We investigated the incidence of bronchopulmonary dysplasia (BPD) in very-low-birth-weight (VLBW) infants in Korea using the Korean Neonatal Network (KNN) data. In total, 2,386 VLBW infants born from January 2013 to June 2014 were prospectively registered. BPD was defined as supplemental oxygen or positive pressure support at 36 weeks postmenstrual age (PMA). The overall incidence of BPD was 28.9%, and the overall mortality rate in the neonatal intensive care units (NICUs) was 11.9%. To investigate recent changes in the incidence of BPD among VLBW infants, we compared the BPD rate in the present study with the latest nationwide retrospective survey conducted between 2007 and 2008. For comparison, we selected infants (23-31 weeks of gestation) (n=1,990) to adjust for the same conditions with the previous survey in 2007-2008 (n=3,841). Among the limited data on VLBW infants (23-31 weeks of gestation), the incidence of BPD increased by 85% (from 17.8% to 33.0%) and the mortality rate in the NICU decreased by 31.4% (from 18.8% to 12.9%) compared to those in the study conducted in 2007-2008. The current trend of increase in the incidence of BPD among infants can be attributed to the increase in the survival rate of VLBW infants.
Apgar Score ; Bronchopulmonary Dysplasia/*epidemiology/mortality ; Databases, Factual ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; Infant Mortality ; Infant, Newborn ; *Infant, Very Low Birth Weight ; Intensive Care Units, Neonatal ; Male ; Odds Ratio ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Survival Rate

BACKGROUND: The etiologies of ischemic cerebrovascular diseases are various-thrombosis or artery to artery embolism, cardiogenic embolism and lipohyalinosis. In the past embolic cerebral infarct was thought to occur uncommonly. But these days substantial portion of patients have been found to have potential embolic sources by transesophageal echo cardiography and carotid duplex doppler. As transesophageal echocardiography has a high yield for identification of potential sources of cardiac embolism in patients with ischemic cerbrovascular diseases, its use has been increasing. In Korea an increasing number of patients with ischemic cerebrovascular diseases have been examined by transesophageal echocardiography since 1990. But in all the previous studies transesophageal echocardiographic evaluation has been confined to the patients with high probability of embolic cerebral infarct. All kinds of ischemic cerebrovascular diseases patients have never been examined by transesophageal echocardiography and carotid duplex doppler and the prevalence of potential embolic sources in Korean ischemic cerebrovascular disease patients is not known. The aim of this study was to evaluate the prevalence of potential cardiovascular embolic sources by transesophageal echocardiography and carotid duplex doppler in unselected patients with ischemic cerebrovascular diseases. METHODS: We evaluated all kinds of ischemic cerebrovascular diseases patients admitted from 1994. 9. 1. until 1995 9. 31. to the Departments of Neurology and Internal Medicine of Kangnam General Hospital. We evaluated them by transesophageal echocardiography, carotid doppler, brain CT(or brain MRI). A significant carotid stenosis was defined as a duplex scandetected lesion producing at least 50% vessel narrowing. The following echocardiographic findings were defined prospectively as potential cardiac sources of embolism : atrial appendage or left atrial cavity thrombus, spontaneous echocardiographic contrast, atrial septal aneurysm, interatrial shunt, ventricular aneurysm, ventricular thrombus, myxomatous mitral valve and protruding atherosclerotic plaque in the ascending aorta or transverse aortic arch. RESULTS: Of 64 patients admitted during the study period, 30 were excluded(Three patients were critically ill, and twenty seven patients refused diagnostic work-up.). Thorough diagnostic work-up was performed in 34 patients. Transesophageal echocardiographic positive findings were present in six patients(17.6%). Of them four(4/34, 11.7%) had spontaneous echo contrast, two(2/34, 5.8%) had left atrial thrombi, one(1/34, 2.9%) had ascending aorta atheroma. Eleven patients(11/34, 32.3%) had abnormalities in carotid doppler study. Five patients(5/34, 14.7%) had abnormalities both in transesophageal echocardiography and carotid doppler study. CONCLUSIONS: The results suggest that among ischemic cerebrovascular diseases patients substantial portion of patients have potential embolic sources. The prevalence of potential embolic sources in Korea may be higher than previously expected. Because the relative small number of the patients studied make it difficult to generalize the results, further studies with a large number of patients are needed.
Aneurysm ; Aorta ; Aorta, Thoracic ; Arteries ; Atrial Appendage ; Brain ; Carotid Stenosis ; Critical Illness ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Hospitals, General ; Humans ; Internal Medicine ; Korea ; Mitral Valve ; Neurology ; Plaque, Atherosclerotic ; Prevalence ; Prospective Studies ; Thrombosis

BACKGROUND: Menopause is an independent risk factor in metabolic syndrome which induced an alteration of the lipid metabolism by hormonal changes. Apolipoprotein A5 gene (APOA5) was related to the regulation of triglyceride and high density lipoprotein cholesterol (HDL-C) level with biosynthesis and decomposition. This study was conducted to investigate the relationship between APOA5 polymorphism and metabolic syndrome in Korean postmenopausal women. METHODS: This study included 307 postmenopausal women with anthropometric and biochemical measurement in 2010-2011. The polymorphism of APOA5 was analyzed by polymerase chain reaction-restriction fragment length polymorphism method with MseI restriction enzyme. RESULTS: The metabolic syndrome prevalence with TT genotype was significantly lower than the frequency in those with TC/CC (27.09%, 38.46%, and 45.71% for TT, TC, and CC, respectively; P < 0.05). Multiple regression analysis of metabolic syndrome risk factors indicated that postmenopausal women with CC genotype had a higher risk with 3 times than that in TT genotype (P < 0.05). APOA5 C carriers showed an increased risk of triglyceride level (odd ratio, 2.93 and 1.85 for CC and TC+CC, respectively; P < 0.05). Interestingly, HDL-C was related to triglyceride directly in comparison to APOA5. CONCLUSION: The results of this study indicate that APOA5 has an influence on serum triglyceride and HDL-C, which contribute to metabolic syndrome in Korean postmenopausal women.
Apolipoproteins ; Apolipoproteins A ; Cholesterol ; Cholesterol, HDL ; Female ; Genotype ; Humans ; Lipid Metabolism ; Lipoproteins ; Menopause ; Metabolic Syndrome X ; Polymorphism, Single Nucleotide ; Prevalence ; Risk Factors ; Triglycerides

In the present study, we tried to investigate immunoreactivity of iron-repressible cell wall proteins and exoproteins of Staphylococcus aureus when the convalescent serum obtained from the patient with septicemia was applied. On SDS-PAGE and western blot analysis, several iron-repressible cell wall proteins expressed in iron-deficient BHI showed strong immunoreactivity, whereas no or relatively weak immunoreactivity was shown in iron-sufficient BHI. Several exoproteins were expressed only in iron-deficient BHI and these exoproteins showed strong immunoreactivity. These results indicate that several iron-repressible cell wall proteins and exoproteins are expressed and are immunogenic in vivo. Since in vivo state is an relatively iron-restricted condition, we recommend the use of iron-deficient media for studies concerning pathogenicity of staphylococcal in human.
Blotting, Western ; Cell Wall* ; Electrophoresis, Polyacrylamide Gel ; Humans ; Sepsis ; Staphylococcus aureus* ; Staphylococcus* ; Virulence

In the present study, we tried to investigate immunoreactivity of iron-repressible cell wall proteins and exoproteins of Staphylococcus aureus when the convalescent serum obtained from the patient with septicemia was applied. On SDS-PAGE and western blot analysis, several iron-repressible cell wall proteins expressed in iron-deficient BHI showed strong immunoreactivity, whereas no or relatively weak immunoreactivity was shown in iron-sufficient BHI. Several exoproteins were expressed only in iron-deficient BHI and these exoproteins showed strong immunoreactivity. These results indicate that several iron-repressible cell wall proteins and exoproteins are expressed and are immunogenic in vivo. Since in vivo state is an relatively iron-restricted condition, we recommend the use of iron-deficient media for studies concerning pathogenicity of staphylococcal in human.
Blotting, Western ; Cell Wall* ; Electrophoresis, Polyacrylamide Gel ; Humans ; Sepsis ; Staphylococcus aureus* ; Staphylococcus* ; Virulence

BACKGROUND: Diffusion weighted magnetic resonance imaging (DWI) and single photon emission computed tomography (SPECT) can demonstrate ischemic brain injury within the first several hours after the onset of symptoms. We investigated the utility of combined DWI and SPECT in the assessment of acute cerebral infarction. METHODS: Nineteen patients with acute middle cerebral artery territory infarction underwent DWI and SPECT within 12 hours of symptom onset (mean, 9.6 hour). In SPECT, we defined abnormality as a perfusion defect region (perfusion ??30% compared to a normal cortex) and an ischemic region (perfusion difference ??10% compared to a contralateral normal hemisphere). The initial DWI and SPECT lesion volume ratios (lesion volume / hemispheric volume) were analyzed with subsequent neurological deficits as determined by the National Institutes of Health Stroke Scale (NIHSS) score and Barthel index (BI). RESULTS: There was a high correlation between clinical scores within 7 days and lesion volumes determined by DWI and SPECT respectively (p<0.05). The lesion volumes detected by DWI and SPECT significantly correlated with each other (p<0.01). Ischemic lesions on SPECT were larger in the group (n=10) with ICA occlusions than in the other group (p=0.034). In 15 patients with cortical lesions, the ratio of perfusion defect volumes on SPECT to lesion volumes on DWI was higher in the group with favorable outcome than in the group with unfavorable outcome (p=0.01). CONCLUSIONS: Both DWI and SPECT are highly correlated with the severity of neurological deficit in acute cerebral infarction. Furthermore, combined use of DWI and SPECT would be more powerful than either study alone in predicting clinical outcome. (J Korean Neurol Assoc 19(2):88~95, 2001)
Brain Injuries ; Cerebral Infarction ; Diffusion Magnetic Resonance Imaging* ; Diffusion* ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Middle Cerebral Artery* ; National Institutes of Health (U.S.) ; Perfusion ; Stroke ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Diffusion weighted magnetic resonance imaging (DWI) and single photon emission computed tomography (SPECT) can demonstrate ischemic brain injury within the first several hours after the onset of symptoms. We investigated the utility of combined DWI and SPECT in the assessment of acute cerebral infarction. METHODS: Nineteen patients with acute middle cerebral artery territory infarction underwent DWI and SPECT within 12 hours of symptom onset (mean, 9.6 hour). In SPECT, we defined abnormality as a perfusion defect region (perfusion ??30% compared to a normal cortex) and an ischemic region (perfusion difference ??10% compared to a contralateral normal hemisphere). The initial DWI and SPECT lesion volume ratios (lesion volume / hemispheric volume) were analyzed with subsequent neurological deficits as determined by the National Institutes of Health Stroke Scale (NIHSS) score and Barthel index (BI). RESULTS: There was a high correlation between clinical scores within 7 days and lesion volumes determined by DWI and SPECT respectively (p<0.05). The lesion volumes detected by DWI and SPECT significantly correlated with each other (p<0.01). Ischemic lesions on SPECT were larger in the group (n=10) with ICA occlusions than in the other group (p=0.034). In 15 patients with cortical lesions, the ratio of perfusion defect volumes on SPECT to lesion volumes on DWI was higher in the group with favorable outcome than in the group with unfavorable outcome (p=0.01). CONCLUSIONS: Both DWI and SPECT are highly correlated with the severity of neurological deficit in acute cerebral infarction. Furthermore, combined use of DWI and SPECT would be more powerful than either study alone in predicting clinical outcome. (J Korean Neurol Assoc 19(2):88~95, 2001)
Brain Injuries ; Cerebral Infarction ; Diffusion Magnetic Resonance Imaging* ; Diffusion* ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Middle Cerebral Artery* ; National Institutes of Health (U.S.) ; Perfusion ; Stroke ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: This study aimed to compare the neonatal outcome by quantifying the effect of maternal age on low birth weight (LBW). METHODS: We reviewed the medical records of 12,742 newborn infants born at CHA Bundang Medical Center from January 2009 to December 2013. Infants were compared after being categorized by the following 4 maternal age groups - <25 years (N=343), 25-34 years (N=8,573), 35-39 years (N=3,186), > or =40 years (N=640). Statistical analysis included use of logistic regression models with likelihood ratio tests for interaction effects. RESULTS: Incidence of perinatal complications tended to increase significantly with maternal age - gestational diabetes mellitus (GDM; P<0.001), pregnancy induced hypertension (PIH; P=0.019), placenta previa (P<0.001), and cesarean section (P<0.001). Compared to the age group of 25-34 years (reference group), no significant differences were found in age group of 35-39 year [odds ratio (OR)=0.945, 95% confidence interval (CI) 0.847-1.056, P=0.319] and > or =40 years (OR=0.841, 95% CI 0.671-1.056, P=0.136) for LBW. After adjusted by gestational age, incidence of in vitro fertilization (IVF), and perinatal complications, maternal age was not found to be an independent risk factor for LBW (OR=0.847, 95% CI 0.730-0.982, P=0.028 for 35-39 years, and OR=0.652, 95% CI 0.481-0.884, P=0.006 for > or =40 years). CONCLUSION: Although incidence of perinatal complications tends to increase with age, neonatal outcome of age group of > or =35 years measured by incidence of LBW infants was not unfavorable compared to the reference group. The result suggests that the thorough prenatal care may be more important than the maternal age itself.
Cesarean Section ; Diabetes, Gestational ; Female ; Fertilization in Vitro ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn* ; Logistic Models ; Maternal Age* ; Medical Records ; Parturition* ; Placenta Previa ; Pregnancy ; Prenatal Care ; Risk Factors

PURPOSE: We evaluated the clinical characteristics of term infants admitted to the neonatal intensive care unit (NICU) from nursery. METHODS: This is a study of NICU-admitted infants who were born > or =37 weeks of gestation at the Bungdang CHA Hospital between January 2012 and August 2013 (n=161). The infants were divided into 3 groups. The "nursery room (NR) group" (n=97) comprised admissions from the nursery following a late deterioration in condition. The "delivery room (DR) group" (n=64) comprised infants who required admission to the NICU immediately after delivery. In addition, healthy term infants who were selected as the "Term group" (n=95). RESULTS: The NR group had a higher incidence of respiratory distress syndrome than DR group (28.9% vs. 14.1%, P=0.029). Compared with the Term group, the NR group had increased incidence of prolonged (>18 h) premature rupture of membranes (PROM) (6.2% vs. 0.0%, P=0.029). By logistic regression analysis, comparing NR group and Term group, a 1 min Apgar score < or =7 points {odds ratio (OR) and 95% confidence intervals (CI) 3.1 (1.0-9.1)}, a requirement of O2 at birth 2.6 (1.2-5.9) and abnormalities detected on an antenatal sonogram 3.3 (1.4-7.8) were associated with an increased risk of admission to NICU. CONCLUSION: Risk factors for NICU admission from nursery in term infants included prolonged PROM, a 1 min Apgar score of < or =7 points, a requirement of O2 at birth, and abnormalities on antenatal sonograms. Term infants with these risk factors should be carefully observed in the early neonatal period.
Apgar Score ; Humans ; Incidence ; Infant* ; Infant, Newborn ; Intensive Care, Neonatal* ; Logistic Models ; Membranes ; Nurseries* ; Parturition ; Patient Admission ; Pregnancy ; Risk Factors ; Rupture ; Term Birth

Agar* ; Diffusion* ; Iron ; Oxygen* ; Staphylococcus aureus* ; Staphylococcus*