Journal of Yeungnam Medical Science

Original Article

Clinical courses and diagnoses of neonates who are transferred due to mild respiratory distress soon after birth in a university hospital.: Jee Hyue Seo, Kyo Ho Lee, Eun Sil Lee; Yeungnam Univ J Med. 2014;31(2):89-93. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.89

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Abstract PDF: BACKGROUND
This study was conducted to investigate the epidemiological features, clinical courses, and diagnoses of neonates who are transferred to neonatal intensive care unit of Yeungnam University Hospital due to tachypnea soon after birth. METHODS: Based on medical records, we performed a retrospective study of neonatal intensive care unit admissions due to tachypnea from January 2010 to December 2013. RESULTS: A total of 311 neonates were included in this study. The patient characteristics showed male predominance at 2.65:1. Among the 311 neonates with tachypnea, 127 (40.8%) neonates needed oxygen supply, and 54 (17.4%) neonates needed assisted mechanical ventilation. Transient tachypnea of the newborns (TTN) (158, 50.8%) showed the highest incidence, followed by pneumonia (63, 20.3%), extrapulmonary infection (37, 11.9%), respiratory distress syndrome (21, 6.8%), air leak (16, 5.1%), meconium aspiration syndrome (12, 3.9%), congenital heart disease (5, 1.6%), metabolic acidosis (3, 1%), primary pulmonary hypertension of newborns (2, 0.6%) and anemia (2, 0.6%). CONCLUSION: Although the neonates with tachypnea showed no other respiratory distress symptom, clinicians should be aware of the possibility of other pulmonary diseases as well as TTN and their extra-pulmonary causes. If tachypnea does not improve within a few hours, the clinician should consider further evaluation and management as soon as possible.

Case Reports

A Case of Hemolytic Disease of a Newborn by an Anti-Di(a) Antibody Treated with Intravenous Immunoglobulin.: Chang Eon Lee, Su Jin Park, Won Duck Kim; Yeungnam Univ J Med. 2013;30(1):21-24. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.21

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Abstract PDF: Hemolytic disease in a newborn that causes early jaundice is common. It is often due to the Rh (D) and ABO incompatibility, but rarely due to unexpected antibodies. Among these unexpected antibodies, the anti-Di(a) antibody rarely occurs. The anti-Di(a) antibody was observed in the serum and red-cell eluate of an infant, and in the serum of his mother. The frequency of the appearance of the Di(a) antigen in the Korean population is estimated to be 6.4-14.5%. This paper reports a case of hemolytic disease in a newborn associated with the anti-Di(a) antibody. A full-term male infant was transferred to the authors' hospital due to hyperbilirubinemia the day after his birth. The laboratory data indicated a hemoglobin value of 11.6 g/dL, a reticulocyte count of 10.6%, a total bilirubin count of 14.4 mg/dL, a direct bilirubin count of 0.6 mg/dL, and a positive result in the direct Coombs' test. Due to the identification of an irregular antibody from the maternal serum, an anti-Di(a) antibody was detected, which was also found in the eluate made from the infant's blood. The infant had been treated with phototherapy and intravenous immunoglobulin since the second day after his birth and was discharged due to an improved condition without exchange transfusion. Therefore, in cases of iso-immune hemolytic disease in a newborn within 24 hours from birth who had a negative result in an antibody screening test, the conduct of an anti-Di(a) antibody identification test is recommended due to the suspicion of an anti-Di(a) antigen, followed by early administration of intravenous immunoglobulin.

A Premature Newborn with Congenital Syphilis.: In Ok Hwang, Eun Sil Lee; Yeungnam Univ J Med. 2007;24(2):333-338. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.333

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Abstract PDF: A preterm newborn affected by congenital syphilis, born to mother not treated during pregnancy is described. The clinical picture was characterized by respiratory distress, cutaneous manifestations, massive hepatosplenomegaly, severe anemia, thrombocytopenia, disseminated intravascular coagulation syndrome and hypoalbuminemia. The patient was treated with daily injections of 190,500 units of crystalline penicillin G for 14 days. Premature infants with these symptoms and signs should be evaluated for congenital syphilis.

Original Articles

The Clitoral Size of the Korean Female Newborn.: Suk Yong Won, Min Whan Koh, Tae Hyung Lee, Mi Jung Eun, Jung Sook Kim, Ok Kyung Kim; Yeungnam Univ J Med. 2001;18(2):287-292. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.287

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Abstract PDF

BACKGROUND
To determine mean clitoral and glans size of Korean female newborn. MATERIALS AND METHODS: The size of glans and clitoris of 68 Korean female newborns born at Yeungnam University Medical Center were measured from May in 1999 to August in 1999. RESULTS: The mean size of the 68 newborns were 2.38+/-1.14 mm in glans length, 2.55+/-1.48 mm in glans width and 4.66+/-1.93 mm in clitoral length. In the premature infants the mean clitoral size was 1.92+/-1.58 mm in glans length, 1.78+/-1.24 mm in glans width and 3.86+/-2.16 mm in clitoral length. In the full term infants 2.53+/-1.12 mm in glans length, 2.75+/-1.58 mm in glans width and 4.94+/-1.89 mm in clitoral length. In low birth weight infants clitoral size was measured 1.55+/-1.10 mm in glans length, 2.04+/-2.03 mm in glans width and 3.29+/-1.87 mm in clitoral length. In normal birth weight infants 2.53+/-1.13 mm in glans length, 2.68+/-1.48 mm in glans width and 4.92+/-1.91 mm in clitoral length. In high birth weight infants 1.54+/-0.50 mm in glans length, 1.63+/-0.53 mm in glans width and 3.18+/-1.04 mm in clitoral length. CONCLUSION: There was no significant correlation between gestational age and clitoral size or glans size, but significant negative correlation was found between birth weight and clitoral size or glans size.

Citations

Citations to this article as recorded by

Reference values for penile and clitoral lengths of healthy term Egyptian newborn infants
Magda Badawy, Lubna A Fawaz, Hend Abd El Baky, Amr Elkhashab, Ahmed A Hussein, Marwa F Mira
Journal of Paediatrics and Child Health.2022; 58(1): 157. CrossRef
The role of androgens in clitorophallus development and possible applications to transgender patients
Frances Grimstad, Elizabeth R. Boskey, Amir Taghinia, Carlos R. Estrada, Oren Ganor
Andrology.2021; 9(6): 1719. CrossRef
Country‐based reference values and international comparisons of clitoral size in healthy Nigerian newborn infants
Olumide Olatokunbo Jarrett, Omolola Ouwakemi Ayoola, Björn Jonsson, Kerstin Albertsson‐Wikland, Martin Ritzen
Acta Paediatrica.2015; 104(12): 1286. CrossRef

A Study on the Bone Density in Newborn Infants: Difference of the Bone Mineral Density according to the Gestational Age and the Birth Weight.: Eun Sil Lee, Son Moon Shin, Han Ku Moon, Yong Hoon Park, Kwang Hae Choi; Yeungnam Univ J Med. 1997;14(2):383-392. Published online December 31, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.2.383

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Abstract PDF: To study the differenced of bone mineral density according to the gestational ages and the birth weight and get a reference data for the diagnosis of metabolic bone diseases in the newborn infants, bone mineral densities of the lumbar vertebrae were measured in fifty-three newborn infants bone at Yeungnam University Hospital from March 1, 1995 to February 28, 1997, whose gestational ages were between 28+3 and 41+3 weeks and who had no intrauterine growth retardation, using dual energy X-ray absorptiometry (X-R 26, Norland, USA) within seven days of life. 1. There was no sexual difference in bone mineral density. The bone density increased significantly as gestational age increased from 0.149+/-0.009 g/cm2 at 28-30wks to 0.229+/-0.034 g/cm2 at 39-41wks of gestational age (p<0.05), but there was no significant difference between bone mineral density at 33-34wks and 35-36wks. There was positive linear correlation netween gestational age and bone mineral density (Y=7.5?10-3X-0.082, r=0.7018, p<0.001). 2. The bone mineral density increased significantly as the birth weight increased from 0.158+/-0.020 g/cm2 in 1,000-1,499 g to 0.251+/-0.021 g/cm2 in 3,500-4,000 g of the birth weight (p<0.05), but there was no significant difference between bone mineral densities in 1,000-1,499 g and 1,500-1,999 g of the birth weight. There was positive linear correlation between the birth weight and the bone mineral density (Y=3.9?10-5X+0.093, r=0.7296, p<0.001). There were positive correlations between the bone mineral density and gestational age, and between the bone mineral density and the birth weight. It can be used as a reference data for the further study on the bone mineral metabolism in the newborn infants including preterm babies.

The Measurement of Blood Flow of Anterior Cerebral Artery in Premature Newborns Using Duplex Dopple Ultrasonography.: Mi Soo Hwang, Kyeung Kug Bae, Jae Kyo Lee; Yeungnam Univ J Med. 1997;14(1):77-84. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.77

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Abstract PDF: We measured the blood flow velocity of the anterior cerebral artery via anterior fontanelle approach of fifty five preterm neonates with duplex Doppler sonography and analyzed the waveform and calculated pulsatility index were increased with increasing gestational age, birth weight, and age of the neonate, but resistive indices decreased. In sick babies, characteristic resistive index increment were seen in patients with intraventricular hemorrhage, but no statistical difference was seen in patients with respiratory distress syndrome. Our results suggest that duplex Doppler sonography is a use ful noninvasive means of monitoring cerebrohemodynamics in normal pretem neonates and flow change of sick babies.

Low volume peritoneal dialysis in newborns and infants.: Young Hoon Park, Soo Ho Ahn, Son Moon Shin, Jeong Ok Hah; Yeungnam Univ J Med. 1991;8(2):128-137. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.128

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Abstract PDF: Peritoneal dialysis has been widely considered to be the dialytic treatment of choice for acute renal failure in infants and young children, because the technique is simple, safe and easily adapted for these patients. Also peritoneal dialysis in infants might have more effective ultrafiltration and clearance than in adults. In certain circumstances associated with hemodynamic instability, ordinary volume peritoneal dialysis (30-50 ml/kg body weight per exchange) or hemodialysis may not be suitable unfortunately. But frequent cycled, low volume, high concentration peritoneal dialysis may be more available to manage the acute renal failure of newborns and infants. Seven infants underwent peritoneal dialysis for hemodynamically unstable acute renal failure with low exchange volume (14.2±4.2 ml/kg), short exchange time (30 to 45 minutes) and hypertonic glucose solution (4.25% dextrose). Age was 1.9±1.3 months and body weight was 4.6±1.6 kg. Etiology of acute renal failure was secondary to sepsis with or without shock (5 cases) and postcardiac operation (2 cases). Catheter was inserted percutaneously with pigtail catheter or Tenkhoff catheter by Seldinger method. Dialysate was commercially obtained Peritosol which contained sodium, chloride, potassium, magnesium, lactate and calcium. Net ultrafiltration (ml/min) showed no difference between low volume dialysis and control (0.27±0.09 versus 0.29±0.09). Blood BUN decreased from 95.7±37.5 to 75.7±25.9 mg/dl and blood pH increased from 7.122±0.048 to 7.326±0.063 after 24 hours of peritoneal dialysis. We experienced hyperglycemia which were controlled by insulin (2 episodes), leakage at the exit site (2), mild hyponatremia (1) and Escherichia coli peritonitis (1). Two children of low volume dialysis died despite the treatment. In our experience, low volume and high concentration peritoneal dialysis with frequent exchange may have sufficient ultrafiltration and clearance without significant complications in the certain risked acute renal failure of infants.

Study of pH and gas analysis of umbilical arterial blood and apgar score as indicators of newborn health.: Dae Hyun Cho, Mi Na Lee, Min Whan Koh, Tae Hyung Lee, Sung Ho Lee; Yeungnam Univ J Med. 1991;8(1):98-106. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.98

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Abstract PDF

Apgar score is most widely used evaluating indicator of newborn health, but it is very subjective. Umbilical cord blood gas analysis is more objective and effective than Apgar score in evaluation of newborn status. Cord blood gas was changed slightly by processing of time after fetal birth. This study was undertaken to observe objectiveness and effectiveness of umbilical arterial blood gas analysis and effects of time interval of cord clamping to newborn health with 122 pregnant women and their babies. We observed following results: 1. There were poor correlation between Apgar score and umbilical cord arterial blood analysis in evaluating of newborn health (P>0.05). 2. There was no clinical significance of Apgar score or umbilical arterial blood gas analysis as single indicator in evaluating of newborn health (P>0.05). 3. Gas analysis and pH of umbilical arterial blood was more helpful in evaluating of newborn health than Apgar score. 4. There were no significant effects of time interval of umbilical cord clamping to newborn health. 5. If there were no indications of early umbilical cord clamping, cord blood sampling at immediately after birth without cord clamping was more effective to evaluate newborn status.

Citations

Citations to this article as recorded by

Assessment of the Value of the Umbilical Cord Blood Gas Parameter as Indicator of the Neonatal Condition
Jeong Min Lee, Hoon Bum Shin, Young Bae Choi, Na Mi Lee, Dae Yong Yi, Sin Weon Yun, Soo Ahn Chae, In Seok Lim
Perinatology.2018; 29(1): 8. CrossRef

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