1.Brain Injury and Short-Term Neurodevelopmental Outcomes in Neonates Treated with Respiratory Extracorporeal Membrane Oxygenation: A Single-Center Experience
Keon Hee SEOL ; Byong Sop LEE ; Kyusang YOO ; Joo Hyung ROH ; Jeong Min LEE ; Jung Il KWAK ; Tae-Gyeong KIM ; Juhee PARK ; Ha Na LEE ; Chae Young KIM ; Soo Hyun KIM ; Ji Yoon JEONG ; Euiseok JUNG
Neonatal Medicine 2025;32(1):39-48
Purpose:
This study aimed to characterize the clinical patterns and severity of brain injury in neonates who survived extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory failure during the neonatal period, to evaluate their short-term neurodevelopmental outcomes, and to identify the factors associated with these outcomes.
Methods:
We retrospectively reviewed the medical records of neonates who survived ECMO between 2018 and 2024. Based on brain magnetic resonance imaging (MRI) findings, the patients were classified into two groups: no/mild and moderate/severe brain injury. Neurodevelopmental outcomes were assessed at 12–40 months of age using the Bayley Scale of Infant Development II/III and/or the Korean Developmental Screening Test.
Results:
Among the 19 neonates included in the study, 18 (94.7%) showed varying degrees of brain injury on MRI (mild: 12, moderate: 1, severe: 5). Neonates with moderate/severe brain injury had significantly longer durations of ECMO support and extended durations of mechanical ventilation and were more likely to receive continuous renal replacement therapy than those with no or mild injury. Developmental delay was identified in 36.8% of survivors and was significantly associated with prolonged mechanical ventilation, longer neonatal intensive care unit stays, and a higher incidence of seizures.
Conclusion
Brain injury is frequently observed on MRI in neonates treated with ECMO. However, its direct association with adverse neurodevelopmental outcomes is not definitive. Since MRI findings alone cannot predict developmental outcomes, clinical and environmental factors should be integrated into prognostic assessments.
2.Brain Injury and Short-Term Neurodevelopmental Outcomes in Neonates Treated with Respiratory Extracorporeal Membrane Oxygenation: A Single-Center Experience
Keon Hee SEOL ; Byong Sop LEE ; Kyusang YOO ; Joo Hyung ROH ; Jeong Min LEE ; Jung Il KWAK ; Tae-Gyeong KIM ; Juhee PARK ; Ha Na LEE ; Chae Young KIM ; Soo Hyun KIM ; Ji Yoon JEONG ; Euiseok JUNG
Neonatal Medicine 2025;32(1):39-48
Purpose:
This study aimed to characterize the clinical patterns and severity of brain injury in neonates who survived extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory failure during the neonatal period, to evaluate their short-term neurodevelopmental outcomes, and to identify the factors associated with these outcomes.
Methods:
We retrospectively reviewed the medical records of neonates who survived ECMO between 2018 and 2024. Based on brain magnetic resonance imaging (MRI) findings, the patients were classified into two groups: no/mild and moderate/severe brain injury. Neurodevelopmental outcomes were assessed at 12–40 months of age using the Bayley Scale of Infant Development II/III and/or the Korean Developmental Screening Test.
Results:
Among the 19 neonates included in the study, 18 (94.7%) showed varying degrees of brain injury on MRI (mild: 12, moderate: 1, severe: 5). Neonates with moderate/severe brain injury had significantly longer durations of ECMO support and extended durations of mechanical ventilation and were more likely to receive continuous renal replacement therapy than those with no or mild injury. Developmental delay was identified in 36.8% of survivors and was significantly associated with prolonged mechanical ventilation, longer neonatal intensive care unit stays, and a higher incidence of seizures.
Conclusion
Brain injury is frequently observed on MRI in neonates treated with ECMO. However, its direct association with adverse neurodevelopmental outcomes is not definitive. Since MRI findings alone cannot predict developmental outcomes, clinical and environmental factors should be integrated into prognostic assessments.
3.Brain Injury and Short-Term Neurodevelopmental Outcomes in Neonates Treated with Respiratory Extracorporeal Membrane Oxygenation: A Single-Center Experience
Keon Hee SEOL ; Byong Sop LEE ; Kyusang YOO ; Joo Hyung ROH ; Jeong Min LEE ; Jung Il KWAK ; Tae-Gyeong KIM ; Juhee PARK ; Ha Na LEE ; Chae Young KIM ; Soo Hyun KIM ; Ji Yoon JEONG ; Euiseok JUNG
Neonatal Medicine 2025;32(1):39-48
Purpose:
This study aimed to characterize the clinical patterns and severity of brain injury in neonates who survived extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory failure during the neonatal period, to evaluate their short-term neurodevelopmental outcomes, and to identify the factors associated with these outcomes.
Methods:
We retrospectively reviewed the medical records of neonates who survived ECMO between 2018 and 2024. Based on brain magnetic resonance imaging (MRI) findings, the patients were classified into two groups: no/mild and moderate/severe brain injury. Neurodevelopmental outcomes were assessed at 12–40 months of age using the Bayley Scale of Infant Development II/III and/or the Korean Developmental Screening Test.
Results:
Among the 19 neonates included in the study, 18 (94.7%) showed varying degrees of brain injury on MRI (mild: 12, moderate: 1, severe: 5). Neonates with moderate/severe brain injury had significantly longer durations of ECMO support and extended durations of mechanical ventilation and were more likely to receive continuous renal replacement therapy than those with no or mild injury. Developmental delay was identified in 36.8% of survivors and was significantly associated with prolonged mechanical ventilation, longer neonatal intensive care unit stays, and a higher incidence of seizures.
Conclusion
Brain injury is frequently observed on MRI in neonates treated with ECMO. However, its direct association with adverse neurodevelopmental outcomes is not definitive. Since MRI findings alone cannot predict developmental outcomes, clinical and environmental factors should be integrated into prognostic assessments.
4.Brain Injury and Short-Term Neurodevelopmental Outcomes in Neonates Treated with Respiratory Extracorporeal Membrane Oxygenation: A Single-Center Experience
Keon Hee SEOL ; Byong Sop LEE ; Kyusang YOO ; Joo Hyung ROH ; Jeong Min LEE ; Jung Il KWAK ; Tae-Gyeong KIM ; Juhee PARK ; Ha Na LEE ; Chae Young KIM ; Soo Hyun KIM ; Ji Yoon JEONG ; Euiseok JUNG
Neonatal Medicine 2025;32(1):39-48
Purpose:
This study aimed to characterize the clinical patterns and severity of brain injury in neonates who survived extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory failure during the neonatal period, to evaluate their short-term neurodevelopmental outcomes, and to identify the factors associated with these outcomes.
Methods:
We retrospectively reviewed the medical records of neonates who survived ECMO between 2018 and 2024. Based on brain magnetic resonance imaging (MRI) findings, the patients were classified into two groups: no/mild and moderate/severe brain injury. Neurodevelopmental outcomes were assessed at 12–40 months of age using the Bayley Scale of Infant Development II/III and/or the Korean Developmental Screening Test.
Results:
Among the 19 neonates included in the study, 18 (94.7%) showed varying degrees of brain injury on MRI (mild: 12, moderate: 1, severe: 5). Neonates with moderate/severe brain injury had significantly longer durations of ECMO support and extended durations of mechanical ventilation and were more likely to receive continuous renal replacement therapy than those with no or mild injury. Developmental delay was identified in 36.8% of survivors and was significantly associated with prolonged mechanical ventilation, longer neonatal intensive care unit stays, and a higher incidence of seizures.
Conclusion
Brain injury is frequently observed on MRI in neonates treated with ECMO. However, its direct association with adverse neurodevelopmental outcomes is not definitive. Since MRI findings alone cannot predict developmental outcomes, clinical and environmental factors should be integrated into prognostic assessments.
5.Brain Injury and Short-Term Neurodevelopmental Outcomes in Neonates Treated with Respiratory Extracorporeal Membrane Oxygenation: A Single-Center Experience
Keon Hee SEOL ; Byong Sop LEE ; Kyusang YOO ; Joo Hyung ROH ; Jeong Min LEE ; Jung Il KWAK ; Tae-Gyeong KIM ; Juhee PARK ; Ha Na LEE ; Chae Young KIM ; Soo Hyun KIM ; Ji Yoon JEONG ; Euiseok JUNG
Neonatal Medicine 2025;32(1):39-48
Purpose:
This study aimed to characterize the clinical patterns and severity of brain injury in neonates who survived extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory failure during the neonatal period, to evaluate their short-term neurodevelopmental outcomes, and to identify the factors associated with these outcomes.
Methods:
We retrospectively reviewed the medical records of neonates who survived ECMO between 2018 and 2024. Based on brain magnetic resonance imaging (MRI) findings, the patients were classified into two groups: no/mild and moderate/severe brain injury. Neurodevelopmental outcomes were assessed at 12–40 months of age using the Bayley Scale of Infant Development II/III and/or the Korean Developmental Screening Test.
Results:
Among the 19 neonates included in the study, 18 (94.7%) showed varying degrees of brain injury on MRI (mild: 12, moderate: 1, severe: 5). Neonates with moderate/severe brain injury had significantly longer durations of ECMO support and extended durations of mechanical ventilation and were more likely to receive continuous renal replacement therapy than those with no or mild injury. Developmental delay was identified in 36.8% of survivors and was significantly associated with prolonged mechanical ventilation, longer neonatal intensive care unit stays, and a higher incidence of seizures.
Conclusion
Brain injury is frequently observed on MRI in neonates treated with ECMO. However, its direct association with adverse neurodevelopmental outcomes is not definitive. Since MRI findings alone cannot predict developmental outcomes, clinical and environmental factors should be integrated into prognostic assessments.
6.Infratemporal Arteriovenous Fistula Presenting with Peripheral Facial Palsy
Man Gyeong HAN ; Yoo Min KANG ; Sang Hee HA
Journal of the Korean Neurological Association 2024;42(4):353-356
Peripheral facial palsy results from facial nerve injury. While most cases are idiopathic (Bell's palsy) with favorable prognosis, other causes such as trauma, infection, and compression have poor outcomes. An arteriovenous fistula (AVF) is a direct connection between an artery and a vein that is treatable with endovascular procedures, making early diagnosis essential. We report a case of a 68-year-old woman with peripheral facial palsy and pulsatile pain for four months, diagnosed with an infratemporal AVF compressing the facial nerve.
7.Infratemporal Arteriovenous Fistula Presenting with Peripheral Facial Palsy
Man Gyeong HAN ; Yoo Min KANG ; Sang Hee HA
Journal of the Korean Neurological Association 2024;42(4):353-356
Peripheral facial palsy results from facial nerve injury. While most cases are idiopathic (Bell's palsy) with favorable prognosis, other causes such as trauma, infection, and compression have poor outcomes. An arteriovenous fistula (AVF) is a direct connection between an artery and a vein that is treatable with endovascular procedures, making early diagnosis essential. We report a case of a 68-year-old woman with peripheral facial palsy and pulsatile pain for four months, diagnosed with an infratemporal AVF compressing the facial nerve.
8.Infratemporal Arteriovenous Fistula Presenting with Peripheral Facial Palsy
Man Gyeong HAN ; Yoo Min KANG ; Sang Hee HA
Journal of the Korean Neurological Association 2024;42(4):353-356
Peripheral facial palsy results from facial nerve injury. While most cases are idiopathic (Bell's palsy) with favorable prognosis, other causes such as trauma, infection, and compression have poor outcomes. An arteriovenous fistula (AVF) is a direct connection between an artery and a vein that is treatable with endovascular procedures, making early diagnosis essential. We report a case of a 68-year-old woman with peripheral facial palsy and pulsatile pain for four months, diagnosed with an infratemporal AVF compressing the facial nerve.
9.Kawasaki Disease Complicated with Giant Coronary Aneurysm in Case of Systematized Epidermal Nevus
Soonchunhyang Medical Science 2023;29(2):83-86
Kawasaki disease (KD) is an acute systemic vasculitis that involves coronary arteries. Systematized epidermal nevus is a skin disease characterized by extensive verrucous and hyperchromic plaques. A male patient, previously diagnosed with systematized epidermal nevus, was referred for high fever. Eye injection, red lip, strawberry tongue, and enlarged neck node were accompanied. Intravenous immunoglobulin (IVGG) and high-dose aspirin were given for the treatment of KD. An echocardiogram revealed a small aneurysm in the right coronary artery (RCA). Second IVGG was administered because of refractoriness. The size of the aneurysm was increased to medium in RCA and another medium-sized aneurysm was found in the left anterior descending artery (LAD). Clopidogrel was added. After 3 days of defervescence, he was discharged. Warfarin was added for a giant aneurysm in LAD, aggravated 8 weeks later after the presentation. 11 months later, giant aneurysm was changed to medium sized aneurysm. Patient is at following with dual antiplatelet therapy without warfarin.
10.Circulating Extracellular-Vesicle-Incorporated MicroRNAs as Potential Biomarkers for Ischemic Stroke in Patients With Cancer
Oh Young BANG ; Eun Hee KIM ; Mi Jeong OH ; Jaein YOO ; Gyun Sik OH ; Jong-Won CHUNG ; Woo-Keun SEO ; Gyeong-Moon KIM ; Myung-Ju AHN ; Seong Wook YANG ;
Journal of Stroke 2023;25(2):251-265
Background:
and Purpose This study aimed to evaluate whether extracellular-vesicle-incorporated microRNAs (miRNAs) are potential biomarkers for cancer-related stroke.
Methods:
This cohort study compared patients with active cancer who had embolic stroke of unknown sources (cancer-stroke group) with patients with only cancer, patients with only stroke, and healthy individuals (control groups). The expression profiles of miRNAs encapsulated in plasma exosomes and microvesicles were evaluated using microarray and validated using quantitative real-time polymerase chain reaction. The XENO-QTM miRNA assay technology was used to determine the absolute copy numbers of individual miRNAs in an external validation cohort.
Results:
This study recruited 220 patients, of which 45 had cancer-stroke, 76 were healthy controls, 39 were cancer controls, and 60 were stroke controls. Three miRNAs (miR-205-5p, miR-645, and miR-646) were specifically incorporated into microvesicles in patients with cancer-related stroke, cancer controls, and stroke controls. The area under the receiver operating characteristic curves of these three miRNAs were 0.7692–0.8510 for the differentiation of patients with cancer-stroke from cancer-controls and 0.8077–0.8846 for the differentiation of patients with cancer-stroke from stroke controls. The levels of several miRNAs were elevated in the plasma exosomes of patients with cancer, but were lower than those in plasma microvesicles. An in vivo study showed that systemic injection of miR-205-5p promoted the development of arterial thrombosis and elevation of D-dimer levels.
Conclusion
Stroke due to cancer-related coagulopathy was associated with deregulated expression of miRNAs, particularly microvesicle-incorporated miR-205-5p, miR-645, and miR-646. Further prospective studies of extracellular-vesicle-incorporated miRNAs are required to confirm the diagnostic role of miRNAs in patients with stroke and to screen the roles of miRNAs in patients with cancer.

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