinal matrix in all 11 cases. IVH of choroid plexus was combined in 2 cases. Severity of IVH were grade I in 9 cases, grade II in 2 cases by Papile's classification. 4) There were no correlations between the grade of IVH and severity of perinatal asphyxia. In conclusion, ultrasonography is very useful in diagnosis and follow-up of IVH in term neonates. Subependymal germinal matrix could be common site of IVH in term neonates because germinal matrix still remains in term neonates despite of its regression. Also this can explain why IVH in our cases is not severe.
Asphyxia ; Autopsy ; Brain ; Choroid Plexus ; Classification ; Diagnosis ; Fetal Distress ; Follow-Up Studies ; Hemorrhage* ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Meconium Aspiration Syndrome ; Parturition ; Pneumonia ; Risk Factors ; Seoul ; Ultrasonography

In the figure 3, designation of severity of bronchopulmonary dysplasia (BPD) was misprinted. Open bars (white) represent severe BPD, not mild BPD. Closed bars (Black) represent mild BPD, not severe BPD. Gray bars in the middle represent moderate BPD without change.

No abstract available.
Humans ; Infant, Newborn*

No abstract available.
Humans ; Infant, Newborn*