Correlation of Coagulation Disorder and Bronchopulmonary Dysplasia in Preterm Infants / 대한주산의학회잡지

OBJECTIVE: Neonatal respiratory distress syndrome (RDS) occurs in preterm infants, due to structural immaturity of the lungs and immaturity of the pulmonary surfactant metabolism and activation of inflammation and clotting contribute to the development of bronchopulmonary dysplasia (BPD). The purpose of this study is to evaluate the influencing factors in the development of BPD among RDS infants with coagulation disorder. METHODS: A retrospective chart review for 49 premature infants who were admitted to Pochun CHA University neonatal intensive care unit between May 2001 and July 2003. Infants with a gestational age <32 weeks or birth weight <1,500 g who had RDS and coagulation disorder were included in this study. Infants were divided into two groups, 22 infants in the BPD group and 27 infants in the Control group. And we evaluated the perinatal, clinical and bleeding manifestations and laboratory finding of 1st, 3rd, 6th days after coagulation disorder occurred. RESULT: The incidence of pregnancy induced hypertension was higher in the control group. Birth weight and gestational age were lower in the BPD group. Duration of ventilatory support and total parenteral nutrition were longer and the incidence of sepsis was higher in the BPD group. No significant difference was observed in laboratory finding when coagulation disorder occurred. CONCLUSION: Laboratory finding of premature when coagulation disorder occurred, was not associated with the prevalence of BPD, The compound effects of other risk factors may be important in the development of BPD.

A Case of Neonatal Cholelithiasis Induced by Prolonged Lack of Enteral Feeding and Total Parenteral Nutrition

Cholelithiasis in infancy is a rare disorder. A number of conditions that occur in the neonatal period predispose to the development of cholelithiasis. Cholelithiasis is more marked in the premature than adult, because of the immaturity of the enterohepatic circulation of bile acids which renders the newborn more susceptible to the cholestatic effect of total parenteral nutrition (TPN). Parenteral nutrition associated cholelithiasis is the major indication for cholecystectomy in the pediatric age group because of severe complication, but a number of recent studies report spontaneous resolution of the stones. We report a case of a female infant with cholelithiasis diagnosed by ultrasonogram at 88 days of age which is probably induced by prolonged lack of enteral feeding and TPN.

The Allergen Sensitization, Family History, Diet Pattern in Atopic Dermatitis under 2 Years of Age / 소아알레르기및호흡기학회지

PURPOSE: This study is intended to investigate results of skin prick tests, family history, and diet pattern in patients under 2 years of age diagnosed with atopic dermatitis (AD). METHODS: A total of 82 AD patients and 53 controls participated in this study. They visited outpatient department of Pediatrics in Pundang Cha hospital from July 2002 to May 2003. Questionnaire survey about family allergy history, duration of breast feeding, time of first weaning, kinds of foods eaten from birth was performed. Skin prick tests were performed with food allergens that consisted of egg, milk, mixed bean, beef, pork, cod, mixed flour and D. f. as aeroallergen, histamine as positive control, normal saline as negative control. RESULTS: Egg (19.5%), milk (11.0%), D. f. (9.8%), cod (8.5%) were the common allergens in AD patients. Erythema and wheal size was 14.6 mm, 2.7 mm in AD patients and 8.5 mm, 1.6 mm in controls (P< 0.05). There was no significant effect of age on the skin reactivity to histamine. Odd ratio of atopy was 31.6 (95% CI: 4.2-240.3) and that of family history was 2.6 (95% CI: 1.3-5.2). The mean age of the start of weaning was 5.6 months in AD patients and 4.5 months in controls (P< 0.05). There were no significant differences in duration of breast feeding and the number of foods eaten from birth between AD patients and controls. CONCLUSION: Egg, milk, D. f., and cod were the common allergens in AD patients under 2 years of age. This means that it is necessary for AD patients to have proper guide for weaning diet and regulation of environment. Allergy history of parents has high relative risk and therefore the high risk infants require positive prophylactic counterplans for AD.