Brazilian adaptation of the McLean Screening Instrument for Borderline Personality Disorder

Abstract Objective Borderline personality disorder (BPD) is a serious and extremely prevalent mental disorder. Early diagnosis is vital for treatment. However, there are no specific screening instruments validated for Brazilian Portuguese. This study aimed to adapt the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) to the Brazilian context. The MSI-BPD is a self-report instrument based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), that enables fast and reliable assessment of BPD, with measures of sensitivity (SN) and specificity (SP) similar to the diagnostic interview for the DSM-5 (Structured Clinical Interview for DSM-V Axis II Disorders [SCID-II]), taken as the gold standard. Methods Two independent translations, a synthesis version, back-translation, and analysis by experts were employed to create the final version of the instrument in Brazilian Portuguese. The translated instrument was administered to 1,702 adults aged 18-59 years to verify evidence of validity relating to content, internal structure, relationship with other variables, and reliability. Results The exploratory and confirmatory factor analyses show that the one-factor structure is adequate. The scale showed satisfactory internal consistency (Kuder-Richardson coefficient [KR-20] of Cronbach's alpha = 0.691) and good test-retest reliability (intraclass correlation coefficient [ICC] = 0.802). Logistic regression analysis using the Personality Inventory for the DSM-5-Brief Form (PID-5-BF) (DSM-5) as reference established an ideal cut-off point of eight symptoms, with adequate SN (0.79) and SP (0.75), similar to the original instrument. The area under the curve (AUC) was 0.830 (95% confidence interval: 0.802-0.858), with a positive predictive value of 89.2%. Conclusion The Brazilian version of the MSI-BPD has adequate psychometric properties for use as a BPD screening tool by clinicians.

Oxidative stress and inflammatory process in borderline personality disorder (BPD): a narrative review

Borderline personality disorder (BPD) is a severe psychiatric condition that affects up to 2.7% of the population and is highly linked to functional impairment and suicide. Despite its severity, there is a lack of knowledge about its pathophysiology. Studies show genetic influence and childhood violence as factors that may contribute to the development of BPD; however, the involvement of neuroinflammation in BPD remains poorly investigated. This article aimed to explore the pathophysiology of BPD according to the levels of brain-derived neurotrophic factor (BDNF), inflammatory cytokines, and oxidative stress substances that exacerbate neuronal damage. Few articles have been published on this theme. They show that patients with BPD have a lower level of BDNF and a higher level of tumor necrosis factor (TNF)-α and interleukin (IL)-6 in peripheral blood, associated with increased plasma levels of oxidative stress markers, such as malondialdehyde and 8-hydroxy-2-deoxyguanosine. Therefore, more research on the topic is needed, mainly with a pre-clinical and clinical focus.

Progress of the influence and mechanism of gut-lung axis in premature bronchopulmonary dysplasia / 国际儿科学杂志

The gut-lung axis refers to the internal relationship and interaction between the gastrointestinal tract and the respiratory tract at multiple levels.Studies have found that gut microbiota may be closely related to the occurrence and progression of bronchopulmonary dysplasia(BPD)in preterm infants through the gut-lung axis.Studying the mechanism of the interaction between them will help us to extend new therapeutic targets and directions from the perspective of microecology for BPD infants.This article reviews the correlation between gut microbiota and BPD, and the research progress of the mechanism of the gut-lung axis in premature BPD from the aspects of insulin-like growth factor 1, metabolomics, immune regulation, direct transfer, and nutrition.It provides new research ideas for the prevention and treatment of BPD.

The high-risk factors of different severities of bronchopulmonary dysplasia (BPD) based on the national institute of child health and human development (NICHD) diagnosis criteria in 2018 / Os fatores de alto risco de diferentes gravidades de displasia broncopulmonar (DBP) com base no instituto nacional de saúde infantil e desenvolvimento humano (NICHD): critérios de diagnóstico em 2018

ABSTRACT Objective To investigate the clinical characteristics of preterm infants with different severities of bronchopulmonary dysplasia (BPD) and disclose the high-risk factors of exacerbating BPD. Methods Collection of clinical data of 91 preterm infants admitted to the NICU and diagnosed with BPD, categorized in groups according to the disease severity: 41 mild cases,, 24 moderate cases, and 26 severe cases. Comparison and analysis of perinatal risk factors, treatment, complications and prognosis of the infants with different severity degrees. Results The severe group had a higher proportion of infants with congenital heart disease (CHD) higher than the moderate group (P < 0.05), and a higher ratio of pneumonia and mechanical ventilation (MV) ≥ seven days than the mild group (P < 0.05). The severe group also presented higher reintubation incidence than both the mild and moderate groups (P < 0.05). The groups presented different (P < 0.05) incidence rates of hemodynamically significant patent ductus arteriosus (hsPDA) . Ridit analysis suggested that the premature infants (PIs) with hsPDA, multiple microbial pulmonary infections, or Klebsiella pneumoniae pneumonia had more severe illness. Conclusion CHD, hsPDA, MV ≥ seven days, reintubation, pneumonia, especially multiple microbial pulmonary infections, and Klebsiella pneumoniae pneumonia are correlated with the severity of BPD and can be used as BPD progression predictor.

RESUMO Objetivo Investigar as características clínicas de prematuros com diferentes gravidades de displasia broncopulmonar (DBP) e divulgar os fatores de alto risco para a DBP. Métodos Coleta de dados clínicos de 91 prematuros internados em UTIN com diagnóstico de DBP, categorizados em grupos de acordo com a gravidade da doença: 41 casos leves, 24 casos moderados e 26 casos graves. Foram feitas a comparação e a análise de fatores de risco perinatais, tratamento, complicações e prognóstico de lactentes com diferentes graus de gravidade. Resultados O grupo grave teve uma proporção maior de bebês com doença cardíaca congênita (DCC) do que o grupo moderado (p < 0,05) e com pneumonia e ventilação mecânica (VM) ≥ 7 dias do que o grupo leve (p < 0,05). O grupo grave também apresentou maior incidência de reintubação do que os grupos leve e moderado (p < 0,05). Os grupos apresentaram diferentes (p < 0,05) taxas de incidência de persistência do canal arterial hemodinamicamente significativa (PCAhs). A análise de ridit sugeriu que os bebês prematuros (BPs) com PCAhs, infecções pulmonares microbianas múltiplas ou pneumonia por Klebsiella pneumoniae tinham doenças mais graves. Conclusão DCC, PCAhs, VM ≥ 7 dias, reintubação, pneumonia, principalmente infecções pulmonares microbianas múltiplas, e pneumonia por Klebsiella pneumoniae estão correlacionadas com a gravidade da DBP e podem ser usadas como preditoras de progressão da DBP.

Improvement of batyl alcohol on alveolarization arrest in newborn rats with bronchopulmonary dysplasia / 上海交通大学学报（医学版）

Objective: To investigate whether batyl alcohol (BTA) can improve the pathology of bronchopulmonary dysplasia (BPD) in newborn rats induced by lipopolysaccharide (LPS) and the mechanism. Methods: Pregnant SD rats (16.5 d) were randomly assigned into Saline group, LPS group, and LPS+BTA group. Amniocentesis injection of LPS was performed to establish neonatal bronchopulmonary dysplasia (BPD) rat model. In LPS+BTA group, LPS and BTA were injected at the same time. After birth, LPS+BTA group was injected with BTA continuously everyday for 7 days. The other two groups were injected with normal saline of equal volume. Lung tissues of neonatal rats on the first, third and seventh day after birth were stained by hematoxylin-eosin (H-E) and resorcin-fuchsin respectively, to observe alveolarization arrest. The mRNA and protein levels of interleukin 1β (IL-1β) in newborn rats lungs were detected by real-time PCR and ELISA. In vitro, mouse macrophages RAW264.7 were cultured to detect IL-1β mRNA levels and protein levels after treatment with LPS and BTA. SD rat bone marrow macrophages were isolated and treated with LPS and BTA. RNA-sequence was taken to screen for possible targets of BTA inhibition of inflammation. Results: The results of H-E staining showed that LPS+BTA group had a milder pathology of BPD, with more secondary septa counts, more alveolar counts, and smaller mean linear intercept (all P<0.05); after BTA intervention the expression levels of IL-1β mRNA and protein in lung tissues of neonatal rats were significantly lower than those in LPS group (both P<0.05). In vitro, IL-1β mRNA and protein increased after LPS stimulation (both P=0.000), but decreased in the LPS+BTA group (both P<0.05). RNA-sequence results showed that BTA inhibited the expressions of some inflammatory factors, such as thrombospondin1 (Thbs1), triggering receptor expressed on myeloid cells 1 (Trem1), and cluster of differentiation 274 (Cd274), and promoted the expressions of some anti-inflammatory factors, such as complement C1q C chain (C1qc), RT1 class Ⅱ, locus Da (RT1-Da), and RT1 class Ⅱ, locus Db1 (RT1-Db1). Conclusion: BTA can improve lung pathology of neonatal rats with BPD by downregulating the expression of IL-1β and reducing inflammatory response.

Estimation of gingival blood glucose using a sensitive self-monitoring device in periodontitis patients

Background: Diabetes Mellitus is a complex disease with varying degree of systemic and oral complications. The prognosis is quite favorable if a disease is diagnosed in early stages. Since a large number of patients seek dental treatment routinely, screening procedures for early detection of subclinical cases can help in diagnosis of asymptomatic diabetes. Aim: The present study was undertaken to evaluate if gingival crevicular blood can be used for the estimation of blood glucose levels in periodontitis patients. Material and Methods: A prospective study was carried out comprising 150 patients Group A comprised of 75 subjects with gingivitis and group B comprised of 75 subjects with periodontitis. For gingival crevicular blood glucose (GCBG) level estimation, the blood was drawn onto the glucometer strip after gently probing the gingival sulcus and the readings were recorded. At the same time, blood Vijayendra Pandey, Akhilesh Chandra, Deepak Kumar, Anup Kumar Singh, Priyankesh, Alok Kumar Gupta. Estimation of gingival blood glucose using a sensitive self-monitoring device in periodontitis patients. IAIM, 2019; 6(6): 51-56. Page 52 was also collected from the index finger onto the glucometer strip for the capillary finger-prick blood glucose (CFBG) sample. Both the values were compared and statistical analysis of data was performed. Results: The mean GCBGL and CFBGL in group A was 98.43 mg/dl ± 18.62 and 103.48 mg/dl ± 13.90 respectively, while in group B it was 136.37 mg/dl ± 36.95 and 141.62 mg/dl ± 51.84, respectively. There was no statistically significant difference (p> 0.05) between the two values in both the groups. Conclusion: It can be concluded that GCBG levels are positively correlated with CFBG levels. Therefore, clearly indicating that gingival crevicular blood collected during diagnostic periodontal examination may be an excellent source of blood sample for glucometric analysis.

Nuevas definiciones de evidencia en la medicina contemporánea: aportes desde la antropología / New definitions of evidence in contemporary medicine: contributions from anthropology

Este artículo explora la importancia productiva de las Humanidades y de las Ciencias Sociales - en particular de la Antropología - a través de la revisión del "impacto" producido en un campo eminentemente empírico: la Medicina. El impacto de las Humanidades en general y la Antropología en particular tiene aquí una doble vertiente: 1) como base crítica epistemológica a una visión positivista "fundamentalista" - la enfermedad es algo meramente biológico - y 2) la incorporación de un nuevo repositorio humanístico en las prácticas contemporáneas. La creciente importancia de las Humanidades en la moderna medicina con la irrupción de la Medicina Basada en Narrativas, movimiento heredero de lo que se ha conocido como "Narrative Turn" en el campo de la Medicina - aquí ofrecemos un estudio de caso alrededor del Trastorno Límite de Persona lidad - cuestiona las aseveraciones que insisten en su falta de productividad y eficacia. Proponemos aquí un movimiento de apertura hacia definiciones de evidencia más incluyentes - en la epistemología y la academia, pero también en la práctica clínica.

This article explores the "productive" importance of the Humanities and Social Sciences - Anthropology particularly - through the revision of the "impact" produced in an eminently empirical field: Medicine, particularly after the hegemony of Evidence Based Medicine (EBM). The impact of the Humanities in general and Anthropology in particular has a two fold meaning: 1) as a critical foundation against the "fundamentalistic" positivist view - disease is something purely biological - and 2) the incorpora tion of a new humanistic repository - maybe better the recovery of many of contemporary practices. The increasing relevance of Humanities on modern medicine with the emergence of Narrative-Based Medicine (NBM), movement of what has become known as "Narrative Turn" in the field of medicine - we offer here a case-study about Borderline Person ality Disorder - challenges the assertions that insist on their lack of productivity and effectiveness. We suggest here an opening movement towards more inclusive definition of evidence-in epistemology and academia, but also in clinical practice.

Fetal Kidney Length: A Useful Parameter For Ultrasonographic Gestational Age Calculation.

Background & Objective: As the technology used in sonography has become more advanced accurate estimation of gestational age (GA) has become more demanding to plan treatments in pregnancy. Fetal kidney length (FKL) alone or its combination with other biometric parameters can be used in GA calculation more precisely in IInd&IIIrd trimester. Methodology: Two hundred three healthy pregnant females of IInd&IIIrd trimester were analyzed for GA calculation via FKL, Bi parietal diameter (BPD) and femur length (FL) using various lenear regression models. Results: Fetal kidney could be seen easily sonographically at 16thwk of gestation. FL was the most accurate single parameter (SE + 7.95 days) followed by FKL + 9.56days; BPD was the least accurate + 9.86 days. GA can be calculated most accurately by combining FKL with FL and BPD with SE + 7.12 days. Conclusion: FKL is easy to measure in IInd and IIIrd trimester and more accurate than BPD for GA estimation. So FKL could be used alone or easily incorporated into the model for dating pregnancies after 16th wk of gestation, in particular when measurements of BPD and FL are difficult.

Clinical Characteristics of Patients with Bronchopulmonary Dysplasia Admitted to Pediatric Intensive Care Unit

PURPOSE: As the incidence of bronchopulmonary dysplasia (BPD) has increased, it is important to understand the clinical outcomes of BPD patients discharged from neonatal intensive care units (NICU). The purpose of our study was to describe the characteristics of BPD patients who are re-hospitalized in a pediatric intensive care unit (PICU) and to evaluate the prognostic outcome factors. METHODS: We retrospectively reviewed the medical records of BPD patients who were admitted to our PICU between May 2006 and November 2014. In total, we identified 101 cases which were divided into two groups, group 1, those who required intensive care for an acute illness or disease aggravation (n=62), and group 2, those who were admitted for post-operative care unrelated to having BPD as a control group (n=39). We subsequently compared the characteristics. RESULTS: Most patients in group 1 were aged less than 1 year, with weight below the 3rd percentile for age at the time of their PICU admission. The main cause for their admission was respiratory failure, requiring mechanical ventilation. When comparing the two groups, group 1 showed higher gestational age at birth, and a longer duration of mechanical ventilation, oxygen support, and NICU hospitalization than group 2. However, we failed to identify any factor significantly associated with the duration of the PICU stay, hospital stay, and mortality. Further large-scale, long-term follow-up studies will be necessary. CONCLUSION: As the majority of patients are admitted to PICU because of respiratory symptoms during their infantile period, careful follow-up with supportive care and prevention of respiratory infection are required.

Biparietal diameter (BPD) growth rate between the first and second trimester as a predictor of poor obstetric and neonatal outcome among the Indian population.

The Objective of this study was to evaluate the association of BPD at 11-14 weeks and pregnancy outcome and to determine the role of incremental BPD growth from 11-14 weeks and 17-20 weeks in pregnancy outcome. Methods: Women (n=910) with singleton pregnancies were included in this prospective observational study after an early anomaly scan (11 to 14 weeks). Outcomes noted were the incidence of adverse events and the neonatal birth weight. Results: Irrespective of their original BPD at 11 to 14 weeks, fetuses had acquired optimum BPD growth rate on a follow up scan at 17-20 weeks, i.e., a majority of them fell in the 10th to 90th percentile group (P value <0.001). Fetuses with BPD below the 10th percentile were small for gestational age (SGA) at birth despite an optimal growth rate. Also, a significant majority of the fetuses with BPD in the 10th to 90th percentile were Appropriate for Gestational Age (AGA) at birth. Conclusion: The BPD at 11 to 14 weeks scan predicts the incidence of SGA and AGA babies, independent of BPD growth rates between first and second trimester. The BPD growth rates were neither significantly different nor predictive of the birth weight or adverse pregnancy outcomes.

Expressions of VEGF and Ang-1 in neonatal rats with hyperoxia-induced BPD and its effects on lung development / 实用医学杂志

Objective To investigate the expressions of VEGF and Ang-1 in neonatal rats with hyperoxia-induced BPD and its effects on lung development. Methods 48 SD neonatal rats (2 or 3 days old) were randomly divided into two group and raised under hyperoxia or air for 1, 3 and 7 days, respectively. Real-time RT-PCR and Western blot were used to determine the level VEGF and Ang-1 mRNAs and proteins in lung tissues of the two groups. HE staining was used to observe the changes of lung morphology. Results The levels of VEGF and Ang-1 mRNAs in the lung on the 7th day in the control group were 0.722 ± 0.372 and 0.828 ± 0.462, respectively, and those in hyperoxia group were 0.239 ± 0.293 and 0.327 ± 0.184 , respectively. The levels of VEGF and Ang-1 proteins on the 7th day in the control group were 0.632 ± 0.289 and 0.573 ± 0.436, respectively, and those in hyperoxia group were 0.358 ± 0.128 and 0.204 ± 0.068 , respectively. Comparing to the control group , the levels of VEGF and Ang-1 mRNAs and proteins on the 7th days significantly decreased in the hyperoxia groups (P<0.05). The lung tissues of the hyperoxia group display dysplastic features with , alveolar simplification , reduced alveolar numbers and retardation on microvascular development. Conclusion VEGF and Ang-1, functioning as an important regulators for pulmonary vascular development , are involved in the pathogenesis of BPD and the lung development.

Riesgo y letalidad suicida en pacientes con trastorno límite de la personalidad (TLP), en un hospital de psiquiatría / Suicidal risk and lethality in patients with borderline personality disorder (BPD), at a psychiatry hospital

Suicide attempt in patients diagnosed with Borderline Personality Disorder (BPD) is the most frequent cause of hospitalization in this clinical category and suicidal risks are usually the first manifestation of such disorder. Patients frequently relapse, thus generating high personal and family costs, including: treatments, hospitalization, medication, work disability in economically active people and even death. The American Psychiatric Association, through the DSM-IV, defines the Borderline Personality Disorder as <>. More specifically, criterion five of the disorder mentions self-mutilating behavior, threats, and recurrent suicidal behavior. DSM-IV reports that 8-10% of borderline patients commit suicide. In our country, however, there are no specific data about people diagnosed with BPD who actually have commited suicide. Prevalence of BPD among the general population ranks from 1 to 2%, from 11 to 20% of the psychiatric population; representing 20% of hospitalized patients. The gender distribution is 3:1, being more frequent among women than men. The objective of this study is the assessment of suicidal risk and lethality of 15 patients diagnosed with Borderline Personality Disorder. This research was conducted at the doctors' offices of the host institution, where 1.39% of a total of 1151 hospitalized patients in 2007 were diagnosed with BPD. The comorbidity of DSM-IV Axis I and BPD is frequent and can be found together with mood disorders (depression, dysthymia), substance-related disorders, eating disorders (bulimia nervosa), post-traumatic stress disorder, anxiety disorder and/or attention-deficit hyperactivity disorder. A research conducted in the USA with 504 patients diagnosed with BPD showed that 93% (n = 379) of the patients showed comorbidity of DSM-IV Axis I and mood disorders. Similar results were reported by other researchers. This study was designed to be a descriptive and transversal study. We went through the records of all the adult patients who had been hospitalized due to suicide ideation or attempt, diagnosed by psychiatrists as Borderline Personality Disorder, and confirmed by the SCID-II, and medicated by a psychiatrist. Selection criteria: 18 year-old patients or older, hospitalized due to suicide attempt or ideation, and diagnosed with BPD. The research was conducted in compliance with the regulations governing human research ethics set forth in the Declaration of Helsinki (1975). The instruments used were: the medical history of the patients, the ID file for clinical and epidemiological studies, the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID -II), the Hopelessness Scale, the Depressive Syndrome Questionnaire, the Suicidal Ideation Scale, the Risk-Rescue Scale and some risk factors such as: sexual abuse, separation from partner, parental divorce, the suicide of a close relative, and alcohol and substance abuse. The results on the lethality of suicide attempts are similar to the results of other studies: women show a higher number of less lethal suicide attempts, and the methods used are also similar (medication intoxication and mutilation). The comorbidity with depressive disorders was of 86.6%, thus our results concur with those of other studies. Regarding risk factors, 86.6% (n = 13) mentioned they have experienced some type of sexual abuse, 46.6% (n = 7) separated from their partner, 40% (n = 6) had divorced parents, and 6.6% (n = 1) had a close relative who had committed suicide. During their last suicide attempt, one of the subjects had consumed alcohol and none of them had taken drugs; however, these behaviors did not appear to potentiate the suicidal risk. According to the scales applied, 46% of the subjects (n = 7) showed severe hopelessness, while 54% (n = 8) ranged between mild or moderate hopelessness; 13% (n = 2) had severe depression according to Calderon's scale. According to the Suicidal Ideation Scale, 93.3% (n=14) had a >10 score, which means patients show risk of attempting suicide again. The Risk-Rescue Scale suggests that most patients (n = 13) exhibited deliberate self-harming behavior (e.g. cutting superficially the skin around the wrist, taking prescription drugs or intoxicating near key people who could rescue them or provide help and rescue), which are not considered true parasuicidal behavior. The literature shows that BPD is the most prevalent of all personality disorders, both in the general and clinical population, the one with the highest number of suicide attempts in the DSM-IV Axis II, and the one with the highest comorbidity with Axis I mood disorders and Axis II personality disorders. The 15 patients in this sample carried out a total of 128 suicide attempts throughout their lives, which coincides with other research results, which describe that a history of multiple suicide attempts is a predictor of future suicidal behavior and increase the suicidal risk. As shown above, there were no cases obtaining high scores in all the scales applied (hopelessness, depression, suicidal ideation, high risk and low rescue), even in the result integration per subject, thus showing very few, high-lethality suicidal cases. It would be a mistake, however, to think that suicide attempts will always be less lethal, since there is always the risk of someone attempting a more lethal suicide that translates into the death of the patient. Suicide attempt assessment in dealing with Borderline Personality Disorder becomes a necessary condition to design better therapeutic strategies, since it allows health professionals to know the degree of lethality and timely treatment. The assessment of suicide attempts enables a more realistic prognosis, which backs up and guides clinical decisions.

The Usefulness of Thymic Size at Birth as a Predictor of Bronchopulmonary Dysplasia

PURPOSE: Recent studies show that chorioamnionitis has an important role in the pathogenesis of bronchopulmonary dysplasia(BPD) and it induces thymic involution. The purpose of this study is to test the usefulness of thymic size at birth as a predictor of BPD. METHODS: This study was conducted on 91 very low birth weight infants of <1, 500 g with mean gestational age of 29.3 weeks and mean birth weight of 1, 161 g who were admitted at NICU of Dong Kang General Hospital for past 4 years of whom 21 infants had BPD. Thymic size was measured on routine chest radiographs taken in the first 3 hours after birth and measured as the ratio between the width of the cardiothymic shadow at the level of the carina and that of the thorax at the costophrenic angles (CT/ T). RESULTS: Correlation of thymic size with gestational age was statistically significant (P=0.003). CT/T of BPD group was smaller than that of non-BPD group (0.27+/-0.06, 0.33+/-0.07, respectively, P<0.01). A significant positive correlation between small thymus at birth and BPD was detected (P=0.003, odds ratio, 21.7), but not in other disease groups. CONCLUSIONS: We concluded that a small thymus at birth on the chest radiograph could be used as an early predictive parameter of the BPD.

The Comparison of Severity according to Preceding Causes of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants

PURPOSE: This report attempts to reveal the incidence and prevalence of bronchopulmonary dysplasia (BPD) and compare the severity according to preceding causes of BPD in very low birth weight (VLBW) infants. METHOD: Retrospective study was done on 293 VLBW infants who were born and admitted to neonatal intensive care unit in Samsung medical center between October, 1995 and December, 2001. Classical BPD was defined as oxygen dependency at 36 week's postmenstrual age (PMA). Ogawa BPD was defined as oxygen dependency at 28 days after birth, with respiratory distress symptoms and the change on chest X-ray finding. This classification further classified as BPD into 5 subtypes by the presence of respiratory distress syndrome (RDS), pathologic chorioamnionitis and the type of chest X-ray finding. BPD by Jobe and Bancalari was defined as oxygen dependency at 28 days after birth and classified as 3 subtypes (severe, moderate, mild) by the severity of oxygen dependency. Comparisons were made among classifications. RESULTS: Classical BPD infants were 56 (19.1%), Ogawa BPD infants were 76 (25.9 %), BPD by Jobe and Bancalari infants were 124 (42.3%). In Ogawa classification, Infants with RDS and the change on chest X-ray were 58 infants (76.4%). There was no statistical difference of mortality between each type of Ogawa BPD. In classification by Jobe and Bancalari, 35 infants (28.2%) belonged to severe BPD and 75 infants (60.5%) belonged to mild BPD. The mortality was highest in severe BPD infants but there was no statistical difference after correction by birth weight. There was no statistical correlation between Ogawa classification and classification by Jobe and Bancalari. CONCLUSION: There was no statistical difference in mortality or severity between each subtype of classifications according to the severity or preceding cause of BPD in very low birth weight infants.

Estimation of Mean Fetal Biometry by Using Ultrasonography in Normal Pregnancy / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to assess the mean fetal biometry and to create a formulae for estimation of gestational week using sonographic biometry measurement. METHODS: A total 271 women of singleton gestation were involved in this study of ultrasonographic fetal biometry. During the period from June 1996 to March 1998, the length of CRL (Crown Rump Length), BPD (Biparietal Diameter), HC (Head Circumference), AC (Abdominal Circumference), HL (Humerus Length) and TL (Tibia Length) of fetuses in normal pregnancy were measured by ultrasonography at Samsung Cheil Hospital and Women's Healthcare Center. The gestational age prediction equations were derived from sigletons with the use of liner regression analysis. RESULTS: We present the percentile ranks of fetal CRL, BPD, HC, AC, HL and TL measurement from 11 to 39 week's gestation and mean value of fetal size at each week. These data were analyzed and several second grade equations were derived from the data. CONCLUSION: We created these authentic equations and tables for mean value of fetal biometry in normal pregnancy at each gestation week with minimal intervariable errors.

The Adaptation of McLean Screening Instrument for Borderline Personality Disorder Among Chinese College Students / 中国临床心理学杂志

Objective:To revise the McLean Screening Instrument for Borderline Personality Disorder(MSI-BPD)in China and explore the four-factor solution in Chinese non-clinical sample.Methods:A total of 1206 college students(749 males and 457 females) from Peking university at the mean age of 20.02?1.77 completed the measures successfully.Results:The MSI-BPD showed good internal consistency and concurrent validity.Confirmatory factor analysis confirmed the four-factor solution(emotional disregulation,impulsivity,cognitive disturbance,unstable interpersonal relationship) in our sample of Chinese college students.Conclusion:MSI-BPD is a valid measure in Chinese college students.Future research should be done for its use in Chinese clinical samples.

Prospective Study of Sonographical Scanning as Prenatal Screening for Abnormal Fetuses With Aneuploid Chromosome / 中国医师杂志

Objective To sonographically measure nuchal skin thickness(NT) and biparietal diameter/femur length (BPD/FL) for normal fetuses between 10 and 24 gestational weeks,screen abnormal cases then to culture fetal cells and chromosome analysis, diagnosis aneuploid chromosome deformed fetuses Methods Ultrosonic estimation of fetal gestation according to gestational sac or CRL or BPD/Fl and AC, measuring NT, BPD/Fl of 100 cases per gestational weeks, drawing normal curve of NT, making curve of 90 th and 10 th NT and BPD/Fl. Restropectively analysis 5 cases trisomy 21.Results The average of NT was 1 76mm between 10 and 13 gestational weeks. The average of NT was 3 52mm between14 and 24 gestational weeks. The value of 50th was 2 40～1 40 between14 and 24 gestational weeks.Conclusions If the value of NT is more than 90 percent of normal fetuses, and if BPD/FL ratio is morn than 90 percent of normal fetuses,the sensitivity of trisome 21 should increase.Combining factors as elderly and high risk parturition, the sensitivity of trisomy 21 is much more increasing.

Macrosomia and Shoulder Dystocia Prediction using Prenatal Ultrasound Measurement / 대한산부인과학회잡지

OBJECTIVE: To determine if birth weight greater than 4000gm can be predicted by ultrasound measurement of abdominal circumference(AC) and if shoulder dystocia in macrosomic infants can be predicted by ultrasound measurement of the difference between the abdominal diameter(AD) and biparietal diameter(BPD). METHODS: A Retrospective study was performed of births occuring from March, 1998 to August, 1999 at department of Obstetrics and Gynecology, College of Medicine, Chung-Ang University. Among neonates of birth weight greater than 4000 gm, 50 cases in that ultrasound examination was done within 2 weeks before delivery were selected for macrosomic group and 50 cases were selected for control group during the same period, among neonate of birth weight from 3100gm to 3900gm. RESULTS: 1) Normal spontaneous vaginal delivery(NSVD) was 41 cases in control group and 30 cases in macrosomic group. Among NSVD, shoulder dystocia was 1 case in 41 cases of control group and was 7 cases in 30 cases of macrosomic group. 2) On ultrasound measurement, 6 cases had AC greater than 35 cm in control group and 45 cases in macrosomic group. Among 30 cases in NSVD was done in macrosomic group, difference between AD and BPD was 2.9 0.271 cm when shoulder dystocia was existed and was 2.1 0.409 cm when shoulder dystocia was not existed. Between the two groups, statistically significant difference was detected. 3) When AC(cutoff value of 35cm) was used for screening of macrosomia, sensitivity for macrosomia was 88.2% and specificity was 89.8% and when AD-BPD difference(cutoff value of 2.6cm) was used for prediction of shoulder dystocia, sensitivity for shoulder dystocia was 66.6% and specificity was 95.2%. CONCLUSIONS: In prenatal ultrasound measurement, AC measurement at third trimester of pregnancy will be a valuable indicator for macrosomia screening. The AD-BPD difference of shoulder dystocia group was greater than uncomplicated group in macrosomia and the AD-BPD difference cutoff value of 2.6cm was significant value statistically.

Association of Early Postnatal Neutropenia and Development of Bronchopulmonary Dysplasia in Preterm Infants

PURPOSE: To see if a similar relationship exists between the decreased number of circulating neutrophils and the development of bronchopulmonary dysplasia (BPD) in preterm infants, we tried to test the hypothesis that claims that preterm infants, who develop BPD, have decreased number of circulating neutrophils than those who do not develop BPD. METHODS: A retrospective cohort study was conducted in 167 preterm infants from August 1995 to July 1997, who were admitted in the neonatal intensive care unit (NICU) of Seoul National University Children's Hospital. RESULTS: BPD was diagnosed in 16% (27/167) of preterm infants. We compared the clinical characteristics of the study population according to the presence or absence of BPD. Compared to non-BPD group, the BPD group had a lower gestational age (29.4 +/- 2.7weeks versus 32.7 +/- 1.7 weeks), lower birth weight (1,240 +/- 486g versus 1,780 +/- 420g), lower incidence of prenatal steroid use (2/27 versus 41/140), decreased number of circulating neutrophils (3,622 +/- 4,866/microliter versus 7,586 +/- 4,545/microliter) at 1 day of life. After adjusting for the variables of the above risk factors, neutropenia (<2,500/microliter) in the peripheral blood increased the odds ratio of developing BPD (OR : 46.3, 95% CI : 17.3-117.2). CONCLUSION: Early postnatal neutropenia might be an important risk factor for the development of BPD and lung injury responsible for the development of BPD might begin at the early postnatal period.

Association of Early Postnatal Neutropenia and Development of Bronchopulmonary Dysplasia in Preterm Infants

PURPOSE: To see if a similar relationship exists between the decreased number of circulating neutrophils and the development of bronchopulmonary dysplasia (BPD) in preterm infants, we tried to test the hypothesis that claims that preterm infants, who develop BPD, have decreased number of circulating neutrophils than those who do not develop BPD. METHODS: A retrospective cohort study was conducted in 167 preterm infants from August 1995 to July 1997, who were admitted in the neonatal intensive care unit (NICU) of Seoul National University Children's Hospital. RESULTS: BPD was diagnosed in 16% (27/167) of preterm infants. We compared the clinical characteristics of the study population according to the presence or absence of BPD. Compared to non-BPD group, the BPD group had a lower gestational age (29.4 +/- 2.7weeks versus 32.7 +/- 1.7 weeks), lower birth weight (1,240 +/- 486g versus 1,780 +/- 420g), lower incidence of prenatal steroid use (2/27 versus 41/140), decreased number of circulating neutrophils (3,622 +/- 4,866/microliter versus 7,586 +/- 4,545/microliter) at 1 day of life. After adjusting for the variables of the above risk factors, neutropenia (<2,500/microliter) in the peripheral blood increased the odds ratio of developing BPD (OR : 46.3, 95% CI : 17.3-117.2). CONCLUSION: Early postnatal neutropenia might be an important risk factor for the development of BPD and lung injury responsible for the development of BPD might begin at the early postnatal period.