Changes in the neonatal and infant mortality rate and the causes of death in Korea

Neonatal mortality rate (NMR) or infant mortality rate (IMR) are the rate of deaths per 1,000 live births at which babies of either less than four weeks or of one year of age die, respectively. The NMR and IMR are commonly accepted as a measure of the general health and wellbeing of a population. Korea's NMR and IMR fell significantly between 1993 and 2009 from 6.6 and 9.9 to 1.7 and 3.2, respectively. Common causes of infantile death in 2008 had decreased compared with those in 1996 such as other disorders originating in the perinatal period, congenital malformation of the heart, bacterial sepsis of newborns, disorders related to length of gestation and fetal growth, intra-uterine hypoxia, birth asphyxia. However, some other causes are on the increase, such as respiratory distress of newborn, other respiratory conditions originating in the perinatal period, other congenital malformation, diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism. In this study, we provide basic data about changes of NMR and IMR and the causes of neonatal and infantile death from 1983 to 2009 in Korea

Biodegradable, flexible silicon nanomembrane-based NO x gas sensor system with record-high performance for transient environmental monitors and medical implants

Abstract: A novel transient electronics technology that is capable of completely dissolving or decomposing in certain conditions after a period of operation offers unprecedented opportunities for medical implants, environmental sensors, and other applications. Here, we describe a biodegradable, flexible silicon-based electronic system that detects NO species with a record-breaking sensitivity of 136 Rs (5 ppm, NO2) and 100-fold selectivity for NO species over other substances with a fast response (~30 s) and recovery (~60 s). The exceptional features primarily depend on not only materials, dimensions, and design layouts but also temperatures and electrical operations. Large-scale sensor arrays in a mechanically pliable configuration exhibit negligible deterioration in performance under various modes of applied loads, consistent with mechanics modeling. In vitro evaluations demonstrate the capability and stability of integrated NOx devices in severe wet environments for biomedical applications

Nomograms for Prediction of Disease Recurrence in Patients with Primary Ta, T1 Transitional Cell Carcinoma of the Bladder

We developed nomograms to predict disease recurrence in patients with Ta, T1 transitional cell carcinoma of the bladder. Thirty-eight training hospitals participated in this retrospective multicenter study. Between 1998 and 2002, a total of 1,587 patients with newly diagnosed non-muscle invasive bladder cancer were enrolled in this study. Patients with prior histories of bladder cancer, non-transitional cell carcinoma, or a follow-up duration of less than 12 months were excluded. With univariate and multivariate logistic regression analyses, we constructed nomograms to predict disease recurrence, and internal validation was performed using statistical techniques. Three-year and five-year recurrence-free rates were 64.3% and 55.3%, respectively. Multivariate analysis revealed that age (hazard ratio [HR]=1.437, p<0.001), tumor size (HR=1.328, p=0.001), multiplicity (HR=1.505, p<0.001), tumor grade (HR=1.347, p=0.007), concomitant carcinoma in situ (HR=1.611, p=0.007), and intravesical therapy (HR=0.681, p<0.001) were independent predictors for disease recurrence. Based on these prognostic factors, nomograms for the prediction of disease recurrence were developed. These nomograms can be used to predict the probability of disease recurrence in patients with newly diagnosed Ta, T1 transitional cell carcinoma of the bladder. They may be useful for patient counseling, clinical trial design, and patient follow-up planning

High levels of serum macrophage migration inhibitory factor and interleukin 10 are associated with a rapidly fatal outcome in patients with severe sepsis

SummaryObjectivesThe aim of this study was to delineate the association between high macrophage migration inhibitory factor (MIF) and interleukin 10 (IL-10) levels in the early phase of sepsis and rapidly fatal outcome.MethodsOne hundred and fifty-three adult subjects with the main diagnosis of severe sepsis (including septic shock) admitted directly from the emergency department of two tertiary medical centers and one regional teaching hospital between January 2009 and December 2011, were included prospectively. MIF and IL-10 levels were measured and outcomes were analyzed by Cox regression analysis according to the following outcomes: rapidly fatal outcome (RFO, death within 48h), late fatal outcome (LFO, death between 48h and 28 days), and survival at 28 days.ResultsAmong the three outcome groups, IL-10 levels were significantly higher in the RFO group (p < 0.001) and no significant differences were seen between the LFO and survivor groups. After Cox regression analysis, each incremental elevation of 1000 pg/ml in both IL-10 and MIF was independently associated with RFO in patients with severe sepsis. Each incremental elevation of 1000 pg/ml in IL-10 increased the RFO risk by a factor of 1.312 (95% confidence interval 1.094–1.575; p=0.003); this was the most significant factor leading to RFO in patients with severe sepsis.ConclusionsPatients with RFO exhibited simultaneously high MIF and IL-10 levels in the early phase of severe sepsis. Incremental increases in both IL-10 and MIF levels were associated with RFO in this patient group, and of the two, IL-10 was the most significant factor linked to RFO

Birth statistics of high birth weight infants (macrosomia) in Korea

PurposeThe authors analyzed the trend from the birth-related statistics of high birth weight infants (HBWIs) over 50 years in Korea from 1960 to 2010.MethodsWe used 2 data sources, namely, the hospital units (1960's to 1990's) and Statistics Korea (1993 to 2010). The analyses include the incidence of HBWIs, birth weight distribution, sex ratio, and the relationship of HBWI to maternal age.ResultsThe hospital unit data indicated the incidence of HBWI as 3 to 7% in the 1960's and 1970's and 4 to 7% in the 1980's and 1990's. Data from Statistics Korea indicated the percentages of HBWIs among total live births decreased over the years: 6.7% (1993), 6.3% (1995), 5.1% (2000), 4.5% (2000), and 3.5% (2010). In HBWIs, the birth weight rages and percentage of incidence in infants' were 4.0 to 4.4 kg (90.3%), 4.5 to 4.9 kg (8.8%), 5.0 to 5.4 kg (0.8%), 5.5 to 5.9 kg (0.1%), and >6.0 kg (0.0%) in 2000 but were 92.2%, 7.2%, 0.6%, 0.0%, and 0.0% in 2009. The male to female ratio of HBWIs was 1.89 in 1993 and 1.84 in 2010. In 2010, the mother's age distribution correlated with low (4.9%), normal (91.0%), and high birth weights (3.6%): an increase in mother's age resulted in an increase in the frequency of low birth weight infants (LBWIs) and HBWIs.ConclusionThe incidence of HBWIs for the past 50 years has been dropping in Korea. The older the mother, the higher was the risk of a HBWI and LBWI. We hope that these findings would be utilized as basic data that will aid those managing HBWIs

Decreasing Trends of Neonatal and Infant Mortality Rates in Korea: Compared with Japan, USA, and OECD Nations

Neonatal mortality rate (NMR) and infant mortality rate (IMR) are two of the most important indices reflecting the level of public health of a country. In this review, we investigated changes in NMR and IMR in Korea and compared the results with those of Japan, USA, and OECD nations. During the past 20 yr, NMR and IMR have lowered remarkably from 6.6 and 9.9 in 1993 to 1.7 and 3.2 in 2009, respectively, in Korea. It is an impressive finding that Korean IMR (3.2 in 2009) is lower than the average of OECD nations (4.7 in 2008), and USA (6.3 in 2009), although higher than Japanese IMR (2.8 in 2009). The proportion of NMR among the IMR calculation decreased from 66.7% in 1993 to 53.1% in 2009. The reason the value of Korea was higher than Japan but lower than USA was speculated to be an aspect of the health care service system. Several suggestions in perinatal, neonatal and infantile health care such as establishment of perinatal care center, research network system, regionalization, and new policies for care of pre-term and high risk pregnancy, are elucidated to achieve further improvement on NMR and IMR in Korea

A Case of Campomelic Dysplasia without Sex Reversal

Campomelic dysplasia (CD; OMIM #114290), a rare form of congenital short-limbed dwarfism, is due to mutations in SOX9, a member of the SOX (SRY-related HMG box) gene family. Multiparous mother at 38 weeks' gestation delivered a 3,272 g baby boy with characteristic phenotypes including bowing of the lower limbs, a narrow thoracic cage, 11 pairs of ribs, hypoplastic scapulae, macrocephaly, flattened supraorbital ridges and nasal bridge, cleft palate, and micrognathia. He underwent a tracheostomy at the age of three months for severe laryngomalacia after a number of repeated hospitalizations due to respiratory problems and died at the age of four months from progressive respiratory failure. He was diagnosed as having CD based on a novel frameshift mutation (p.Gln458ArgfsX12) in the SOX9 gene, the mutation which has not yet been reported in Korea

Cordycepin Increases Nonrapid Eye Movement Sleep via Adenosine Receptors in Rats

Cordycepin (3′-deoxyadenosine) is a naturally occurring adenosine analogue and one of the bioactive constituents isolated from Cordyceps militaris/Cordyceps sinensis, species of the fungal genus Cordyceps. It has traditionally been a prized Chinese folk medicine for the human well-being. Because of similarity of chemical structure of adenosine, cordycepin has been focused on the diverse effects of the central nervous systems (CNSs), like sleep regulation. Therefore, this study was undertaken to know whether cordycepin increases the natural sleep in rats, and its effect is mediated by adenosine receptors (ARs). Sleep was recorded using electroencephalogram (EEG) for 4 hours after oral administration of cordycepin in rats. Sleep architecture and EEG power spectra were analyzed. Cordycepin reduced sleep-wake cycles and increased nonrapid eye movement (NREM) sleep. Interestingly, cordycepin increased θ (theta) waves power density during NREM sleep. In addition, the protein levels of AR subtypes (A1, A2A, and A2B) were increased after the administration of cordycepin, especially in the rat hypothalamus which plays an important role in sleep regulation. Therefore, we suggest that cordycepin increases theta waves power density during NREM sleep via nonspecific AR in rats. In addition, this experiment can provide basic evidence that cordycepin may be helpful for sleep-disturbed subjects