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Review Article
Neonatology (Perinatology)
Short- and long-term outcomes of very low birth weight infants in Korea: Korean Neonatal Network update in 2019
Jang Hoon Lee, YoungAh Youn, Yun Sil Chang; Korean Neonatal Network
Clin Exp Pediatr. 2020;63(8):284-290.   Published online February 5, 2020
The Korean Neonatal Network (KNN) has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. The survival rate of all VLBWIs was 86% in Korea. The overall prevalence of cerebral palsy was 6.2%–6.6%. Bilateral blindness and hearing loss were reported in 0.2%–0.3%, 0.8%–1.9%, respectively. The KNN has published annual reports and papers for facilitating the improvement of VLBWIs outcome in Korea.
Mesenchymal stem cells transplantation for neuroprotection in preterm infants with severe intraventricular hemorrhage
So Yoon Ahn, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2014;57(6):251-256.   Published online June 30, 2014

Severe intraventricular hemorrhaging (IVH) in premature infants and subsequent posthemorrhagic hydrocephalus (PHH) causes significant mortality and life-long neurological complications, including seizures, cerebral palsy, and developmental retardation. However, there are currently no effective therapies for neonatal IVH. The pathogenesis of PHH has been mainly explained by inflammation within the subarachnoid spaces due to the hemolysis of extravasated blood after IVH. Obliterative...

Case Report
A novel PRF1 gene mutation in a fatal neonate case with type 2 familial hemophagocytic lymphohistiocytosis
Jae Yeon Kim, Jeong Hee Shin, Se In Sung, Jin Kyu Kim, Ji Mi Jung, So Yoon Ahn, Eun Sun Kim, Ja-Young Seo, Eun-Sook Kang, Sun-Hee Kim, Hee-Jin Kim, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2014;57(1):50-53.   Published online January 31, 2014

Hemophagocytic lymphohistiocytosis (HLH) occurs in the primary form (genetic or familial) or secondary form (acquired). The familial form of HLH (FHL) is a potentially fatal autosomal recessive disorder that occurs because of constitutional defects in cell-mediated cytotoxicity. Here, we report a fatal neonatal case of type 2 FHL (FHL2) that involved a novel frameshift mutation. Clinically, the newborn presented with...

Retropharyngeal abscess coinfected with Staphylococcus aureus and Mycobacterium tuberculosis after rhinoviral infection in a 1-month-old infant
Jeong Hee Shin, Se In Sung, Jin Kyu Kim, Ji Mi Jung, Eun Sun Kim, Soo Han Choi, Yae Jean Kim, Kang Mo Ahn, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2013;56(2):86-89.   Published online February 25, 2013

A retropharyngeal abscess is a rare disease entity in young infants but can develop after nasopharyngeal viral infection. Group B Streptococcus and Staphylococcus aureus are the most common pathogens in young infants, however, Mycobacterium tuberculosis is very rare. We report the case of retropharyngeal abscess and coinfection with S. aureus and M. tuberculosis in a very young infant presenting with...

Sequential magnetic resonance spectroscopic changes in a patient with nonketotic hyperglycinemia
Ji Hun Shin, So Yoon Ahn, Jeong Hee Shin, Se In Sung, Ji Mi Jung, Jin Kyu Kim, Eun Sun Kim, Hyung Doo Park, Ji Hye Kim, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2012;55(8):301-305.   Published online August 23, 2012

Nonketotic hyperglycinemia (NKH) is a rare inborn error of amino acid metabolism. A defect in the glycine cleavage enzyme system results in highly elevated concentrations of glycine in the plasma, urine, cerebrospinal fluid, and brain, resulting in glycine-induced encephalopathy and neuropathy. The prevalence of NKH in Korea is very low, and no reports of surviving patients are available, given the...

Original Article
Continuous renal replacement therapy in neonates weighing less than 3 kg
Young Bae Sohn, Kyung Hoon Paik, Hee Yeon Cho, Su Jin Kim, Sung Won Park, Eun Sun Kim, Yun Sil Chang, Won-Soon Park, Yoon-Ho Choi, Dong-Kyu Jin
Clin Exp Pediatr. 2012;55(8):286-292.   Published online August 23, 2012
Purpose

Continuous renal replacement therapy (CRRT) is becoming the treatment of choice for supporting critically ill pediatric patients. However, a few studies present have reported CRRT use and outcome in neonates weighing less than 3 kg. The aim of this study is to describe the clinical application, outcome, and complications of CRRT in small neonates.

Methods

A retrospective review was performed in 8...

Neuroprotective effects of L-carnitine against oxygen-glucose deprivation in rat primary cortical neurons
Yu Jin Kim, Soo Yoon Kim, Dong Kyung Sung, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2012;55(7):238-248.   Published online July 17, 2012
Purpose

Hypoxic-ischemic encephalopathy is an important cause of neonatal mortality, as this brain injury disrupts normal mitochondrial respiratory activity. Carnitine plays an essential role in mitochondrial fatty acid transport and modulates excess acyl coenzyme A levels. In this study, we investigated whether treatment of primary cultures of rat cortical neurons with L-carnitine was able to prevent neurotoxicity resulting from oxygen-glucose deprivation...

Review Article
Regionalization of neonatal intensive care in Korea
Yun Sil Chang
Clin Exp Pediatr. 2011;54(12):481-488.   Published online December 31, 2011

In the current era of low-birth rate in Korea, it is important to improve our neonatal intensive care and to establish an integrative system including a regional care network adequate for both high-risk pregnancies and high-risk newborn infants. Therefore, official discussion for nation-wide augmentation, proper leveling, networking, and regionalization of neonatal and perinatal care is urgently needed. In this report,...

Case Report
Idiopathic severe hypermagnesemia in an extremely low birth weight infant on the first day of life
Hye Sun Hyun, Hyun Sin Choi, Jin Kyu Kim, So Yoon Ahn, Hey Soo Yoo, Eun Sun Kim, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2011;54(7):310-312.   Published online July 31, 2011

A preterm female infant born at 27 weeks of gestation with a birth weight of 990 g developed acute hypotonia, apnea, hypotension and bradycardia mimicking septic shock syndrome at 14h after birth. Laboratory tests indicated a severe hypermagnesemia of 45 mg/dL. The renal function, complete blood count and maternal blood concentrations of magnesium were normal, and the blood cultures were...

Original Article
Outcomes of small for gestational age micropremies depending on how young or how small they are
Hee Joon Yu, Eun Sun Kim, Jin Kyu Kim, Hye Soo Yoo, So Yoon Ahn, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2011;54(6):246-252.   Published online June 30, 2011
Purpose

The outcomes of small for gestational age (SGA) infants especially in extremely low birth weight infants (ELBWIs) are controversial. This study evaluated the mortality and morbidity of ELBWIs, focusing on whether or not they were also SGA.

Methods

The medical records of 415 ELBWIs (birth weight <1,000 g), who were inborn and admitted to the Samsung Medical Center neonatal intensive care unit...

Effect of SynagisⓇ (palivizumab) prophylaxis on readmission due to respiratory syncytial virus in very low birth weight infants
Soo Kyoung Park, Yu Jin Jung, Hye Soo Yoo, So Yoon Ahn, Hyun Joo Seo, Seo Heui Choi, Myo Jing Kim, Ga Won Jeon, Soo Hyun Koo, Kyung-Hoon Lee, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2010;53(3):358-363.   Published online March 15, 2010
Purpose : The aim of this study was to determine the efficacy of SynagisⓇ (palivizumab) in reducing the respiratory syncytial virus (RSV) readmission rate in very low birth weight infants (VLBWI ) and the subgroup that showed the most effective vaccination. Methods : We enrolled 350 VLBWI who had been discharged alive from the neonatal intensive care unit of Samsung Medical...
Analysis of prognostic factors of laparotomy for necrotizing enterocolitis in extremely low birth weight infants
Jin Kyu Kim, Yi Sun Kim, Hye Soo Yoo, So Yoon Ahn, Hyun ju Seo, Seo Heui Choi, Soo Kyung Park, Yu Jin Jung, Myo Jing Kim, Ga Won Jeon, Soo Hyun Koo, Kyung-Hoon Lee, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2010;53(2):167-172.   Published online February 15, 2010
Purpose : With improved survival of extremely low birth weight infants (ELBWI), there is an increase in the incidence of necrotizing enterocolitis (NEC) requiring laparotomy, and the risk of morbidity and mortality in these ELBWI is increased. Thus, we determined the prognostic factors in ELBWI who underwent laparotomy for NEC. Methods : We retrospectively reviewed the medical records of 35 ELBWI...
Case Report
A case of pulmonary vascular air embolism in a very-low-birth-weight infant with massive hydrops
Myo Jing Kim, Hee Joon Yu, Cha Gon Lee, Soo Kyoung Park, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2009;52(12):1392-1395.   Published online December 15, 2009
Pulmonary vascular air embolism is a rare and, universally, almost a fatal complication of positive pressure ventilation in newborn infants. Here, we report a case of this unusual complication in a very-low-birth-weight infant who showed the clinical and radiological features of this complication along with pulmonary hypoplasia and massive hydrops. The possible pathogenesis has been discussed and a brief review...
Original Article
Clinical course and prognosis of hemodynamically significant congenital heart defects in very low birth weight infants
Hye Soo Yoo, Ji Eun Kim, Soo Kyoung Park, Hyun Ju Seo, Yoo Jin Jeong, Seo Heui Chio, Soo In Jeong, Sung Hoon Kim, Ji Hyuk Yang, June Huh, Yun Sil Chang, Tae Gook Jun, I Seok Kang, Won Soon Park, Pyo Won Park, Heung Jae Lee
Clin Exp Pediatr. 2009;52(4):481-487.   Published online April 15, 2009
Purpose : This study investigated the clinical course and prognostic factor of very low birth weight infants (VLBWI) with hemodynamically significant congenital heart defects (CHDs). Methods : Medical records of 1,098 VLBWI with birth weight <1,500 g who had been admitted to the neonatal intensive care unit of Samsung Medical Center from October 1994 to December 2007 were reviewed retrospectively. The...
Gastrointestinal surgery in very low birth weight infants : Clinical characteristics
Ji Eun Kim, Hye Soo Yoo, Hea Eun Kim, Soo Kyoung Park, Yoo Jin Jeong, Seo Heui Choi,, Hyun Joo Seo, Yun Sil Chang, Jeong Meen Seo, Won Soon Park, Suk Koo Lee
Clin Exp Pediatr. 2009;52(3):295-302.   Published online March 15, 2009
Purpose : To report our experience of gastrointestinal (GI) operations (OP) performed in very low birth weight infants (VLBWI) and to evaluate their clinical characteristics. Methods : Among the 1,117 VLBWI admitted to the SMC neonatal intensive care unit from November 1994 to February 2007, the medical records of 37 infants who underwent GI OP (except inguinal hernia OP) and 1,080...
Rotavirus-associated neonatal necrotizing enterocolitis
Hyun Joo Seo, Yu Jin Jung, Soo Kyung Park, Seo Hui Choi, Ji Hyuk Lee, Myo Jing Kim, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2009;52(1):56-60.   Published online January 15, 2009
Purpose : This study aimed to test whether rotavirus-associated necrotizing enterocolitis (RV+NEC) produced different clinical findings or outcomes from those of non-rotavirus necrotizing enterocolitis (RV-NEC). Methods : Eight patients from the RV+NEC group and 22 patients from the RV-NEC group diagnosed with modified Bell stage II or higher NEC were selected for this study. Fecal specimens from all infants were tested...
Periventricular leukomalacia induced by in utero clamping of pregnant rat aorta in fetal rats
Yun Sil Chang, Dong Kyung Sung, Saem Kang, Soo Kyung Park, Yu Jin Jung, Hyun Joo Seo, Seo Heui Choi, Won Soon Park
Clin Exp Pediatr. 2008;51(8):874-878.   Published online August 15, 2008
Purpose : This study was undertaken to develop an animal model of periventricular leukomalacia (PVL) induced by in utero clamping of pregnant rat aorta in fetal rats. Methods : A timed pregnanct Sprague-Dawley rat on embryonic day 21 just prior to delivery was sedated and anesthetized, and a Harvard ventilator for small animals was applied. Following laparotomy, the maternal aorta was...
Improved survival rate with decreased neurodevelopmental disability in extreme immaturity
Ga Won Jeon, Myo Jing Kim, Sung Shin Kim, Jae Won Shim, Yun Sil Chang, Won Soon Park, Mun Hyang Lee
Clin Exp Pediatr. 2007;50(11):1067-1071.   Published online November 15, 2007
Purpose : The aim of this study was to determine whether improved survival of extremely low birth weight infants (ELBWI) was associated with decreased neurodevelopmental disability later in life, and also to identify the factors influencing this disability. Methods : ELBWI admitted to the neonatal intensive care unit of Samsung Medical Center, survived, and followed up until the corrected age...
Effect of prophylactic indomethacin in extremely low birth weight infants
Bo Lyun Lee, Su Jin Kim, Soo Hyun Koo, Ga Won Jeon, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2006;49(9):959-965.   Published online September 15, 2006
Purpose : The purpose of this study was to investigate the effect of prophylactic indomethacin on reduction of patent ductus arteriosus(PDA) and intraventricular hemorrhage(IVH) in extremely low birth weight infants(ELBWI). Methods : Retrospective review of 84 ELBWI who were admitted to our neonatal intensive care unit from June 2004 to April 2006 was performed. Patients were divided into prophylactic group(n=28) and...
Effects of NG-monomethyl-L-arginine and L-arginine on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion after cerebral hypoxia-ischemia in newborn piglets
Sun Young Ko, Saem Kang, Yun Sil Chang, Eun Ae Park, Won Soon Park
Clin Exp Pediatr. 2006;49(3):317-325.   Published online March 15, 2006
Purpose : This study was carried out to elucidate the effects of nitric oxide synthase(NOS) inhibitor, NG-monomethyl-L-arginine(L-NMMA) and nitric oxide precursor, L-arginine(L-Arg) on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion(RR) after hypoxia- ischemia(HI) in newborn piglets. Methods : Twenty-eight newborn piglets were divided into 4 groups; Sham normal control(NC), experimental control(EC), L-NMMA(HI & RR with L-NMMA), and L-Arg(HI & RR...
Evaluation of Perinatal and Management Factors Associated with Improved Survival in Extremely Low Birth Weight Infants
Sung Eun Park, Ga Won Jeon, Chang Won Choi, Jong Hee Hwang, Soo Hyun Koo, Yu Jin Kim, Chang Hoon Lee, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2005;48(12):1324-1329.   Published online December 15, 2005
Purpose : The aim of this study was to evaluate recent improvements in the survival rate of extremely low birth weight (ELBW) infants and to identify perinatal and management factors that are associated with improved survival. Methods : Two groups of ELBW infants who were admitted to our neonatal intensive care unit (NICU) during two distinct eras : November 1994-December...
Etiology, Management, and Prognosis of Severe Hyperbilirubinemia (Serum Bilirubin Level=25 mg/dL) in Newborn
Jong Hee Hwang, Ji Hyun Lee, Yu Jin Kim, Su Hyun Koo, Jang Hun Lee, Chang Won Cho, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2005;48(10):1102-1106.   Published online October 15, 2005
Purpose : The present study examined the etiology, management, and the difference of prognosis according to methodology of treatment in severe hyperbilirubinemia with total serum bilirubin levels of more than 25 mg/dL. Methods : Medical records of severe hyperbilirubiemia in newborns(serum level=25 mg/dL) admitted to the NICU of Samsung Medical Center between October 1994 and June 2004 were reviewed retrospectively. Infants...
Outcomes and Management of Fetal Infants with Birth Weight Below 500 g at a Tertiary Center
Yun Sil Chang, Yu Jin Kim, Soo Hyun Koo, Jang Hoon Lee, Jong Hee Hwang, Chang Won Choi, Jae Won Shim, Sung Shin Kim, Sun Young Ko, Eun Kyung Lee, Won Soon Park
Clin Exp Pediatr. 2005;48(9):939-945.   Published online September 15, 2005
Purpose : The purpose of this study was to report outcome of fetal infants with birth weight below 500 g known as lower limit of viability and to evaluate treatment characteristics and short-term morbidity of their survivors. Methods : We retrospectively analyzed the medical records of all fetal infants with birth weight below 500 g who were delivered at Samsung Medical...
Medical Lecture Course
Endogenous Neurogenesis in Postnatal Brain
Yun Sil Chang
Clin Exp Pediatr. 2005;48(8):806-812.   Published online August 15, 2005
Repair mechanisms in the postnatal and mature central nervous system(CNS) have long been thought to be very limited. However recent works have shown that the mature CSN contains neural progenitors, precursors, and stem cells that are capable of generating new neurons, astrocytes, and oligodendrocytes especially in germinative areas such as the subventricular zone of the lateral ventricles, the dentate gyrus...
Original Article
The Effects of Early Enteral Feeding in Extremely Low Birth-Weight Infants
Ga Won Jeon, Sung Eun Park, Chang Won Choi, Jong Hee Hwang, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2005;48(7):711-715.   Published online July 15, 2005
Purpose : With the recent improved survival of extremely low birth weight infants(ELBWI), enteral feeding has become a major issue. This study investigates the effects of early enteral feeding in ELBWI on their morbidity, duration of hospitalization, and mortality. Methods : ELBWI admitted to the neonatal intensive care unit at Samsung Medical Center from November 1994 to April 2004 who survived...
Near-Infrared Spectroscopy for Monitoring Cerebral Hemodynamics in Hyperbilirubinemia-induced Newborn Piglets
Jong Hee Hwang, Chang Won Choi, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2005;48(6):649-654.   Published online June 15, 2005
Purpose : The present study examined how changes in cerebral hemodynamics in newborn piglets with bilirubin infusion can be evaluated by near infrared sepctroscopy(NIRS). Methods : Seventeen newborn piglets were randomly divided into the following three experimental groups : six in the control group(CG); seven in the bilirubin infusion group(BG), and four in the bilirubin infusion with 7-nitroindazole group(NG). To...
Single Cell Dissociation Methods for Flow Cytometric Cell Death Analysis of Hypoxia-Ischemia Injured Newborn Rat Pup Brain
Jong Hee Hwang, Dong Kyung Sung, Chang Won Choi, Saem Kang, Yun Sil Chang, Won Soon Park, Munhyang Lee
Clin Exp Pediatr. 2005;48(5):545-550.   Published online May 15, 2005
Purpose : Newborn brain tissue has to be dissociated into a single cell suspension for flow cytometric analysis of cell death during hypoxia-ischemia. Thus the development of a method to dissociate cells from the brain tissue with least damage and maintenance of membrane and antigen integrity remains the challenge for the in vivo application of this technique. We evaluated the...
Extubation Time by Birth Weight and the Predictors for Success/Failure at the First Extubation in Extremely Low Birth Weight Infants
Chang Won Choi, Sung Eun Park, Ga Won Jeon, Eun Jung Yoo, Jong Hee Hwang, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2005;48(5):488-494.   Published online May 15, 2005
Purpose : To outline the aspects of extubation by birth weight and find the predictors for success/ failure at the first extubation in extremely low birth weight infants. Methods : One hundred thirteen extremely low birth weight infants(<1,000 g) who were admitted to NICU at Samsung Seoul Hospital between Jan. 2000 and Jun. 2004 were enrolled. Clinical characteristics that are thought...
Effects of 7-Nitroindazole on Brain Cell Membrane Function and Energy Metabolism during Transient Global Cerebral Hypoxia-Ischemia and Reoxygenation-Reperfusion in Newborn Piglets
Chang Won Choi, Jong Hee Hwang, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2004;47(2):204-209.   Published online February 15, 2004
Purpose : Our study was undertaken to discover whether a selective neuronal nitric oxide synthase inhibitor, 7-nitroindazole, influences brain cell membrane function and energy metabolism during and after transient global hypoxia-ischemia(HI) in newborn piglets. Methods : Cerebral HI was induced by temporary complete occlusion of bilateral common carotid arteries and simultaneous breathing with 8% oxygen for 30 minutes, followed by release...
Change in the Limit of Viability of Fetal Infants
Chang Won Choi, Jong Hee Hwang, Jae Won Shim, Sung Sin Kim, Sun Young Ko, Eun Kyung Lee, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2003;46(12):1194-1199.   Published online December 15, 2003
Purpose : To determine the change in the limit of viability in fetal infants and the incidence of major complications in neonatal intensive care unit(NICU) at Samsung Medical Center(SMC). Methods : Sevety-three infants weighing less than 800 g at birth and 117 infants born earlier than 27 weeks gestational age, who were admitted to NICU at SMC between November 1994...