Comparison of Operator Workloads Associated with the Single-unit Anyfusion® Pump and the Changeover from a Syringe Pump to an Infusion Pump

Comparison of the Incidences of Neonatal Morbidities by Different Criteria of Histologic Chorioamnionitis in Extremely Low Gestational Age Newborns

PURPOSE: The objective of the study was to compare the incidences of the neonatal morbidity, using the various criteria of histologic chorioamnionitis (HC) in the extremely low gestational age newborns (ELGANs), who were born before the 28 weeks of gestational age. METHODS: Sixty two ELGANs who were born and admitted to the Seoul National University Bundang Hospital from 2007 to 2011 were included. A total of seven criteria of HC were made according to the site within the placenta and the extent of the neutrophil infiltration. The incidence of the major neonatal morbiditiy was compared between the HC-exposed and the HC-unexposed ELGANs according to each criterion of HC. RESULTS: There were no significant differences in the birth weight, gestational age, and sex between the HC-exposed and the HC-unexposed ELGANs by any criteria. The incidence of respiratory distress syndrome (RDS) was significantly lower in the HC-exposed ELGANs only in the criterion of any extent of the umbilical cord inflammation (funisitis). The incidence of retinopathy of prematurity (ROP) was significantly higher in the HC-exposed ELGANs in the criterion of any extent of amnionitis or funisitis. The incidences of other major morbidities did not differ between the HC-exposed and the HC-unexposed ELGANs by any criteria. CONCLUSION: The presence of funisitis reflected the lung maturation effect of chorioamnionitis, as indicated by the decreased incidence of RDS. Among other major neonatal morbidities, only ROP was significantly associated with HC. The ROP occurred more frequently in the funisitis or amnionitis-exposed ELGANs.

Growth and Neurodevelopmental Outcomes of Preterm Twins Conceived by In Vitro Fertilization

PURPOSE: To compare the growth and neurodevelopmental outcomes of preterm twins conceived by in vitro fertilization (IVF) with those naturally conceived. METHODS: We reviewed the electronic medical records of 64 children assessed by K-ASQ (Korean ages & stages questionnaires) at 18 month or 24 month of corrected age. Physical growth was evaluated by Z-scores of weight, length and head circumference at 12 months and 24 months. RESULTS: Thirty eight (59.4%) preterm twins were the in vitro fertilization group and 26 (40.6%) preterm twins were in the natural conception group. Significantly higher rate of monochorionicity and small for gestational age were detected in the natural conception group (P value=0.001, P value=0.025, respectively). Z scores of weight, length and head circumference were calculated in 56 (87.5%) infants and 51 (79.7%) infants at 12 months and 24 months, respectively. Physical growth did not differ between the two groups. Fifty nine (92.2%) and 40 (65.2%) preterm twins were assessed by K-ASQ at 18 months and 24 months, respectively. There were no significant differences in the rates of cases scored less than -2 standard deviation below the mean in K-ASQ between the IVF and natural conception groups. CONCLUSION: Growth and neurodevelopmental outcomes of preterm twins conceived by IVF were comparable with that of naturally conceived preterm twins.

A case of mucolipidosis II presenting with prenatal skeletal dysplasia and severe secondary hyperparathyroidism at birth / 소아과

Mucolipidosis II (ML II) or inclusion cell disease (I-cell disease) is a rarely occurring autosomal recessive lysosomal enzyme-targeting disease. This disease is usually found to occur in individuals aged between 6 and 12 months, with a clinical phenotype resembling that of Hurler syndrome and radiological findings resembling those of dysostosis multiplex. However, we encountered a rare case of an infant with ML II who presented with prenatal skeletal dysplasia and typical clinical features of severe secondary hyperparathyroidism at birth. A female infant was born at 37(+1) weeks of gestation with a birth weight of 1,690 g (T (p.Arg1031X) and c.3456_3459dupCAAC (p.Ile1154GlnfsX3), the latter being a novel mutation. The infant was treated with vitamin D supplements but expired because of asphyxia at the age of 2 months.

Differences in Mortality and Morbidity according to Birth Order in Preterm Twins Born by Cesarean Section / 대한주산의학회잡지

PURPOSE: Birth rate of preterm twins has gradually increased recently, and preterm twins have higher morbidity and higher mortality compared with term twins. Hence, we carried out the study to find out whether there were differences in mortality and morbidity according to birth order. METHODS: We examined the medical records of premature babies, who were born under 37 weeks of gestational age from January, 2004 to December, 2009. Among 226 twins (113 pairs),we compared the following parameters between the first-born twins and the second-born twins: birth weight, Apgar score at 1 & 5 minutes, days of ventilator use, days of total oxygenation use, hemoglobin after birth, maximum total bilirubin within 4 weeks, mortality, and morbidities including transient tachypnea of newborn (TTN), respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA), retinopathy of prematurity (ROP), brain white matter disease (WMD), necrotizing enterocolitis (NEC), and sepsis. RESULTS: There were no difference between birth weight, Apgar score at 1 & 5 minute, duration of ventilator use, duration of total oxygenation use, hemoglobin after the birth, maximum total bilirubin and morbidities. Moreover, there were no statistical differences in mortality between the first twin and the second (3.5% vs. 4.4%, P=0.734). Subdivided into preterm twins less than 32 weeks of gestational age, mortalities were 13.3% vs. 16.7% (P=0.718). There were no differences in morbidity and other factors between two groups. CONCLUSION: According to our study, there were no notable statistical differences in mortality and morbidity based on birth order of preterm twins. However, larger studies are necessary.

Case Report of Pediatric Gastroenteritis Due to CTX-M-15 Extended-Spectrum beta-Lactamase-Producing Salmonella enterica Serotype Enteritidis / 대한진단검사의학회지

A clinical isolate of Salmonella enterica serotype Enteritidis in Korea was found to produce the extended-spectrum beta-lactamase CTX-M-15. The isolate was recovered in 2008 from the stool of a 3-yr-old boy with gastroenteritis. This isolate was found to be resistant to multiple drugs, including ampicillin, piperacillin, cefotaxime, ceftazidime, cefepime, and aztreonam. The resistance to cefotaxime was transferred by conjugation to recipient Escherichia coli J53. The patient was eventually successfully treated with trimethoprim-sulfamethoxazole. This is the first report of the bla (CTX-M-15) gene in S. enterica serotype Enteritidis in Korea.