• Clinical and Experimental Pediatrics
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• 제64권11호
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• pp.599-601
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• 2021

• Journal of Korean Neurosurgical Society
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• 제66권3호
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• pp.263-273
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• 2023

While the survival rate of preterm infants has increased dramatically over the last few decades, intraventricular hemorrhage and subsequent hydrocephalus remain major unsolved problems in neonatal intensive care. Once intraventricular hemorrhage occurs, severe neurological sequelae are inevitable. Treatment of this complicated pathology and achievement of favorable neurofunctional outcomes in fragile infants are crucial challenges for pediatric neurosurgeons. Fibrinolytic therapy, which chemically dissolves hematoma, is a promising and useful treatment method. In this paper, the historical background of fibrinolytic therapy for post-intraventricular hemorrhagic hydrocephalus in preterm infants is reviewed and a recent method of fibrinolytic therapy using urokinase is introduced.

• Clinical and Experimental Pediatrics
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• 제53권6호
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• pp.694-700
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• 2010

Purpose: To assess the validity of individual and combined prognostic effects of severe bronchopulmonary dysplasia (BPD), brain injury, retinopathy of prematurity (ROP), and parenteral nutrition associated cholestasis(PNAC). Methods: We retrospectively analyzed the medical records of 80 extremely low birthweight (ELBW) infants admitted to the neonatal intensive care unit (NICU) of the Severance Children's Hospital, and who survived to a postmenstrual age of 36 weeks. We analyzed the relationship between 4 neonatal morbidities (severe BPD, severe brain injury, severe ROP, and severe PNAC) and poor outcome. Poor outcome indicated death after a postmenstrual age of 36 weeks or survival with neurosensory impairment (cerebral palsy, delayed development, hearing loss, or blindness) between 18 and 24 months of corrected age. Results: Each neonatal morbidity correlated with poor outcome on univariate analysis. Multiple logistic regression analysis revealed that the odds ratios (OR) were 4.9 (95% confidence interval [CI], 1.0-22.6; $P$=0.044) for severe BPD, 13.2 (3.0-57.3; $P$<.001) for severe brain injury, 5.3 (1.6-18.1; $P$=0.007) for severe ROP, and 3.4 (0.5-22.7; $P$=0.215) for severe PNAC. Severe BPD, brain injury, and ROP were significantly correlated with poor outcome, but not severe PNAC. By increasing the morbidity count, the rate of poor outcome was significantly increased (OR 5.2; 95% CI, 2.2-11.9; $P$<.001). In infants free of the above-mentioned morbidities, the rate of poor outcome was 9%, while the corresponding rates in infants with 1, 2, and more than 3 neonatal morbidities were 46%, 69%, and 100%, respectively. Conclusion: In ELBW infants 3 common neonatal mornidifies, severe BPD, brain injury and ROP, strongly predicts the risk of poor outcome.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권2호
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• pp.215-220
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• 2009

목 적: 최근 모유수유의 장점이 알려지며 모유수유 아들이 늘고 있다. 이유기 영유아의 가장 흔한 영양장애인 IDA (Iron deficiency anemia)가 모유수유아와 다른 형태의 수유아에서 어떻게 나타나고 있는지 알아보고 IDA와 대조군의 이유식 진행 상황 및 이유지식 등에 대해 알아보았다. 방 법: 2006년 3월부터 2009년 1월까지 인하대병원에 내원한 6~24개월의 영유아 중 IDA를 진단받은 70명과 IDA가 없는 140명의 보호자에게 수유 형태, 이유식 진행 상황 및 이유지식을 묻는 설문을 시행하였다. IDA군의 자료와 함께 IDA가 없는 군을 대조군으로 하여 분석하였다. 결 과: IDA군은 IDA가 없는 군에 비해 이유식을 늦게 시작하며 IDA군에의 모유수유아 비율이 대조군에 비해 높은 것으로 나타났다(p<0.01). 모유수유군은 다른 형태의 수유군에 비해 의미 있게 늦은 6.4개월에 이유식을 시작하는 것으로 나타났다. 이유식을 완성하기 까지 58.1%가 1개월 정도 걸렸으며 4개월 이상 걸린 경우도 19.8%나 되었다. 이유 지식 정도에서 두 군은 의미 있는 차이를 보이지 않았다(p=0.32). 결 론: 생후 6개월경에 체내 저장철이 떨어지며 철의 요구량이 급증하게 된다. 일반적으로 영유아가 이유식에 익숙해지기까지 시간이 걸리고, 초기 이유식 내에는 철분 함량이 적으므로 이 시기 철분 필요량을 충분히 공급할 수 없을 것으로 생각한다. IDA 또는 철결핍을 예방하기 위해 이유식을 좀 더 일찍 권장 해 6개월에는 체내 필요량만큼의 철분이 공급될 수 있게 해야할 것으로 보인다.

• Clinical and Experimental Pediatrics
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• 제49권1호
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• pp.14-17
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• 2006

Infants who are born prematurely or with low birth weight should be immunized at the same postnatal chronologic age. They should receive BCG, DTaP, IPV vaccines according to the same recommended schedule as full term infants. Hepatitis B vaccine schedule is modified when hepatitis B vaccine is administered a infant with birth weight less than 2,000 g. The recommended standard dose of each vaccine should be administered. Proportion of children experiencing vaccine-related adverse events dose not differ between full-term and preterm infants. Immunization with routinely recommended childhood vaccines is safe for preterm and low birth weight infants.

• Clinical and Experimental Pediatrics
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• 제64권7호
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• pp.313-321
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• 2021

Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

• Clinical and Experimental Pediatrics
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• 제56권10호
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• pp.417-423
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• 2013

Vitamin D is an essential component of bone and mineral metabolism; its deficiency causes growth retardation and skeletal deformities in children and osteomalacia and osteoporosis in adults. Hypovitaminosis D (vitamin D insufficiency or deficiency) is observed not only in adults but also in infants, children, and adolescents. Previous studies suggest that sufficient serum vitamin D levels should be maintained in order to enhance normal calcification of the growth plate and bone mineralization. Moreover, emerging evidence supports an association between 25-hydroxyvitamin D (25[OH]D) levels and immune function, respiratory diseases, obesity, metabolic syndrome, insulin resistance, infection, allergy, cancers, and cardiovascular diseases in pediatric and adolescent populations. The risk factors for vitamin D insufficiency or deficiency in the pediatric population are season (winter), insufficient time spent outdoors, ethnicity (non-white), older age, more advanced stage of puberty, obesity, low milk consumption, low socioeconomic status, and female gender. It is recommended that all infants, children, and adolescents have a minimum daily intake of 400 IU ($10{\mu}g$) of vitamin D. Since the vitamin D status of the newborn is highly related to maternal vitamin D levels, optimal vitamin D levels in the mother during pregnancy should be maintained. In conclusion, given the important role of vitamin D in childhood health, more time spent in outdoor activity (for sunlight exposure) and vitamin D supplementation may be necessary for optimal health in infants, children, and adolescents.

• 한국의류학회지
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• 제29권1호
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• pp.1-12
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• 2005

This study was to suggest a feasible sizing system of infants and children's swim-suits. The basic body dimensions were selected after surveying the swimsuit manufacturers. The control dimensions and the secondary dimensions were taken from the 1997 National Anthropometric Survey data for the establishment of the sizing system. While in the current market swimsuit sizes were generally measured by the hip circumference for boys, and the bust and hip circumference for girls, the height was selected in this study as the control dimension because the height is well recognized by the customers and the KS standards specify the height to be the control dimension for infant's and children's wear. In the new sizing system of this study, the height was a control dimension, and hip was selected as a secondary dimension for boys. and bust and hip were selected as secondary dimensions for girls. Conclusively, in this study we suggest 12 sizes in case of 5cm height interval by the KS sizing system and 7 sizes in case of loom height interval by the current market sizing system, based on the height as a control dimension, for a standard swim-suit sizing system for infants and children.

• Journal of Chest Surgery
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• 제46권6호
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• pp.391-401
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• 2013

Mechanical circulatory support (MCS) in the pediatric heart failure population has a limited history especially for infants, and neonates. It has been increasingly recognized that there is a rapidly expanding population of children diagnosed and living with heart failure. This expanding population has resulted in increasing numbers of children with medically resistant end-stage heart failure. The traditional therapy for these children has been heart transplantation. However, children with heart failure unlike adults do not have symptoms until they present with end-stage heart failure and therefore, cannot safely wait for transplantation. Many of these children were bridged to heart transplantation utilizing extracorporeal membranous oxygenation as a bridge to transplant which has yielded poor results. As such, industry, clinicians, and the government have refocused interest in developing increasing numbers of MCS options for children living with heart failure as a bridge to transplantation and as a chronic therapy. In this review, we discuss MCS options for short and long-term support that are currently available for infants and children with end-stage heart failure.

• Childhood Kidney Diseases
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• 제27권2호
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• pp.111-116
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• 2023

Purpose: This article was to investigate the association between urinary tract infections (UTIs) and high weight status in infancy. Methods: We conducted a nationwide matched cohort study from January 2018 to December 2020 using data from the Korean National Health Insurance System and the Korean National Health Screening Program for Infants and Children. We analyzed the association between UTI diagnosis codes and high weight status (which was defined as being in the 90th percentile or higher of weight-for-age). Results: We found that 22.8% of infants with UTIs exhibited high weight status, compared to 20.0% of non-UTI infants (P<0.001). Per our multivariable analyses, the adjusted odds ratio for high weight status was 1.09 (95% confidence interval, 1.06-1.13). Conclusions: UTI in the first 12 months of life was associated with a weight-for-age percentile of ≥90. Our findings corroborate those of previous single-center studies and emphasize the importance of careful monitoring for this at-risk group.