• Clinical and Experimental Pediatrics
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• 제64권4호
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• pp.157-164
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• 2021

Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, a small number of coronavirus disease 2019 (COVID-19) cases in neonates have been reported worldwide. Neonates currently account for only a minor proportion of the pediatric population affected by COVID-19. Thus, data on the epidemiological and clinical features of COVID-19 in neonates are limited. Approximately 3% of neonates born to mothers with COVID-19 reportedly tested positive for SARS-CoV-2. Current limited data on neonates with COVID-19 suggest that neonatal COVID-19 shows a relatively benign course despite a high requirement for mechanical ventilation. However, neonates with pre-existing medical conditions and preterm infants appear to be at a higher risk of developing severe COVID-19. The greatest perinatal concern of the COVID-19 pandemic is the possibility of vertical transmission, especially transplacental transmission of SARS-CoV-2. Although direct evidence of the vertical transmission of SARS-CoV-2 is lacking, its possibility during late pregnancy cannot be ruled out. This review summarizes available case studies on COVID-19 in neonates and introduces what is currently known about neonatal COVID-19 with focus on its vertical transmission.

• Journal of Genetic Medicine
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• 제6권1호
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• pp.74-80
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• 2009

목 적: 임신 제1삼분기와 2삼분기에 시행하고 있는 다운증후군 선별검사 지표들이 다른 임신합병증 예측에 있어서 갖는 의의를 알아보고자 한다. 대상 및 방법: 2005년 1월부터 2006년 12월까지 만2년간 강남차병원 산부인과에서 산전진찰을 받으며 임신 제1삼분기에 PAPP-A와 NT, 2삼분기에AFP, hCG, Inhibin-A, 그리고 uE3로 다운증후군 선별검사를 시행 받고 분만한 3,121명의 산모와 이들의 신생아를 대상으로 하였다. 의무기록지 검토를 통해 산모의 나이, 임신합병증과 제태연령, 분만시와 분만후의 합병증 유무, 그리고 integrated test 시기와 각 지표의 수치를 조사하여 SPSS 프로그램을 이용하여 정규성 검정과 t-test, 그리고 로지스틱 회귀분석을 시행하였다. 결 과: 다운증후군 선별검사의 표지물질들이 다른 임신 합병증에서도 이상소견을 보였는데, 특히 조산과 자간전증 시에 AFP 수치의 증가, hCG증가, Inhibin-A증가, PAPP-A감소, NT 감소가 있었다. Inhibin-A는 자간전증, 저체중아 출산, 조산시에 임신 제2삼분기에 증가되어 있었는데 odds ratio는 각각 2.843, 1.446, 1.287이었다. AFP는 임신 24주 이전의 태아손실(odds ratio 2.868)과 조산(odds ratio 1.653)시 에 임신 제2삼분기에 증가하였고, 임신 제1삼분기의 PAPP-A는 자간전증(odds ratio 0.51)과 조산(odds ratio 0.75)시에 감소함을 알 수 있었다. 결 론: 모든 산전 클리닉에서 시행하고 있는 다운증후군 선별검사의 지표 중 특히 임신 제2삼분기의 Inhibin-A와 AFP, 제1삼분기의 PAPP-A의 이상 수치는 태반기능 관련 임신합병증인 조산, 자간전증과 저체중아 출산의 동반 가능성이 높아 이를 이용하면 이들 질환의 고위험군을 분류할 수 있으며, 이런 산모를 대상으로 보다 주의깊은 산전관리와 상담이 가능할 것으로 생각된다.

• Clinical and Experimental Reproductive Medicine
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• 제22권2호
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• pp.171-181
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• 1995

Ovarian hyperstimulation syndrome(OHSS) is one of the well-known complication of controlled ovarian hyperstimulation(COH). Though there have been numerous measures to prevent the occurrence of OHS, it has not been completely preventable until now. The fluid shift from the intravascular space to the third space is due to decreased oncotic pressure of the serum. The objective of this study was to evaluate if IV administration of 20% albumin in those patients with OHSS risk can make prevention of severe OHSS. We retrospectively analysed 70 patients undergoing IVF-ET who had serum peak estradiol($E_2$) level of >2,500 pg/ml and/or the number of oocytes retrieved over 20. The treatment group(n=39) received albumin while the control group(n=31) did not. After 40 grams of human albumin diluted in 1,000 ml of 0.9% sodium chloride solution, the treatment group received half of the fluid during oocyte retrieval, the remainder in the recovery suite. The results were as follows; There were significant differences in the levels of serum peak $E_2$ and number of oocytes retrieved between the two groups(p<0.05). However, there were no significant differences in the incidence of OHSS and pregnancy rate or multifetal pregnancy rate. In conclusion, administration of albumin to OHSS risk patients did not reduce the rate of OHSS in IVF-ET. However, if we consider the fact that there were differences in the level of peak serum $E_2$ and oocyte numbers, further prospective study may be needed.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.337-346
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• 2001

Objective : To determine the clinical risk factors associated with the mode of delivery decision and to compare cesarean section rates after adjusting for risk factors identified among Korean hospitals. Methods Data were collected from 9 general hospitals in two provincial regions by medical record abstraction during February 2000. A total of 3,467 cases were enrolled and analyzed by stepwise logistic regression. Performance of the risk-adjustment model (discrimination and calibration) was evaluated by the C statistic and the Hosmer-Lemeshow test. Crude rates, predicted rates with 95% confidence intervals, and adjusted rates of cesarean section were calculated and compared among the hospitals. Results : The average crude cesarean section rate was 53.2%, ranging from 39.4% to 65.7%. Several risk factors such as maternal age, previous history of cesarean section, placenta previa, placental abruption, malpresentation, amniotic fluid abnormality, gestational anemia, infant body weight, pregnancy-induced hypertension, and chorioamnionitis were found to have statistically significant effects on the mode of delivery. It was confirmed that information about most of these risk factors was able to be collected through the national health insurance claims database in Korea. Performance of the risk-adjustment model was good (c statistic=0.815, Hosmer-Lemeshow test=0.0621). Risk factor adjustment did lead to some change in the rank of hospital cesarean section rates. The crude rates of three hospitals were beyond 95% confidence intervals of the predicted rates. Conclusions : Considering that cesarean section rates in Korean hospitals are too high, it is apparent that some policy interventions need to be introduced. The concept and methodology of risk adjustment should be used in the process of health policy development to lower the cesarean section rate in Korea.

• Toxicological Research
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• 제18권1호
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• pp.13-22
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• 2002

In Korea, 2,320 tonnes of acetanilide were mostly wed as intermediates for synthesis in phar-maceuticals or additives in synthesizing hydrogen peroxide, varnishes, polymers and rubber. Only small amount of 120 kg were wed as a stabilizer for hydrogen peroxide solution for hair colouring agents in 1998. Readily available environmental or human exposure data do not exist in Korea at the present time. However, potential human exposures from drinking water, food, ambient water and in work places are expected to be negligible because this chemical is produced in the closed system in only one company in Korea and the processing factory is equipped with local ventilation and air filtering system. Acetanilide could be distributed mainly to water based on EQC model. This substance is readily biodegradable and its bioaccumulation is low. Acute toxicity of acetanilide is low since the L $D_{50}$ of oral exposure in rats is 1,959 mg/kg bw. The chemical is not irritating to skin, but slightly irritating to the eyes of rabbits. horn repeated dose toxicity, the adverse effects in rats were red pulp hyperplasia of spleen, bone marrow hyperplasia of femur and decreased hemoglobin, hematocrit and mean corpuscular hemoglobin concentration. The LOAEL for repeated dose toxicity in rats was 22 mg/kg/day for both sexes. Acetanilide is not considered to be genotoxic. In a reproductive/developmental toxicity study, no treatment-related changes in precoital time and rate of copulation, impregnation, pregnancy were shown in all treated groups. The NOAELs for reproduction and developmental toxicity (off-spring toxicity) are considered to be 200 mg/kg bw/day and 67 mg/kg bw/day, respectively. Ecotoxicity data has been generated in a limited number of aquatic species of algae (72 hr- $E_{b}$ $C_{50}$; 13.5 mg/l), daphnid (48hr-E $C_{50}$ > 100 mg/l) and fish (Oryzias latipes, 96hr-L $C_{50}$; 100 mg/l). Form the acute toxicity values, the predicted no effect concentration (PNEC) of 0.135 mg/1 was derived win an assessment factor of 100. On the basis of these data, acetanilide was suggested as currently of low priority for further post-SIDS work in OECD.in OECD.D.

• 대한간호학회지
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• 제25권2호
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• pp.330-340
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• 1995

This study was conducted to find out the degree of paternal attachment to neonate, and to identify factors affecting paternal attachment. The main purpose was to make the base data for nursing intervention to improve parternal attachment. The subjects of this study were 20 fathers whose partners have delivered premature neonate and 30 fathers whose partners have delivered normal neonate in 3 university hospitals in Seoul. Data were collected from Feb. 10 to Apr. 10 1994 by self report questionaires. The instrument for this study was based on 7 kinds of characteristics of paternal attachment by Greenberg St Morris(1974), and developed by re-searcher The statistical methods for data analysis were percentage, mean, standard deviation, 1-test, ANOVA with S.P.S.S. program. The conclusions are as follows. 1. Fathers had the high degree of paternal attachent to neonate, but were afraid of active touch. 2. The factors that affect paternal attachment were delivery odor, past experience about own father except delivery pattern, pregnancy plan, sex of nonate. 3. There were not significant correlations between paternal attachment and early visual contact frequency of father-neonate. 4. In the degree of paternal attachment, though normal neonate father showed somewhat higher result than premature neonate father, there was not statistically significant difference between two groups(t=-1.83, P=0.076). But in the character of tactail awarness there were significant differences between two groups, hence nursing interventions are needed to help the premature neonate's father bring early tactile con-tact. Pother research about factors affecting paternal attachment to neonate and high risk neonate as well as low birth weight neonate is reguired.

• 부모자녀건강학회지
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• 제8권2호
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• pp.137-146
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• 2005

This study was conducted to find out the paternal attachment to neonate, and to identify factors affecting paternal attachment. The purpose was to make the base data for nursing intervention to improve paternal attachment. The subjects of this study were 93 fathers whose partners have delivered normal neonate in 1 hospital in Busan. Data were collected from Sep. 1th to Oct. 31th 2005 by a self-report questionnaire. The instrument for this study was based on 7 kinds of characteristics of paternal attachment by Greenberg & Morris(1974), and modified by researchers. The statistical methods for data analysis were percentage, mean, standard deviation, t-test, ANOVA with SPSS program Ver 10. The conclusions are as follows. Fathers had the high degree of paternal attachment to neonate. But, there were not significant correlations between paternal attachment and the father's demographic characteristics, pregnancy plan, delivery pattern, delivery order, sex of neonate and past experience. Also there were not significant correlations between paternal attachment and early visual contact frequency of father-neonate. Further research about factors affecting paternal attachment to neonate and high risk neonate as well as low birth weight neonate is required.

• Journal of Genetic Medicine
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• 제12권2호
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• pp.118-122
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• 2015

Noninvasive prenatal test (NIPT) is a novel screening method for the diagnosis of fetal chromosomal aneuploidies. NIPT is based on technology that detects cell-free fetal DNA in maternal plasma and analyzes it with massively parallel sequencing technology to determine whether the fetus is at risk of trisomy 21, trisomy 18, trisomy 13 or sex chromosome abnormalities (SCAs). NIPT has been reported to have sensitivity of 99% and a false positive rate of less than 1% for detecting trisomy 21 and trisomy 18. Although extension of the application of NIPT to other SCAs has been attempted, there are concerns in extending NIPT to SCAs because of maternal or fetal mosaicism, undetected maternal SCAs, and multiple pregnancies. Recently, we assessed a pregnancy with the rare Turner syndrome mosaicism 45, X/47, XXX, which was reported as 45, X with NIPT. We present the case here and briefly review the current literatures on NIPT in testing for fetal monosomy X. To the best of our knowledge, this is the first report of the 45, X/47, XXX mosaicism in Korea to be reported as 45, X by NIPT with whole genome sequencing. This case report will provide valuable information for counseling women who want to undergo NIPT.

• Clinical and Experimental Reproductive Medicine
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• 제40권4호
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• pp.163-168
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• 2013

Objective: Preimplantation genetic diagnosis (PGD) is an assisted reproductive technique for couples carrying genetic risks. Charcot-Marie-Tooth (CMT) disease is the most common hereditary neuropathy, with a prevalence rate of 1/2,500. In this study, we report on our experience with PGD cycles performed for CMT types 1A and 2F. Methods: Before clinical PGD, we assessed the amplification rate and allele drop-out (ADO) rate of multiplex fluorescent polymerase chain reaction (PCR) followed by fragment analysis or sequencing using single lymphocytes. We performed six cycles of PGD for CMT1A and one cycle for CMT2F. Results: Two duplex and two triplex protocols were developed according to the available markers for each CMT1A couple. Depending on the PCR protocols, the amplification rates and ADO rates ranged from 90.0% to 98.3% and 0.0% to 11.1%, respectively. For CMT2F, the amplification rates and ADO rates were 93.3% and 4.8%, respectively. In case of CMT1A, 60 out of 63 embryos (95.2%) were diagnosed and 13 out of 21 unaffected embryos were transferred in five cycles. Two pregnancies were achieved and three babies were delivered without any complications. In the case of CMT2F, a total of eight embryos were analyzed and diagnosed. Seven embryos were diagnosed as unaffected and four embryos were transferred, resulting in a twin pregnancy. Two healthy babies were delivered. Conclusion: This is the first report of successful pregnancy and delivery after specific PGD for CMT disease in Korea. Our PGD procedure could provide healthy babies to couples with a high risk of transmitting genetic diseases.

• 한국보건간호학회지
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• 제16권2호
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• pp.315-324
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• 2002

Objectives : This study was conducted to explore the relating factors with the delivery of low-birth-weight infants in Pyungtaek city. Methods : A questionnaire survey was obtained from 51 mothers with low-birth-weight babies and 90 mothers with full-term normal babies from April to October in 2001. Questionnaire consisted of demographic characteristics, dietary habits including alcohol. drugging, and smoking, past and present disease, prenatal risk factors and prenatal check-up, and complications related to labor and delivery. Results : 1. In the low-birth-weight infants group, father's education level and mother's height were significantly lower, and proportion of old age mothers was significantly higher than those of the normal infant group. 2. Mothers with low-birth-weight infants experienced more premature rupture of membrane, placenta previa, ecclampsia, and twin pregnancy than mothers with normal infants. Gestational period of mothers with low-birth-weight infants was significantly shorter than that of mothers with normal infants. 3. No differences were found in eating habit, alcohol and drug ingestion, smoking, exposing to dangerous materials in two groups, but both groups were highly exposed to indirect smoking, although mothers rarely smoke. Conclusion : The findings of this study indicate that high risk group such as less educated, or older mothers need more prenatal health assessment and support from public health services. Addition to determine the risk factors related to the delivery of low-birth-weight infants, public health nurses pay more attention and develop efficient management system for vulnerable women and infants.