PURPOSE: Ibuprofen and indomethacin has been used in treatment of patent ductus arteriosus (PDA) in Korea. But, there were few reports about oral ibuprofen for the treatment of PDA. We aimed to evaluate the efficacy and safety of oral ibuprofen versus intravenous indomethacin for the treatment of PDA in very low birth weight (VLBW) infants. METHODS: A retrospective study of VLBW infants treated with oral ibuprofen or intravenous indomethacin for symptomatic PDA at Inje University Sanggye Paik Hospital between February 2002 and April 2012 was performed. RESULTS: We identified 43 infants that received oral ibuprofen and 9 infants that received intravenous indomethacin. There were no significant differences in the efficacy and safety between oral ibuprofen group and intravenous indomethacin group. There was no significant difference between the use of oral ibuprofen before 48 hours after birth and after 48 hours the efficacy and safety. CONCLUSION: In our study, oral ibuprofen appears to be as effective as intravenous indomethacin for the treatment of PDA in VLBW infants with similar complication rates.
Ductus Arteriosus, Patent ; Humans ; Ibuprofen ; Indomethacin ; Infant ; Infant, Very Low Birth Weight ; Korea ; Parturition ; Retrospective Studies

PURPOSE: Extended spectrum beta-lactamase (ESBL) producing organism is an important cause of infections in the neonatal intensive care unit (NICU) since 1990s. The aim of this study is to investigate the differences of clinical characteristics and hematologic studies between neonates with ESBL-positive organism and those with ESBL-negative organism. METHODS: The subjects included 48 neonates admitted to NICU at Inje University Sanggye Paik Hospital from January 2005 to September 2010, from whom a total of 58 Escherichia coli or Klebsiella pneumonia were detected. The data were categorized in 2 groups, neonates with ESBL-positive and ESBL-negative. We compared clinical characteristics and hematologic studies between two groups. RESULTS: Of 48 neonates and 53 isolates, ESBL-positive were 18 neonates and 20 isolates. Both ESBL-positive and ESBL-negative isolates were largely found in urine, each with 10 and 23. Of 20 ESBL-positive isolates, 13 (65%) and 7 (35%) were ESBL producing Escherichia coli and Klebsiella pneumonia, respectively. ESBL-positive neonates were associated with low 1 and 5 minutes Apgar scores (P=0.002 and P=0.001, respectively), more uses of oxygen (56% vs. 27%; P=0.005), longer duration of oxygen uses (15.8+/-38.43 days vs. 4.3+/-12.5 days; P=0.008) and more frequent anemia (33% vs. 7%; P=0.040). CONCLUSION: ESBL-positive neonates may have more anemia and lower Apgar score at birth. We can consider the use of cabapenem earlier if infant with previous antibiotics is confirmed to be infected with ESBL-positive organisms.
Anemia ; Anti-Bacterial Agents ; Apgar Score ; beta-Lactamases ; Escherichia ; Escherichia coli ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Klebsiella ; Oxygen ; Parturition ; Pneumonia

PURPOSE: To evaluate the relationship between pericytes and endothelial cells in retinal neovascularization through histological and immunofluorescent studies. METHODS: C57BL/6J mice were exposed to hyperoxia from postnatal day (P) 7 to P12 and were returned to room air at P12 to induce a model of oxygen-induced retinopathy (OIR). The cross sections of enucleated eyes were processed with hematoxylin and eosin. Immunofluorescent staining of pericytes, endothelial cells, and N-cadherin was performed. Microfluidic devices were fabricated out of polydimethylsiloxane using soft lithography and replica molding. Human retinal microvascular endothelial cells, human brain microvascular endothelial cells, human umbilical vein endothelial cells and human placenta pericyte were mixed and co-cultured. RESULTS: Unlike the three-layered vascular plexus found in retinal angiogenesis of a normal mouse, angiogenesis in the OIR model is identified by the neovascular tuft extending into the vitreous. Neovascular tufts and the three-layered vascular plexus were both covered with pericytes in the OIR model. In this pathologic vascularization, N-cadherin, known to be crucial intercellular adhesion molecule, was also present. Further evaluation using the microfluidic in vitro model, successfully developed a microvascular network of endothelial cells covered with pericytes, mimicking normal retinal angiogenesis within 6 days. CONCLUSIONS: Pericytes covering endothelial cells were observed not only in vasculature of normal retina but also pathologic neovascularization of OIR mouse at P17. Factors involved in the endothelial cell-pericyte interaction can be evaluated as an attractive novel treatment target. These future studies can be performed using microfluidic systems, which can shorten the study time and provide three-dimensional structural evaluation.
Animals ; Brain ; Cadherins ; Endothelial Cells ; Eosine Yellowish-(YS) ; Fungi ; Hematoxylin ; Human Umbilical Vein Endothelial Cells ; Humans ; Hyperoxia ; In Vitro Techniques ; Lab-On-A-Chip Devices ; Mice ; Microfluidics ; Microvessels ; Neovascularization, Pathologic ; Pericytes ; Placenta ; Retina ; Retinal Neovascularization ; Retinaldehyde