PURPOSE: There are many known risk factors for a retinopathy of prematurity (ROP). We analyzed the most important risk factors and predictors of ROP among them. METHODS: We retrospectively reviewed the medical records of all premature infants admitted to the neonatal intensive care unit (NICU), between January 2010 and December 2012 at Gangnam CHA Medical Center, Seoul. . All infants (n=185) were hospitalized for more than 28 days, received eye examination for ROP and showed one of the following criteria: birth weight (BW) below 1,500 g, gestational age (GA) below 32 weeks, or oxygen treatment (> or =40% oxygen for more than 3 days). We divided the infants into the Non-ROP group (n=162) and the ROP group (n=23, more than stage 1) and analyzed group comparisons, risk factors and the importance of each factor of ROP by SPSS 13.0. RESULTS: Risk factors were duration of oxygen uses [Odds ratio (OR): 1.064, 95% confidence interval (CI): 1.007-1.125, P=0.028] and intravenous (IV) steroid (OR: 1.234, 95% CI: 1.000-1.523, P=0.049) by multi-factor adjustment. The most important factor was oxygenation duration. The following factors were time to full enteral feedings, and IV steroid duration. CONCLUSION: The incidence of ROP will be decreased if we can reduce the length of oxygen uses, IV steroid use and advance the full feeding achievement.
Birth Weight ; Enteral Nutrition ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Medical Records ; Oxygen ; Retinopathy of Prematurity* ; Retrospective Studies ; Risk Factors ; Seoul

OBJECTIVES: This study was to examine the effectiveness of computerized cognitive ability enhancement program (CCAEP) using Smart-toy. The CCAEP using Smart-toy which can interact with children via bluetooth is a kids-friendly and convenient method for improving children's cognitive abilities by increasing their motivation for performing the program. We developed the CCAEP which designed to train auditory-verbal memory, visual-spatial memory, auditory-verbal working memory, and visual-spatial working memory. METHODS: Eighteen children aged 8 to 10 participated in CCAEP individual training composed of 8 sessions of 40 minutes each for 4 weeks. The effect of the training was measured with Smart Toyweb's cognitive assessment tasks (smart device based assessment) as well as traditional neuropsychological tests before and after the training. RESULTS: Children showed significant improvement in auditory-verbal memory, visual-spatial memory, auditory-verbal working memory and visual-spatial working memory abilities after the training. CONCLUSION: This study demonstrated promising results suggesting the effectiveness of CCAEP using Smart-Toy in clinical settings as well as school and home situations. Further controlled study with larger sample size including various clinical groups is needed to confirm the present results.
Child* ; Humans ; Memory ; Memory, Short-Term ; Methods ; Motivation ; Neuropsychological Tests ; Sample Size

Difference in crude neonatal and infant mortality rates (NMR and IMR) among different countries is due to the differences in its two determinants: birth weight distribution (BWD) and birth weight-specific mortality rates (BW-SMRs). We aimed to determine impact of BWD and BW-SMRs on differences in crude NMR and IMR among Korea, Japan, and the U.S. Our study used the live birth data of the period 2009 through 2010. Crude NMR/IMR are the lowest in Japan, 1.1/2.1, compared to 1.8/3.2, in Korea, and 4.1/6.2, in the U.S., respectively. Japanese had the best BW-SMRs of all birth weight groups compared to the Koreans and the U.S. The U.S. BWD was unfavorable with very low birth weight (< 1,500 g) rate of 1.4%, compared to 0.6% in Korea, and 0.8% in Japan. If Koreans and Japanese had the same BWD as in the U.S., their crude NMR/IMR would be 3.9/6.1 for the Koreans and 1.5/2.5 for the Japanese. If both Koreans and Japanese had the same BW-SMRs as in the U.S., the crude NMR/IMR would be 2.0/3.8 for the Koreans and 2.7/5.0 for the Japanese. In conclusion, compared to the U.S., lower crude NMR or IMR in Japan is mainly attributable to its better BW-SMRs. Koreans had lower crude NMR and IMR, primarily from its favorable BWD. Comparing crude NMR or IMR among different countries should include further exploration of its two determinants, BW-SMRs reflecting medical care, and BWD reflecting socio-demographic conditions.
Asian Continental Ancestry Group ; Birth Weight* ; Humans ; Infant ; Infant Mortality* ; Infant* ; Infant, Very Low Birth Weight ; Japan* ; Korea* ; Live Birth ; Mortality* ; Parturition*

Despite a remarkable increase in Asian births in the U.S., studies on their birth outcomes have been lacking. We investigated outcomes of births to Asian parents and biracial Asian/White parents in the U.S. From the U.S. birth data (1992–2012), we selected singleton births to Korean, Chinese, Japanese, Filipino, Asian Indian, and Vietnamese. These births were divided into three groups; births to White mother/Asian father, Asian mother/White father, and births to the both ethnic Asian parents. We compared birth outcomes of these 18 subgroups to those of the White mother/White father group. Mean birthweights of births to the Asian parents were significantly lower, ranging 18 g to 295 g less than to the White parents. Compared to the rates of low birthweight (LBW) (4.6%) and preterm birth (PTB) (8.5%) in births to the White parents, births to Filipino parents had the highest rates of LBW (8.0%) and PTB (11.3%), respectively, and births to Korean parents had the lowest rates of both LBW (3.7%) and PTB (5.5%). This pattern of outcomes had changed little with adjustments of maternal sociodemographic and health factors. This observation was similarly noted also in births to the biracial parents, but the impact of paternal or maternal race on birth outcome was different by race/ethnicity. Compared to births to White parents, birth outcomes from the Asian parents or biracial Asian/White parents differed depending on the ethnic origin of Asian parents. The race/ethnicity was the strongest factor for this difference while other parental characteristics hardly explained this difference.
Asian Americans ; Asian Continental Ancestry Group* ; Continental Population Groups ; Fathers ; Humans ; Parents* ; Parturition* ; Premature Birth ; United States*

Helicobacter pylori-eliminating effects of FEMY-R7, composed of fucoidan and evening primrose extract, were investigated in mice and humans. Male C57BL/6 mice were infected with the bacteria by intragastric inoculation (1x10(9) CFU/mouse) 3 times at 2-day intervals, and simultaneously, orally treated twice a day with 10 or 100 mg/kg FEMY-R7 for 2 weeks. In Campylobcter-like organism-detection test, FEMY-R7 markedly reduced the urease-positive reactivity. In a clinical sudy, human subjects, confirmed to be infected with Helicobacter pylori, were orally administered twice a day with a capsule containing 150 mg FEMY-R7 for 8 weeks. FEMY-R7 significantly decreased both the Delta over baseline-value in urea breath test and the serum pepsinogens I and II levels. The results indicate that FEMY-R7 not only eliminates H. pylori from gastric mucosa of animals and humans, but also improves gastric function.
Animals ; Bacteria ; Breath Tests ; Gastric Mucosa ; Helicobacter ; Helicobacter pylori ; Humans ; Male ; Mice* ; Oenothera biennis* ; Pepsinogen A ; Pepsinogens ; Urea

Fetomaternal hemorrhage (FMH) is due to the entry of fetal blood into the maternal circulation. Although very rare, FMH complicates pregnancies, presents with severe symptoms, and leads to fetal death. Majority of FMH cases are idiopathic and difficult to diagnose. The known used diagnostic tests are Kleihauer-Betke Test (KBT) and flow cytometry, which can detect fetal hemoglobin in the maternal blood. However, such methods have limited use because of low sensitivity, labor-intensive and error-susceptible procedures, poor reproducibility, and tendency to overestimate the FMH volume. Other tests include high performance liquid chromatography (HPLC) and alpha-fetoprotein (AFP) tests, which can be as favorable to confirm FMH as KBT. However, in case of acute FMH, the diagnostic results of KBT, flow cytometry, and HPLC may be false negative. AFP test is a noninvasive, fast, easily assessable, adjuvant, and confirmatory diagnostic test. Published Korean articles show confirmed FMH by KBT or HPLC in singleton late-preterm and term neonates. Herein, we report a case of monochorionic diamniotic twin neonates (birth weight <1,500 g) who presented borderline fetal hemoglobin level because of acute FMH and were diagnosed with FMH by maternal AFP. Our experience of diagnosing FMH rapidly by AFP test will be very helpful to clinicians for the prevention and treatment of FMH during pregnancy.

Purpose: We aimed to analyze the correlations between the Bayley Scales of Infant Development (BSID)-III and Korean Developmental Screening Test (K-DST) in very-low-birth-weight (VLBW; birth weight <1,500 g) preterm infants. Methods: We enrolled 53 VLBW infants (mean gestational age, 28.9±2.11 weeks; mean birth weight, 1,158.5±241.1 g) and assessed them using the BSID-III and K-DST at a corrected age of 18 to 24 months. We analyzed the correlations between the BSID-III and K-DST subdomains and evaluated whether the estimated developmental levels were consistent with the corrected ages. Results: In the BSID-III, the composite scores for cognition, motor, and language were 105.9±13.1 (median, 105; 66th percentile; 95% confidence interval [CI], 98 to 113), 100.9±12.4 (100; 50th percentile; 95% CI, 92 to 108), and 94.9±16.8 (97.5; 34th percentile; 95% CI, 87 to 102), respectively. The scaled scores for receptive/expressive language and gross/fine motor were 9.9±2.9 (10.5)/8.2±2.7 (8) and 9.6±2.4 (9)/10.6 ±2.3 (10), respectively. In the K-DST, the mean scores of cognition (17.8±4.7 [18.5]), language (16.6±7.2 [20]), fine motor (19.4±3.4 [20]), gross motor (19.9±3.8 [21]), sociality (18.6±4.7 [20]), and self-control (17.3±5.1 [18]) were within the range of normal developmental status. Among the overlapping subdomains, cognition (r=0.58, P= 0.003) and language (r=0.86, P<0.001), but not fine and gross motor status (r=0.05, P= 0.79; r=0.16, P=0.44, respectively), showed significant correlation between the BSID-III and K-DST. Conclusion The language and cognition domains of the K-DST were significantly correlated with the BSID-III in preterm VLBW infants. Clinicians should consider these discrepancies and correlations when evaluating the developmental status of preterm VLBW infants.

Fetomaternal hemorrhage (FMH) is due to the entry of fetal blood into the maternal circulation. Although very rare, FMH complicates pregnancies, presents with severe symptoms, and leads to fetal death. Majority of FMH cases are idiopathic and difficult to diagnose. The known used diagnostic tests are Kleihauer-Betke Test (KBT) and flow cytometry, which can detect fetal hemoglobin in the maternal blood. However, such methods have limited use because of low sensitivity, labor-intensive and error-susceptible procedures, poor reproducibility, and tendency to overestimate the FMH volume. Other tests include high performance liquid chromatography (HPLC) and alpha-fetoprotein (AFP) tests, which can be as favorable to confirm FMH as KBT. However, in case of acute FMH, the diagnostic results of KBT, flow cytometry, and HPLC may be false negative. AFP test is a noninvasive, fast, easily assessable, adjuvant, and confirmatory diagnostic test. Published Korean articles show confirmed FMH by KBT or HPLC in singleton late-preterm and term neonates. Herein, we report a case of monochorionic diamniotic twin neonates (birth weight <1,500 g) who presented borderline fetal hemoglobin level because of acute FMH and were diagnosed with FMH by maternal AFP. Our experience of diagnosing FMH rapidly by AFP test will be very helpful to clinicians for the prevention and treatment of FMH during pregnancy.

Purpose: We aimed to analyze the correlations between the Bayley Scales of Infant Development (BSID)-III and Korean Developmental Screening Test (K-DST) in very-low-birth-weight (VLBW; birth weight <1,500 g) preterm infants. Methods: We enrolled 53 VLBW infants (mean gestational age, 28.9±2.11 weeks; mean birth weight, 1,158.5±241.1 g) and assessed them using the BSID-III and K-DST at a corrected age of 18 to 24 months. We analyzed the correlations between the BSID-III and K-DST subdomains and evaluated whether the estimated developmental levels were consistent with the corrected ages. Results: In the BSID-III, the composite scores for cognition, motor, and language were 105.9±13.1 (median, 105; 66th percentile; 95% confidence interval [CI], 98 to 113), 100.9±12.4 (100; 50th percentile; 95% CI, 92 to 108), and 94.9±16.8 (97.5; 34th percentile; 95% CI, 87 to 102), respectively. The scaled scores for receptive/expressive language and gross/fine motor were 9.9±2.9 (10.5)/8.2±2.7 (8) and 9.6±2.4 (9)/10.6 ±2.3 (10), respectively. In the K-DST, the mean scores of cognition (17.8±4.7 [18.5]), language (16.6±7.2 [20]), fine motor (19.4±3.4 [20]), gross motor (19.9±3.8 [21]), sociality (18.6±4.7 [20]), and self-control (17.3±5.1 [18]) were within the range of normal developmental status. Among the overlapping subdomains, cognition (r=0.58, P= 0.003) and language (r=0.86, P<0.001), but not fine and gross motor status (r=0.05, P= 0.79; r=0.16, P=0.44, respectively), showed significant correlation between the BSID-III and K-DST. Conclusion The language and cognition domains of the K-DST were significantly correlated with the BSID-III in preterm VLBW infants. Clinicians should consider these discrepancies and correlations when evaluating the developmental status of preterm VLBW infants.

Objectives: . To train participants to localize sound using virtual reality (VR) technology, appropriate auditory stimuli that contain accurate spatial cues are essential. The generic head-related transfer function that grounds the programmed spatial audio in VR does not reflect individual variation in monaural spatial cues, which is critical for auditory spatial perception in patients with single-sided deafness (SSD). As binaural difference cues are unavailable, auditory spatial perception is a typical problem in the SSD population and warrants intervention. This study assessed the applicability of binaurally recorded auditory stimuli in VR-based training for sound localization in SSD patients. Methods: . Sixteen subjects with SSD and 38 normal-hearing (NH) controls underwent VR-based training for sound localization and were assessed 3 weeks after completing training. The VR program incorporated prerecorded auditory stimuli created individually in the SSD group and over an anthropometric model in the NH group. Results: . Sound localization performance revealed significant improvements in both groups after training, with retained benefits lasting for an additional 3 weeks. Subjective improvements in spatial hearing were confirmed in the SSD group. Conclusion . By examining individuals with SSD and NH, VR-based training for sound localization that used binaurally recorded stimuli, measured individually, was found to be effective and beneficial. Furthermore, VR-based training does not require sophisticated instruments or setups. These results suggest that this technique represents a new therapeutic treatment for impaired sound localization.