Spontaneous pneumomediastinum in a term newborn without mechanical ventilation or underlying lung disease is rare. We present a case of a newborn baby who developed respiratory distress after birth and cystic pneumomediastinum which improved spontaneously with thymic hyperplasia as demonstrated on chest radiography, CT and MRI. The combination of cystic pneumomediastinum and thymic hyperplasia in a newborn has not been reported, thus far.
Humans ; Hyperplasia ; Infant, Newborn ; Lung Diseases ; Mediastinal Emphysema ; Parturition ; Respiration, Artificial ; Thorax ; Thymus Gland ; Thymus Hyperplasia

Interstitial deletions involving the chromosome band 15q22q24 are very rare and only nine cases have been previously reported. Here, we report on a 12-day-old patient with a de novo 15q22q23 interstitial deletion. He was born by elective cesarean section with a birth weight of 3,120 g at 41.3-week gestation. He presented with hypotonia, sensory and neural hearing loss, dysmorphism with frontal bossing, flat nasal bridge, microretrognathia with normal palate and uvula, thin upper lip in an inverted V-shape, a midline sacral dimple, severe calcanovalgus at admission, and severe global developmental delay at 18 months of age. Fluorescence in situ hybridization findings confirmed that the deleted regions contained at least 15q22. The chromosome analysis revealed a karyotype of 46,XY,del(15) (q22q23). Parental chromosome analysis was performed and results were normal. After reviewing the limited literature on interstitial 15q deletions, we believe that the presented case is the first description of mapping of an interstitial deletion involving the chromosome 15q22q23 segment in Korea. This report adds to the knowledge of the clinical phenotype associated with the 15q22q23 deletion.
Birth Weight ; Cesarean Section ; Developmental Disabilities ; Female ; Fluorescence ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; In Situ Hybridization ; Karyotype ; Korea ; Lip ; Muscle Hypotonia* ; Palate ; Parents ; Phenotype ; Pregnancy ; Uvula

PURPOSE: This research was done to compare obstetric pain, anxiety and cervical dilatation between an epidural analgesia group and a control group. METHODS: Participants were assigned to the experimental or control group depending on their decisions for pain relief. Subjective / objective obstetric pain, anxiety level and cervical dilatation were measured and ANOVA was used for comparison of groups and paired t-test to make pre-post comparisons. RESULTS: Homogeneity of pain, anxiety and cervical dilatation were assessed at the latent phase. Cervical dilatation was larger in the control group than the experimental group, at both the active and the transitional phase (F=22.9, p<.001; F=39.9, p<.001 respectively). The degree of pain and anxiety were not significantly different between the groups. Within the experimental group, subjective / objective pain and anxiety level were significantly lower postanalgesia compared to pre-analgesia in the active phase. All variables, except for sweating in the objective pain measurement, changed significantly at the transient phase. CONCLUSION: The results of this evidence-based research indicate that epidural analgesia while effective in relieving pain and anxiety may have an adverse effect on the cervix during labor stage I. Epidural analgesia should be used carefully during cervical dilatation in labor stage I.
Analgesia ; Analgesia, Epidural ; Anxiety ; Cervix Uteri ; Female ; Labor Pain ; Labor Stage, First ; Pain Measurement ; Pregnancy ; Sweat ; Sweating

This study aimed to investigate current therapeutic strategies for patent ductus arteriosus (PDA) in very-low-birth-weight (VLBW) infants in Korea. A total of 2,254 VLBW infants among 2,386 from Korean Neonatal Network cohort born from January 2013 to June 2014 were included. No PDA was seen for 1,206 infants (53.5%) and the infants diagnosed or treated for PDA were 1,048 infants (46.5%). The proportion of infants with PDA was decreased according to the increase in gestational age (GA) and birthweight. Infants with PDA were divided into groups according to the therapeutic strategies of PDA: prophylactic treatment (PT, n = 69, 3.1%), pre-symptomatic treatment (PST, n = 212, 9.4%), symptomatic treatment (ST, n = 596, 26.4%), and conservative treatment (CT, n = 171, 7.6%). ST was the most preferred treatment modality for preterm PDA and the proportion of the patients was decreased in the order of PST, CT, and PT. Although ST was still the most favored treatment in GA < 24 weeks group, CT was more preferred than PST or ST when compared with GA > or = 32 weeks group [CT vs. PST, OR 5.3, 95% CI 1.56-18.18; CT vs. ST, OR 2.9, 95% CI 1.03-8.13]. A total of 877 infants (38.9%) received pharmacological or surgical treatment about PDA, and 35.5% (801 infants) received pharmacological treatment, mostly with ibuprofen. Seventy-six infants (3.4%) received primary ligation and 8.9% (201 infants) received secondary ligation. Diverse treatment strategies are currently used for preterm PDA in Korea. Further analyses of neonatal outcomes according to the treatment strategies are necessary to obtain a standardized treatment guideline for preterm PDA.
Cohort Studies ; Databases, Factual ; Ductus Arteriosus, Patent/surgery/*therapy ; Echocardiography ; Gestational Age ; Humans ; Ibuprofen/therapeutic use ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Natriuretic Peptide, Brain/analysis ; Republic of Korea

H-type tracheoesophageal fistula (TEF) is extremely rare in infants and children, and clinical manifestations of this condition are diverse based on its severity. Some cases of congenital TEF diagnosed in adulthood have been reported, which indicate the difficulty of early diagnosis of this disease. Gastroesophageal reflux (GER) may induce chronic aspiration, pulmonary aspiration, apparent life-threatening events, and failure to thrive. We report a 5-month- old boy whose recurrent pneumonia and wheezing did not improve under usual treatment and led to acute respiratory distress syndrome. He was found to have severe GER on the second-trial of the esophagogram and was eventually revealed to have congenital H-type TEF upon repeated evaluation.
Child ; Early Diagnosis ; Failure to Thrive ; Gastroesophageal Reflux ; Humans ; Infant ; Pneumonia ; Respiratory Distress Syndrome, Adult ; Respiratory Sounds ; Tracheoesophageal Fistula

PURPOSE: A prospective, controlled trial was conducted to evaluate growth, efficacy, safety and nutritional status for very low birth weight infants fed with human milk fortified with Maeil human milk fortifier (Maeil HMF(R); Maeil Dairies Co., Ltd.). METHODS: We enrolled 45 premature infants with a birth weight <1,500 g and gestational age <33 weeks, who were born at Dong-A University Hospital from October, 2006 through December, 2007. They were divided into 2 groups: infants in one group were fed with human milk fortified with HMF(R), and the second were fed with preterm formula. Growth, biochemical indices, feeding tolerance, and other adverse events in each group were assessed serially and compared relatively. Follow-up data were also collected after discharge at 1, 3, and 6 months corrected age. RESULTS: Characteristics of the 2 groups including average gestational age, birth weight, sex, respiratory distress syndrome, patent ductus arteriosus, and other adverse events (sepsis, retinopathy of prematurity, and intraventricular hemorrhage) showed no significant difference. Average feeding start day (8.00+/-3.27 d vs. 8.86+/-5.37 d) (P=0.99) and the number of days required to reach full feeding after start feeding (41.78+/-20.47 d vs 36.86+/-20.63 d) (P=0.55) were not significantly different in the group fed human milk fortified with HMF(R) when compared with the group that was fed preterm formula. The duration of total parenteral nutrition and the incidence of feeding intolerance also showed no differences between the 2 groups. Although infants fed with human milk fortified with HMF(R) showed faster weight gain than those fed with preterm formula at the end stage of the admission period, other growth indices of the two groups showed no significant difference. No significant correlations were found between the 2 groups with regard to weight gain velocity, height gain velocity, head circumference velocity, and post- discharge follow up growth indices. CONCLUSION: Premature infants fed human milk fortified with HMF(R) showed no significant difference compared with those fed preterm formula in growth, biochemical indices, and adverse events. Using human milk fortifier can be an alternative choice for very low birth weight infants, who need high levels nutritional support even after discharge from NICU.
Birth Weight ; Ductus Arteriosus, Patent ; Follow-Up Studies ; Gestational Age ; Head ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Milk, Human ; Nutritional Status ; Nutritional Support ; Parenteral Nutrition, Total ; Prospective Studies ; Retinopathy of Prematurity ; Weight Gain

PURPOSE: The aim of present study was to assess the utility of serum biochemical markers for predicting the metabolic bone disease (MBD) in very low birth weight infants (VLBWI). METHODS: Medical records of 104 VLBWI from 2003 to 2008 were reviewed in this retrospective study. Study patients were divided in MBD and control group according to the finding of wrist radiography performed at 4 weeks of life. We compared the serum biochemical markers including alkaline phosphate (ALP), calcium (Ca), phosphate (P) between two groups at birth, 1 and 4 weeks of life. The value of serum vitamin D (Vit. D) was measured at 4-5 weeks of life. RESULTS: The mean gestational age and birth weight of study patients were 30(+6) +/- 2.0 weeks and 1,308.2 +/- 136.7 g. The incidence of MBD was 28.9% (31 / 104). At birth, higher values of serum ALP (438.1 +/- 129.1 mg/dL vs 360.5 +/- 122.8 mg/dL) were found in MBD group. At 1 week of life, higher values of serum Ca (11.0 +/- 1.7 mg/dL vs 10.3 +/- 1.7 mg/dL) and lower values of serum P (3.2 +/- 1.2 mg/dL vs 4.1 +/- 1.3 mg/dL) were found in MBD group. At 4 weeks of life, higher values of serum ALP activities (1,397.6 +/- 635.6 U/L vs 789.0 +/- 573.0 U/L), lower values of serum P (4.2 +/- 2.0 mg/dL vs 5.4 +/- 1.8 mg/dL) and Vit. D (17.7 +/- 7.2 ng/mL vs 30.0 +/- 15.5 ng/mL) were found in MBD group. Risk factors of MBD were male and Vit. D deficiency with high ALP at 4 weeks of life. CONCLUSION: These results suggest that high ALP concentrations at 4 weeks of life may predict MBD with Vit. D deficiency in VLBWI.
Biomarkers ; Birth Weight ; Bone Diseases ; Bone Diseases, Metabolic ; Calcium ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Very Low Birth Weight ; Male ; Medical Records ; Parturition ; Retrospective Studies ; Risk Factors ; Vitamin D ; Wrist

PURPOSE: The aim of present study was to assess the utility of serum biochemical markers for predicting the metabolic bone disease (MBD) in very low birth weight infants (VLBWI). METHODS: Medical records of 104 VLBWI from 2003 to 2008 were reviewed in this retrospective study. Study patients were divided in MBD and control group according to the finding of wrist radiography performed at 4 weeks of life. We compared the serum biochemical markers including alkaline phosphate (ALP), calcium (Ca), phosphate (P) between two groups at birth, 1 and 4 weeks of life. The value of serum vitamin D (Vit. D) was measured at 4-5 weeks of life. RESULTS: The mean gestational age and birth weight of study patients were 30(+6) +/- 2.0 weeks and 1,308.2 +/- 136.7 g. The incidence of MBD was 28.9% (31 / 104). At birth, higher values of serum ALP (438.1 +/- 129.1 mg/dL vs 360.5 +/- 122.8 mg/dL) were found in MBD group. At 1 week of life, higher values of serum Ca (11.0 +/- 1.7 mg/dL vs 10.3 +/- 1.7 mg/dL) and lower values of serum P (3.2 +/- 1.2 mg/dL vs 4.1 +/- 1.3 mg/dL) were found in MBD group. At 4 weeks of life, higher values of serum ALP activities (1,397.6 +/- 635.6 U/L vs 789.0 +/- 573.0 U/L), lower values of serum P (4.2 +/- 2.0 mg/dL vs 5.4 +/- 1.8 mg/dL) and Vit. D (17.7 +/- 7.2 ng/mL vs 30.0 +/- 15.5 ng/mL) were found in MBD group. Risk factors of MBD were male and Vit. D deficiency with high ALP at 4 weeks of life. CONCLUSION: These results suggest that high ALP concentrations at 4 weeks of life may predict MBD with Vit. D deficiency in VLBWI.
Biomarkers ; Birth Weight ; Bone Diseases ; Bone Diseases, Metabolic ; Calcium ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Very Low Birth Weight ; Male ; Medical Records ; Parturition ; Retrospective Studies ; Risk Factors ; Vitamin D ; Wrist

No abstract available.
Amino Acids* ; Blastocyst* ; Embryonic Structures*

PURPOSE: Enteroviruses are the most common cause of aseptic meningitis in patients of all ages. A definite diagnosis of enteroviral meningitis can be established by detection of virus directly in CSF specimens. But this is time-consuming and lacks sensitivity, so polymerase chain reaction(PCR) detecting of viral RNA in patient specimens such as CSF, stool has been demonstrated. But little is known about the influence of sampling time on the results of CSF PCR and stool PCR. We investigated diagnostic utility of PCR of CSF and stool according to sampling time after the onset of symptoms. METHODS: PCR results were analyzed according to sampling time for 42 patients diagnosed aseptic meningits in our hospital from 11(th) January to 30(th) August, 2005. RESULTS: The diagnostic yield of the test was higher of CSF specimens obtained < or = 2 days after clinical onset(positive PCR results 9/18, 50 percent), compared with CSF collected >2 days after onset(positive PCR results 1/24, 4.2 percent)(P=0.001). Instead, positive PCR results of fecal specimens maintained highly(average 90.5 percent), 10 cases had also positive PCR results even 5-6 days after onset. 10 cases of CSF specimens had positive enterovirus PCR results containing coxsackievirus B5 (n=6), coxsackievirus B3(n=3). 38 cases of stool specimens had positive enterovirus PCR results containing echovirus 18(n=7), echovirus 9(n=3), coxsackievirus B5(n=8), coxsackievirus B3(n=3). 6 cases(coxackie B5) had positive CSF PCR and stool PCR, both. CONCLUSION: Stool PCR was clinically sensitive for detecting enterovirus during enteroviral meningits and could give a presumptive diagnosis throughout the disease course. A definite diagnosis was obtained by CSF PCR, but its utility was clearly lower for samples obtained >2 days after clinical onset. Therefore, it is recommended that, in addition to performance of CSF PCR, fecal samples obtained from patients with suspected enteroviral meningitis should be tested by PCR, especially when the duration of symptoms is >2 days.
Cerebrospinal Fluid ; Diagnosis ; Enterovirus ; Enterovirus B, Human ; Humans ; Meningitis ; Meningitis, Aseptic* ; Polymerase Chain Reaction ; RNA, Viral